AARC Advocacy/TAKE ACTION

AARC Advocacy/TAKE ACTION, April 25–29, 2022

Improve Patient Access to Pulmonary Rehabilitation and to Respiratory Therapists

The American Association for Respiratory Care is a strong advocate for respiratory therapists, the respiratory care profession, and patients who suffer from chronic respiratory disease.

For our 2022 advocacy campaign, the AARC supports legislation that improves patient access to pulmonary rehabilitation services and to respiratory therapists who are experts in providing education and exercise that are essential components of the program. In addition to individuals diagnosed with moderate, severe, and very severe chronic obstructive pulmonary disease (COPD), the Medicare program has extended coverage of pulmonary rehabilitation services to include individuals who have had confirmed or suspected COVID-19 and experience persistent symptoms that include respiratory dysfunction for a least 4 weeks. Now, more than ever, it is important that we improve access and utilization of these vital programs.

Our 2022 advocacy campaign is comprised of two action requests. Additional information is provided in our Frequently Asked Questions:

You can take action now by completing a short message that will be sent directly to your Representatives and Senators.


The AARC Social Media Toolkit has the resources you need to spread the word on Facebook and Twitter.


Our Frequently Asked Questions provide additional information about legislative initiatives.

Improving Access to Quality Cardiac Rehabilitation — (H.R. 1956 and S. 1986)

The Ask: We are asking members of Congress to cosponsor the Improving Access to Quality Cardiac Rehabilitation Act (H.R. 1956/S. 1986) to expedite expansion of the types of practitioners who can order cardiac and pulmonary rehabilitation services and provide direct supervision that will help programs in rural and underserved areas where there are physician shortages.

This bill expands the type of practitioners who are eligible to provide direct supervision of cardiac and pulmonary rehabilitation programs to include physician assistants, nurse practitioners, and clinical nurse specialists effective Jan. 1, 2022, thereby moving up the current effective date from Jan. 1, 2024. Currently, only physicians can provide direct supervision. It also allows these new practitioners to administer programs, prepare and sign treatment plans, and prescribe exercise. Moving the effective date to expand coverage can reduce barriers and improve access to timely rehabilitation services, especially for those who live in rural or underserved areas where there are physician shortages. Adding additional practitioners to provide direct supervision and perform other duties means more patients can receive the benefits of the expertise of respiratory therapists.

Making Permanent Temporary Waivers that Allow Virtual PR Services

The Ask: We want Congress to make permanent the temporary waivers that were implemented under the Hospital Without Walls program established during the public health emergency (PHE) that allow respiratory therapists to provide pulmonary rehabilitation services virtually under the hospital outpatient benefit to qualified individuals in their home and to make permanent the authority of RTs to furnish telehealth services under Medicare’s “incident to” benefit in which an eligible practitioner bills for the service in the physician office setting as currently allowed under the PHE waivers.

In response to the COVID-19 PHE, the Centers for Medicare & Medicaid Services (CMS) deployed a combination of temporary, emergency waivers and flexibilities to allow the virtual delivery of cardiac and pulmonary rehabilitation services usually provided in the hospital outpatient setting to Medicare beneficiaries in their homes under the Hospital Without Walls program. Also, as part of the telehealth waivers that included physician practices, CMS permitted respiratory therapists to furnish pulmonary rehab and other telehealth services in which the eligible practitioner bills Medicare. These flexibilities expire at the conclusion of the PHE.

Without a permanent fix by Congress, CMS has no further authority to permit payment for these types of services provided in the home via two-way audio/visual telecommunications to continue beyond current deadlines. Medicare beneficiaries living in rural and underserved areas will be severely impacted if they can no longer receive these services via telehealth. A permanent solution is needed to improve patient access to pulmonary rehabilitation that can assist patients in reducing exacerbations and improve their quality of life and to continue the services of respiratory therapists who are experts in pulmonary medicine to observe their exercise in the home, meet educational needs, and stay in contact to ensure adherence.

You can help support our efforts by going to our Take Action Now link below and completing a short message that will be sent directly to your Representatives and Senators. It only takes a few minutes, so don’t delay. Your participation and support for AARC activities can make a difference!

Take Action Now

AARC 75th Anniversary logo

Celebrating Our Past
Building Our Future