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Pulmonary Rehabilitation

HomeMembersAssemblies and SectionsAssembliesPulmonary Rehabilitation ▶ Reimbursement Updates and Tools
Reimbursement Updates and Tools

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

Please Support This Vital Initiative
Send the copdsos.org link to members and contacts – ask for their support!
Share on your social media!

 

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.