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March 10, 2006


March 10, 2006


House Legislation on Pulmonary Rehabilitation Introduced

Reps. Charles Pickering (R-MS) and John Lewis (D-GA) introduced legislation last week to establish a pulmonary and cardiac rehabilitation benefit in Medicare.  If enacted, this legislation would create a national coverage policy of pulmonary rehabilitation.  The Pickering/Lewis bill is a companion to the Senate legislation introduced by Sens. Mike Crapo (R-ID) and Blanche Lincoln (D-AR) last year.  

Currently, there is no national coverage policy for pulmonary rehabilitation.  Some Medicare fiscal intermediaries do cover pulmonary rehabilitation services, while others do not.  However, Medicare does cover pulmonary rehabilitation services for lung volume reduction surgery (LVRS) patients.  This has lead to confusing coverage situation where some Medicare beneficiaries – depending on location or LVRS status - have access to pulmonary rehabilitation services and others do not.  Establishing a national coverage policy, with appropriate reimbursement, for pulmonary rehabilitation services under Medicare is a key advocacy goal of the ATS.   


ATS to Survey New Procedure Codes for Ventilator Management

As a reminder, the ATS is still seeking members to participate in a survey to collect data on a new set of ventilator management codes recently approved by the AMA CPT committee.  Physicians who provide ventilator management services to patients are encouraged to participate in a web-based survey to help establish the relative value units for these newly developed ventilator management codes.  The relative value units play an essential role in setting the Medicare reimbursement rate for the new codes. 

The new codes being surveyed are: 

9465X1 - Ventilation assist and management, initiation of pressure or volume preset ventilators for assisted or controlled breathing; hospital inpatient/observation; initial day

9465X2 - Hospital inpatient/observation, each subsequent day

9465X3 - Nursing facility, per day

9465X4 - Home ventilator management care plan oversight of a patient (patient not present) in home, domiciliary or rest home (e.g., assisted living) requiring the review of status, review of laboratories and other studies and revision of orders and respiratory care plan (as appropriate), within a calendar month, 30 minutes or more

The survey process will extend through March 15.  If you perform ventilator management services and are interested in participating in the survey effort, please contact Gary Ewart in the ATS Washington Office for further details.  Mr. Ewart can be reached at (202) 785-3355 or via email at gewart@thoracic.org.

ATS to Survey New Procedure Codes for Ventilator Management

ATS Lobbies Congress on Physician Shortage

Last week, ATS and patient advocates joined forces to lobby Congress to address the looming physician supply shortage.  Representatives from the Pulmonary Hypertension Association and Sarcoidosis Research Network joined ATS members to visits to key members of Congress.  The purpose of the lobby day was to educate members of Congress and their staff on the growing body of literature documenting a future physician shortage, discuss policy steps to address the shortage and urge congressional action.


Immediate Past-President Sharon I.S. Rounds MD testified before the House Military Quality of Life and Veterans Affairs Appropriations Subcommittee in support of increased funding for the VA Medical and Prosthetic Research program.  In her comments, Dr. Rounds stressed the need for increased funding to support the veteran-focused research being conducted at the VA.


ATS Participants in EPA Field Hearings on Clean Air

In March, ATS members across the country participated in a series of field hearings sponsored by the Environmental Protection Agency to collect public input on the proposed new standard for particle pollution.   In December 2005, the EPA proposed a new national standard for fine particulate matter (PM2.5) of:

  • 15 µ/m3 average annual exposure
  • 35 µ/m3 24-hour exposure

The proposed standard represents a tightening of the 24-hour standard, but does not change the current average annual standard.  Additionally, the EPA is proposing a coarse thoracic particle standard (PM10-2.5 ) that applies to urban areas only, and exempts coarse thoracic particle emissions for mining and agricultural activities.  EPA is further proposing to not require any monitoring of coarse thoracic particle emissions in rural areas.   

The EPA field hearings were held in Philadelphia, Chicago and San Francisco.  In Philadelphia, ATS member Arthur Frank M.D., Ph.D. focused comments on the PM2.5 part of the rule, and how the EPA proposal does not provide adequate protection from the adverse health effects of exposure to PM2.5.  In his comments, Dr. Frank noted several studies have shown adverse health effects, in terms of increased morbidity and mortality, at levels below the proposed EPA standard.  Dr. Frank reiterated that the ATS supports a more stringent standard for PM2.5 of:

  • 12 µ/m3 average annual exposure
  • 25 µ/m3 24-hour exposure

At the Chicago hearing, Joseph Garcia, M.D. presented that ATS comments on the need for addition research funding at EPA and other federal agencies to answer questions regarding air pollution.  John Balmes, M.D. presented the ATS comments at the San Francisco hearing.  Dr. Balmes focused on the PM10-2.5 component of the rule and noted there was no scientific justification for excluding rural areas or emissions from mining and agriculture.  Dr. Balmes presented the ATS recommendation for one national standard and for continued emissions monitoring in rural areas.


ATS Joins Letter Outlining Tobacco Control Policy Priorities

The ATS joined over 30 national physician and public health organizations in a letter to Congress urging action on key policy goals for tobacco control.  Topping the list was enacting legislation to give the Food and Drug Administration authority to regulate tobacco products.  Other key items on the tobacco control agenda included ratification of the Framework Convention on Tobacco Control treaty, increased funding for tobacco cessation programs, funding the Centers for Disease Control and Prevention tobacco prevention programs, and curbing tobacco smuggling and internet sales. 


ATS Joins Cover the Uninsured Week May 1–7, 2006

Since 2002, the American Thoracic Society has joined efforts to highlight the plight of Americans who are uninsured by participating in the national campaign of Cover the Uninsured Week.  According to the Robert Wood Johnson Foundation, nearly 46 million Americans, including more than 8 million children, are living without health insurance.

During the week of May 1–7, thousands of individuals and organizations will mobilize to tell Congress that it’s time to take meaningful steps toward solutions to address why so many Americans are without health insurance.  “During and leading up to May 1–7, 2006, Americans from all sectors of society will draw attention to the issue of the uninsured through activities such as press conferences, health and enrollment fairs, business events, campus activities, and interfaith events in all 50 states and the District of Columbia. These activities will tell our nation’s leaders that health coverage must be their priority,� said Risa Lavizzo-Mourey, M.D., M.B.A., president and CEO of the Robert Wood Johnson Foundation.

Points of Contact

Gary Ewart Senior Director, Government Relations
Nuala Moore Senior Legislative Representative
Joe Kirby DC Office Administrator