Government Affairs Activities

Medicare Respiratory Therapy Initiative

The Medicare Respiratory Therapy Initiative has been introduced in Congress and continues to gain support. This legislation would revise the Medicare program to permit certain qualified respiratory therapists to provide a variety of respiratory therapy services, such as smoking cessation, asthma management and MDI device selection and patient education to Medicare patients in a physician’s office without the physician having to physically present. If enacted, this new benefit will enhance patient access to respiratory therapists in the physician’s office.

Outpatient Pulmonary Rehabilitation

After several years of effort Congress enacted legislation that creates an outpatient pulmonary rehabilitation benefit under the Medicare program. The benefit was implemented nationwide on January 1, 2010. Along with our pulmonary community partners, the AARC worked diligently to first enact the legislation and then to assure that the regulations that implemented the law were as comprehensive as the Medicare Agency would permit.

Centers for Medicare and Medicaid Services (CMS)

The AARC has enhanced its communication with key departments within CMS to resolve persistent concerns affecting the provision of respiratory therapy. We have received official clarification on issues ranging from acceptable inhaled medication delivery times, to the use of protocols, and clarification on who may write and/or sign orders for respiratory therapy services and within what timeframe.

Center for Disease Control and Prevention (CDC) and COPD Action Plan

COPD (the fourth leading cause of death in America) receives limited focus by government health agencies, despite the 16 million Americans who are diagnosed with this chronic disease. The AARC, along with like minded associations, is advocating Congress to provide funding to the CDC to specifically track, collect data and do focused research on COPD.

Home Medical Equipment and Care

Congress and the Centers for Medicare and Medicaid Services, CMS, continue to single out the providers of home medical equipment, HME, for disproportionate share of cuts and reductions in payments under the Medicare program. The Industry has struggled under the burden of the 36-month oxygen cap, a 9.5 percent DME cut and the reprise of competitive bidding, that alone occurring over the past few years and not inclusive of additional previous reductions. The AARC has voiced it opposition to these policy cuts and changes and the detrimental impact it is having on the quality of services and equipment the Medicare pulmonary patient is and will continue to receive. Furthermore, the AARC has been an active participant in a wide ranging Coalition that endeavors to enact legislation that would revise the home oxygen therapy benefit under Medicare.

As an example, of the AARC’s long term involvement in HME issues the association has been providing input on the Competitive Bidding process over the 14 years during the time when the program was being developed. In the 1990s, AARC past President Patrick Dunne was the respiratory therapy community’s representative to the Medicare’s National Technical Experts Panel on the development of the competitive bidding endeavor. Our concern was and continues to be that Medicare recognize the service component that suppliers provide in the delivery of home respiratory equipment.

Read correspondence related to the AARC’s involvement in the competitive bidding process:

• 1998 — To HCFA (predecessor of CMS)
• 1999 — To HCFA
• 2000 — To DMEPOS
• 2002 — To Congress

Respiratory Therapy Representation to a Key Medicare Advisory Committee

Karen Stewart, MS, RRT, FAARC continues to be the AARC’s representative to the Medicare Coverage Advisory Committee. This federal committee advises the Centers for Medicare and Medicaid Services (CMS) on whether specific medical items and services are reasonable and necessary under Medicare law.

Oxygen Use On Airlines

AARC has long supported federal action to require airlines to permit patients who use approved portable oxygen concentrators and other respiratory equipment to take their equipment on board with a minimum of red tape and cost. After several years where this was an option for airlines, the Department of Transportation (DOT) implemented final rules that now make it mandatory that airlines permit patients with approved respiratory equipment on board. The AARC applauds the foresight of the DOT in their recognition and support of oxygen dependent patients.

RTs and Disaster Response

The AARC continues to assist the Department of Health and Human Services (HHS) in its efforts to prepare and respond to natural or manmade disasters. The AARC has worked with the Office of Mass Casualty Planning, which has recognized that the nation needs to have a cohort of respiratory therapists who can be called up by the Federal government in times of natural or manmade emergencies. In addition, the AARC received a contract from HHS to conduct the first of its kind National Ventilator Survey. This was a historic request for the association and one that we were proud to take on as a contractor. The AARC has developed a document to be used by the state, local and federal governments on the appropriate acquisition of ventilators.

Congressional COPD Caucus

AARC continues to work with Congressional COPD Caucus to raise the profile and advocate for legislation that targets and addresses the needs of the pulmonary patient.

Tobacco/Smoking Cessation

AARC continues to participate in Coalition efforts to enhance regulation of the tobacco industry. Our focus is both national (support for greater government regulation over tobacco products) and state directed. Our focus on state issues range from supporting increased excise taxes on tobacco products, supporting state efforts to restrict smoking in the work and other public places and urging states to effectively allocate Tobacco Settlement funds for health promotion and smoking cessation activities.

The AARC has analyzed and provided an extensive document that explains the recent Medicare coverage policy on smoking cessation.

CPT Codes

The AARC has a representative on the Health Care Advisory Committee to the AMA’s CPT Coding Editorial Panel. The Editorial Panel assesses the requests for and determines the need for new procedure codes. This provides the AARC with an opportunity to comment, from the respiratory therapy perspective on any proposed changes including additions, revisions and deletions of codes.

Asthma Awareness

The AARC participates in the annual Asthma Awareness Day on Capitol Hill, with the goal of educating members of Congress and their staff on this important issue. Respiratory therapists volunteer to provide spirometry testing to the public and Capitol Hill Congressional staff. We also provide information on the profession of respiratory therapy.