Close icon
Join Renew CRCE Transcript
AARC University AARConnect Respiratory Care
Career Center Store

Advocacy

AARC Legislative Agenda Frequently Asked Questions

Our 2025 advocacy campaign focuses on improving patient access to pulmonary rehabilitation programs and to the expertise of respiratory therapists. As noted on our website, we are asking Congress to co-sponsor the Sustainable Cardiopulmonary Rehabilitation Services in the Home Act (H.R. 1406 and S.248), and to make permanent temporary waivers implemented during the public health emergency (PHE) that allow cardiac rehabilitation (CR) and pulmonary rehabilitation (PR) services typically delivered in the hospital outpatient setting to be furnished virtually in a patient’s home and to include respiratory therapists as telehealth practitioners for services delivered in the physician office setting.

Advocating for these initiatives keeps the respiratory care profession in the minds of Congressional leaders and bolsters our image as experts in pulmonary care. These Frequently Asked Questions (FAQs) provide you with additional information that can make our advocacy efforts a success.

Why is it important to support this bill and how will it help patients?

When the cardiac and pulmonary rehabilitation programs were first implemented in 2010, the statutory language defined them as “physician-supervised” programs. The Centers for Medicare & Medicaid Services (CMS) made it clear that the language was very specific and, therefore, unlike other outpatient therapeutic programs that allowed direct supervision to be provided by qualified nonphysician practitioners, only physicians could provide direct supervision of CR and PR services.

Over the years, this restriction has led to barriers to access, especially in Critical Access Hospitals where due to the location in rural or underserved areas, physician shortages are more prevalent. Legislation enacted in 2018 would allow physician assistants, nurse practitioners and critical nurse practitioners to provide direct supervision of CR and PR programs, but not until Jan. 1, 2024. The “Improving Access to Quality Cardiac Rehabilitation Act” moves up the effective date to Jan. 1, 2022, and expands their services to administer programs, prepare and sign treatment plans, and prescribe exercise in addition to providing direct supervision.

Moving up the effective date provides programs that are struggling due to lack of the ability to provide direct physician supervision to have the help they need from other qualified practitioners so they can continue providing important treatment options for those with COPD and now COVID-19. As of Jan. 1, 2022, CMS expanded coverage of PR programs to include beneficiaries who had suspected or confirmed COVID-19 and continued to experience respiratory dysfunction for 4 weeks. Hospitalization was not a requirement for coverage, which opened the door for more patients with respiratory distress to receive the expertise of respiratory therapists who are a vital part of the multi-disciplinary team providing patient care.

To amend title XVIII of the Social Security Act to permanently extend certain in-home cardiopulmonary rehabilitation flexibilities established in response to COVID–19, and for other purposes.

IN THE SENATE OF THE UNITED STATES

January 24, 2025

Mrs. Blackburn (for herself and Ms. Klobuchar) introduced the following bill; which was read twice and referred to the Committee on Finance

A BILL

To amend title XVIII of the Social Security Act to permanently extend certain in-home cardiopulmonary rehabilitation flexibilities established in response to COVID–19, and for other purposes.

Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

This Act may be cited as the “Sustainable Cardiopulmonary Rehabilitation Services in the Home Act”.

SEC. 2. CODIFYING VIRTUAL CARDIOPULMONARY REHABILITATION FLEXIBILITIES ESTABLISHED IN RESPONSE TO COVID–19.