ATS Pulmonary Rehabilitation Reimbursement Work Group
Goals:
- Define and address reimbursement gaps and inequities.
- Improve opportunities for PR payment, awareness, and access.
- Key Message:
- PR has multiple patient-relevant benefits including improved survival after a COPD hospitalization Lindenauer PK, et al. JAMA. 2020;323 (18):1813-1823.
- Target: Providers, patients, regulators, health care organizations and the National Heart Lung and Blood Institute of the NIH.
| ATS Work Group Members | |
|---|---|
| Chris Garvey – ATS, AACVPR | Trina Limberg - AACVPR, AARC |
| Brian Carlin – ATS, AACVPR, AARC, ACCP | Karen Lui - AACVPR |
| Rich Casaburi - ATS | Katy Menson - ATS |
| Judy Corn - ATS | Mike Nelson - ATS, ACCP |
| Rebecca Crouch - ATS, AACVPR, APTA | Miriam O'Day - AARC |
| Anupam Kumar | Cassie Kennedy |
| Grace Anne Dorney Koppel - COPD Foundation | Phil Porte |
| Gary Ewart - ATS | Carly Rochester - ATS |
| Mary Gawlicki - ATS | John Studdard - ACCP, AACVPR |
| Aimee Kizziar - AACVPR | Ruth Myers - ATS Staff |
Work Group Activities
- National Campaign, Social Media Blitz
- Slogan: "Live better and live longer" via
- #PulmonaryRehabilitationMatters
- #PulmonaryRehabilitationWellnesDay
- #WorldHealthDay, including PR Infographic
- Joint Sign-on Letter of support and outreach by 18 pulmonary societies and patient organizations
- NHLBI COPD National Action Plan: Community Action Tool
- Slogan: "Live better and live longer" via
- Collaboration
- Support from national societies:
- Resources/Tools
- COPD SOS: Public Service Annoucement Campaign created by the Dorney-Koppel Foundation to raise awareness of COPD. The campaign targets:
- The undiagnosed millions who are unaware that they have COPD and are at increased risk of serious outcomes from COVID.
- The need for appropriate screening and accurate diagnoses of persons at increased risk.
- Effective COPD treatment including Pulmonary Rehabilitation.
- Equitable funding for COPD research.
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- Videos (15, 30 and 60 minutes) are available for use on social media and other platforms.
- COPD SOS: Public Service Annoucement Campaign created by the Dorney-Koppel Foundation to raise awareness of COPD. The campaign targets:
Please Support This Vital Initiative
Send the copdsos.org link to members and contacts – ask for their support!
Share on your social media!
-
- Live Better: What is PR? What are PR benefits? PR Program Directory
- AACVPR PR Program Directory
- Pulmonary Rehabilitation Public Service Announcement Video for patients, providers, payers and the community
- ATS Pulmonary Rehabilitation Reimbursement Update – Pulmonary Rehabilitation in the United States: Updates on Covered Indications and Reimbursement
- COPD Foundation
- Dedicated COPD SOS webpage
- Pulmonary Rehabilitation webpages – partnership with the ATS/Gawlicki Foundation
- PR Toolkit
- Podcasts
- Quarterly Bites
Legislative Activities and Updates
Important Legislation
AACVPR is collaborating with partner professionals to improve access to PR as well as cardiac and intensive cardiac rehabilitation (PR/CR/ICR) services for Medicare beneficiaries. MESSAGE: Two Bills Together = Powerful Progress for Programs & Patients!
- H.R. 3348: SOS: Sustaining Outpatient Services Act will allow hospital outpatient PR/CR to receive the hospital reimbursement rate, no matter where the program is located – on or off campus. This bill would end the current 40% payment reduction if a program relocated to a new or different off-campus location.
- H.R. 1956: Increasing Access to Quality Cardiac Rehabilitation Act of 2021 will allow non-physician practitioners (NPPs) to independently order and supervise PR/CR/ICR services. This will increase access for PR and CR patients, particularly in rural areas, by expanding who can order and supervise PR and CR. This change is currently scheduled to occur in 2024. Passage of this bill will move the effective date to 2022.
HELP MAKE THESE BILLS HAPPEN – TAKE ACTION HERE
Click on Send a Letter and follow the prompts!
Thank You! You have just helped your profession, your program, and your patients.
Regulatory Issues of Note
- Virtual direct MD PR supervision: Goal to make permanent by December 31, 2021.
- Value-based care: Medicare advantage can opt to waive co-insurance for PR.
The Work Group encourages U.S. PR programs to have one or members join AACVPR to get timely Medicare payment and regulatory updates.
The Work Group thanks Alex Jenkins and Francois Abi Fadel for their considerable help.
