12/9/2019: Please read this important message from Anne Marie Hummel
Hi All:
Below is a message I sent to the Ambulatory and Post-Acute Care section on Friday. AARC is part of a new workgroup to find ways to improve payment for pulmonary rehab programs. You may recall in our "Other Issues" paper we left with Congressional staff last year, we supported legislation that would exempt new or expanding CR or PR programs from being billed at the physician fee schedule rate rather than the hospital outpatient rate if they were part of an "off campus" (beyond 250 yards from the main campus) provider department. A bill has now been introduced that would fix the problem.
If you know of RTs who work in pulmonary rehab, please direct them to the AACVPR site to TAKE ACTION. We are working on updating our advocacy website but do not want to delay providing support. I am also sending this message to the HOD_PRES listserv.
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I am writing to the Ambulatory and Post-Acute Care section to TAKE ACTION on H.R. 4838, an important bill to protect payment for expanding or new CR and PR programs.
BACKGROND
In recent years, hospitals began to increase the acquisition of physician practices, resulting in Medicare paying a higher amount under the hospital outpatient payment methodology for the same service that would otherwise have been paid under the physician fee schedule rate, creating a strong incentive for hospitals to game the system.
To address the issue, the 2015 Bipartisan Budget Act, implemented by CMS in 2017, added a section to Medicare law prohibiting hospitals from billing at the hospital outpatient rate if an existing off-campus service (beyond 250 yards from the main campus) moved to a new location or a new hospital service opened that was located greater than 250 yards from the main campus. A very limited number of exceptions were permitted, e.g., services furnished in an emergency department, in an on-campus department, or a remote location within 250 yards of the main campus.
This action has created an "unintended consequence" for CR and PR programs that wish to expand access to services or create a new service in an "off-campus" department. Since Medicare data confirm there is no incentive for hospitals to purchase CR and PR programs in order to obtain higher payment rates (see link below), AARC and other pulmonary organizations met with CMS to ask for an exemption, but CMS indicated it had no authority to do so under current law.
www.aacvpr.org/Portals/0/DOTH/...
TAKE ACTION
H.R. 4838, the Sustaining Outpatient Services (SOS) Act, championed by the American Association for Cardiovascular and Pulmonary Rehabilitation (AACVPR) and the National Association for Medical Direction of Respiratory Care (NAMDRC), amends the law to set financial thresholds that would allow certain hospital outpatient services like cardiac and pulmonary rehab to be exempt from reduced reimbursement.
The AARC has advocated tirelessly for ways to improve payment for pulmonary rehabilitation (PR) services since the inception of the Medicare program and most recently has joined a workgroup dedicated to continuing the fight for better payment. We strongly support this bill.
As we are currently working on updating our advocacy website, we are asking RTs who work in these programs to use the AACVPR's TAKE ACTION link (see below) where you will see a button for CR/PR Practitioners to ask for co-sponsorship. Additional background information is available in the second link. We appreciate your support and hope you'll TAKE ACTION NOW.
www.aacvpr.org/Advocacy-Take-Action
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Anne Marie Hummel
Associate Executive Director
Advocacy and Government Affairs
Phone: 703-492-9764
Email: anneh@aarc.org
Email: ashummel@aol.com
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Below is a message I sent to the Ambulatory and Post-Acute Care section on Friday. AARC is part of a new workgroup to find ways to improve payment for pulmonary rehab programs. You may recall in our "Other Issues" paper we left with Congressional staff last year, we supported legislation that would exempt new or expanding CR or PR programs from being billed at the physician fee schedule rate rather than the hospital outpatient rate if they were part of an "off campus" (beyond 250 yards from the main campus) provider department. A bill has now been introduced that would fix the problem.
If you know of RTs who work in pulmonary rehab, please direct them to the AACVPR site to TAKE ACTION. We are working on updating our advocacy website but do not want to delay providing support. I am also sending this message to the HOD_PRES listserv.
----------------------------------
I am writing to the Ambulatory and Post-Acute Care section to TAKE ACTION on H.R. 4838, an important bill to protect payment for expanding or new CR and PR programs.
BACKGROND
In recent years, hospitals began to increase the acquisition of physician practices, resulting in Medicare paying a higher amount under the hospital outpatient payment methodology for the same service that would otherwise have been paid under the physician fee schedule rate, creating a strong incentive for hospitals to game the system.
To address the issue, the 2015 Bipartisan Budget Act, implemented by CMS in 2017, added a section to Medicare law prohibiting hospitals from billing at the hospital outpatient rate if an existing off-campus service (beyond 250 yards from the main campus) moved to a new location or a new hospital service opened that was located greater than 250 yards from the main campus. A very limited number of exceptions were permitted, e.g., services furnished in an emergency department, in an on-campus department, or a remote location within 250 yards of the main campus.
This action has created an "unintended consequence" for CR and PR programs that wish to expand access to services or create a new service in an "off-campus" department. Since Medicare data confirm there is no incentive for hospitals to purchase CR and PR programs in order to obtain higher payment rates (see link below), AARC and other pulmonary organizations met with CMS to ask for an exemption, but CMS indicated it had no authority to do so under current law.
www.aacvpr.org/Portals/0/DOTH/...
TAKE ACTION
H.R. 4838, the Sustaining Outpatient Services (SOS) Act, championed by the American Association for Cardiovascular and Pulmonary Rehabilitation (AACVPR) and the National Association for Medical Direction of Respiratory Care (NAMDRC), amends the law to set financial thresholds that would allow certain hospital outpatient services like cardiac and pulmonary rehab to be exempt from reduced reimbursement.
The AARC has advocated tirelessly for ways to improve payment for pulmonary rehabilitation (PR) services since the inception of the Medicare program and most recently has joined a workgroup dedicated to continuing the fight for better payment. We strongly support this bill.
As we are currently working on updating our advocacy website, we are asking RTs who work in these programs to use the AACVPR's TAKE ACTION link (see below) where you will see a button for CR/PR Practitioners to ask for co-sponsorship. Additional background information is available in the second link. We appreciate your support and hope you'll TAKE ACTION NOW.
www.aacvpr.org/Advocacy-Take-Action
------------------------------
Anne Marie Hummel
Associate Executive Director
Advocacy and Government Affairs
Phone: 703-492-9764
Email: anneh@aarc.org
Email: ashummel@aol.com
------------------------------
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The Wisconsin State Society for Respiratory Care closely monitors issues that may have an affect on our patients and the profession of Respiratory Care. We actively work with legislators to educate them about the value of the Respiratory Care Practitioner and to ensure our patients receive the quality of care they deserve.
Below are some helpful links to help you participate in federal and local legislation concerning Respiratory Care. Find your State Legislator Find your House Representative Find your Senator AARC Government Affairs AARC Capitol Connection Library of Congress |
TRACKING LEGISLATION By checking out AARC’s legislative agenda, you can find bill numbers for the bills that are of interest to the AARC; for example, H.R. 2550, the Medicare Telehealth Parity Act. Use the Library of Congress website and type in the bill number in the Search box and click on it to find the bill. |