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July 2, 2007


July 2, 2007


CMS Rejects Call to Create Pulmonary Rehabilitation National Coverage Policy

Last week, the Centers for Medicare and Medicaid Services (CMS- which administers the Medicare program) stated that they do not intend to create a national coverage policy for pulmonary rehabilitation services at this time.

In the memo, CMS indicates that respiratory therapy provided in a comprehensive Outpatient Rehabilitation Facility (CORF) is already covered, but that because "the Social Security Act does not expressly define a comprehensive Pulmonary Rehabilitation Program as a part B benefit, and that the evidence is not adequate to draw conclusions on the benefit of individual components of pulmonary rehabilitation, we are not making any proposed national coverage determinations about these services at this time." In short, CMS is stating that because pulmonary rehabilitation is not expressly listed in Medicare legislation, CMS has no authority or obligation to create a national coverage policy.

The CMS decision is a disappointment to the respiratory community and will mean the current variation in coverage and access to pulmonary rehabilitation services will persist for Medicare beneficiaries. The CMS decision also make Congressional action on the pending pulmonary rehabilitation legislation (S. 329/H.R. 552), introduced by Sens. Crapo
(R-ID) and Lincoln (D-AR) in the Senate and Reps Lewis (D-GA) and Pickering (R-MS) in the House. The legislation would specifically create a pulmonary rehabilitation benefit in Medicare statutes. The pulmonary rehabilitation legislation now has 31 cosponsors in the Senate and 120 cosponsors in the House.


ATS Hosts U.S. Senate Briefing on TB

On June 27th, the ATS Washington Office, in conjunction with Sens. Sherrod Brown (D-OH) and Barbara Boxer (D-CA), hosted a U.S. Senate staff briefing, XDR-TB: How Old TB Control Tools & Investment into New Tools Can Combat This Global Health Threat, that featured some of the nation's leading experts on tuberculosis (TB). Speakers included Charles Daley, MD, head of the Mycobacterial and Respiratory Infections Division at National Jewish Medical and Research Center, where drug resistant patient Andrew Speaker is being treated, Maria Freire, CEO of the Global Alliance for TB Drug Development and Charles DeGraw, TB Controller for the state of Louisiana. Dr. Daley provided a global overview of the challenges of global and domestic TB control, with a focus on the evolution and prevalence of drug resistant TB. Dr. Freire discussed the need for new TB drugs, diagnostics and vaccines and pointed out the significant gap that exists in TB research funding. Mr. DeGraw discussed the mechanics of TB control in the states and the need for more state resources to combat TB amid the rise of drug resistant cases. The briefing attracted attendance from 25 congressional offices, including a number of key Senate offices such as the Health, Education, Labor and Pensions and Finance committees. Senate staffers were particularly interested in the prevalence of drug resistant TB in the U.S. and how the research gap on new tools to fight TB can be closed.

Staffers also voiced keen interest in legislation to combat TB domestically, through the Comprehensive TB Elimination Act, S.1551/H.R.1532 and globally through the Stop TB Now Act, S.968/H.R.1567, which have been scheduled for House and Senate committee consideration during the month of July. The ATS thanks Sens. Brown and Boxer for their sponsorship of the briefing and for their continued leadership on TB.


ATS Joins Health and Education Community to Support FY08 Appropriations Bill

The ATS has joined with over 1,000 organizations to support passage of the House Fiscal Year 2008 Labor-Health and Human Services and Education Appropriations bill. The bill provides funding for all health research and services and education programs and includes a 2.6% increase over FY07 for the National Institutes of Health and a $4% increase for the Centers for Disease Control and Prevention. The letter, sponsored jointly by the Coalition for Health Funding and the Committee for Education Funding, applauds House leaders for a "fiscally responsible effort to turn around the steady divestment in some of the most important domestic programs" and requests all House Representatives to vote in favor the bill. The House is expected to vote on the bill later this month and the ATS Washington Office will keep members informed of this vote.

Points of Contact

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