Since implementation of the comprehensive cardiac and pulmonary rehabilitation programs in 2010, the AARC has advocated for improved patient access to pulmonary rehabilitation services and achieving ways to ensure adequate reimbursement.
Recently, the AARC worked with the American Association of Cardiovascular and Pulmonary Rehabilitation (AACVPR) and the American Thoracic Society (ATS) in drafting a letter to the Administrator of the Centers for Medicare & Medicaid Services (CMS) urging the agency to fix inconsistences in the Medicare program around the length of time virtual cardiac and pulmonary rehabilitation services are available.
For example, pulmonary rehabilitation services as part of Medicare’s comprehensive benefit furnished in the physician office or clinic setting are covered as a telehealth service through December 31, 2023. Yet, the same pulmonary rehabilitation services furnished in the hospital outpatient setting, which account for 98% of programs and can be provided via real-time, two-way, audio/visual communications technologies (e.g., not considered telehealth), expire at the end of the public health emergency (PHE), currently scheduled to end April 16, 2022. Because the PHE must be extended every 90 days to allow current waivers to remain in place, when it might finally end adds uncertainty to the lives of vulnerable patients who have found relief in being able to stay in their homes to receive pulmonary rehabilitation services.
Since most programs are in the hospital outpatient setting, this inconsistency based on the type of setting, if not corrected, will lead to the loss of services that have been critical to Medicare beneficiaries during the pandemic and have immense potential beyond the current situation. In short, the ability to produce additional evidence of the clinical benefits of virtual delivery in this setting will be lost.
The letter explains in detail the problems with current policies and recommends CMS continue the virtual delivery option for cardiac and pulmonary rehabilitation in the hospital outpatient setting through the end of calendar year 2022, and preferably through 2023. This will allow programs additional time to assess the effectiveness of this delivery model.
The AARC has also added its name along with 335 other organizations to a letter to key Congressional leaders that asks Congress to take steps to facilitate a pathway to comprehensive permanent telehealth reform. A key recommendation is for Congress to remove pre-pandemic barriers by extending the telehealth waivers allowed under the PHE through the end of December 2024. This action would allow Congress and the administration to evaluate the impact telehealth has on patient care and the health outcomes for those patients who rely on treatment options that enable them to remain in their homes. The letter was initiated by the Executives for Health Innovation, the Alliance for Connected Care, and the American Telemedicine Association, among others. Read the press release here.
The AARC is committed to doing its best to ensure Medicare beneficiaries with COPD and now those with suspected or confirmed COVID-19 who experience persistent symptoms that include respiratory dysfunction for at least 4 weeks continue to receive pulmonary rehabilitation in their homes, allowing respiratory therapists to stay in contact, observe exercise with real-time audio-visual technologies, meet education needs, and improve their quality of life.
Email newsroom@aarc.org with questions or comments, we’d love to hear from you.
Anne Marie Hummel is the AARC’s Associate Executive Director for Advocacy and Government Affairs where she brings her years of regulatory experience in the Federal Government to overseeing federal and state legislative and regulatory policies that impact the respiratory care profession. Check out AARC’s Advocacy menu on our website to learn more. Outside of work, Anne Marie loves interior design, tackling 1000-piece puzzles and spending time with her granddaughter.
