What is Pulmonary Rehabilitation?
Pulmonary rehabilitation (PR) is a lifesaving, multi-disciplinary program for Medicare beneficiaries diagnosed with Chronic Obstructive Pulmonary Disease (COPD). A PR program is individually tailored and designed to optimize physical and social performance and improve quality of life. Sessions are limited to a maximum of two 1-hour sessions per day up to 36 sessions, with the option for an additional 36 sessions if medically necessary. The program includes:
- Physician-prescribed exercise.
- Education or training.
- Psychosocial assessment.
- Outcomes assessment.
- Individualized treatment plan.
Respiratory Therapists are Clinical Experts
Respiratory therapists are experts in pulmonary medicine and and play an important role in the treatment and care of Medicare beneficiaries who participate in these programs. They:
- Evaluate the patient and create a treatment plan for the patient’s pulmonary rehab program.
- Assess patients during exercise to assure progress to improve endurance.
- Monitor oxygen needs to ensure positive outcomes, as appropriate.
- Educate patients/caregivers on triggers of their disease to achieve improved health.
- Teach patients self-management skills to reduce exacerbations.
Co-Sponsorship of HR 1406 is Important to Patients
To amend title XVIII of the Social Security Act to permanently extend certain in-home cardiopulmonary rehabilitation flexibilities established in response to COVID-19.
Overview
Medicare beneficiaries who require supplemental oxygen can’t access oxygen systems appropriate for their medical needs. This is even worse for those who require liquid oxygen. To help fix this issue, the AARC has been working with a comprehensive coalition of oxygen stakeholders that includes, providers, patients, and the durable medical equipment industry. We have met with the Centers for Medicare and Medicaid Services (CMS) to ask for oxygen reform through regulatory change. And although CMS has made minor changes, but have been clear that the solution must come from Congress. Congress must pass legislation to ensure anyone who requires supplemental oxygen can access the most appropriate type of oxygen equipment for their needs. Congress must prioritize patients and solve this problem.
The 4 Pillars of Reform
- Create a patients’ bill of rights to ensure care is focused on patient needs.
- Ensure access to liquid oxygen for patients for whom it is medically necessary.
- Create a statutory service element to provide adequate reimbursement for respiratory therapists to ensure patients have access to their expertise.
- To ensure predictable and adequate reimbursement and to protect against fraud and abuse, establish national standardized documentation requirements that rely upon a template rather than prescriber medical records to support claims for supplemental oxygen suppliers.
Is there a bill number?
Not yet.
Do we have draft legislation to addresses this issue?
Yes and we can share that with you upon request.
Do we have a CBO score?
No. But we do have a “CBO-style” score. $654 million over 10 years.
