Reimbursement and Legislation

The Cardiac and Pulmonary Rehabilitation Act (HR552/S.329)

Has Passed!!!!

Thank You MSCVPR Members!

Congress recently passed the Medicare Improvements for Patients and Providers Act of 2008, now Public Law 110-275. Included in this bill is a provision which creates specific benefit categories for both Cardiac and Pulmonary Rehabilitation. This was the direct result of efforts by the American Association of Cardiovascular and Pulmonary Rehabilitation (AACVPR) and other cardiac and pulmonary professional and patient organizations over the past few years to gain support in Congress for The Pulmonary and Cardiac Rehabilitation Act (HR 552/S.329).

The significance of these new provisions is that Medicare beneficiaries who show clinical need for cardiac or pulmonary rehabilitation services should have timely access to formal rehabilitation programs. Historically, the Centers for Medicare and Medicaid Services (CMS) have had discretionary authority on many of the key decisions regarding coverage of these services. Consequently, there has been inconsistency in patient access and in the services covered by Medicare, particularly with the delivery of pulmonary rehabilitation, around the country.

While CMS has long recognized cardiac rehabilitation programs as a covered service, the Centers for Disease Control and Prevention and researchers have repeatedly emphasized that the service is dramatically underutilized, resulting in suboptimal clinical care for patients with coronary artery disease. As a result, costly, life-threatening recurrent cardiovascular events that can be potentially reduced with the appropriate use of cardiac rehabilitation services. In the pulmonary arena, the new law will require CMS to provide national coverage of rehabilitation services when medically indicated by the patient’s physician.

The new law that addresses cardiac and pulmonary rehabilitation takes effect on January 1, 2010.

Day on the Hill
On March 1st and 2nd, representatives from MSCVPR (Beth Dole, Carla Vordran , Donna Donakowski and Matt Lyons) met in Washington DC with the offices of Senator Levin and Stabenow, as well as, House of Representative offices Stupak, Elhers, Camp, Dingell and Upton. At these meetings, MSCVPR discussed issues relating to legislation (S 329 and HR 552), which would provide a separate benefit category for cardiac and pulmonary rehabilitation. These meetings were very successful in raising awareness towards this issue and produced two co-sponsors of the House Bill- Congressmen Bart Stupak and Vernon Ehlers!

Instructions for contacting your Senator/Representative
AACVPR has recommended that MSCVPR members write to their Congressmen and Senators who co-sponsored bill HR 552/S.329 and thank them for their support  Without their support, this would have never happened.

Link to congressional emails:
Senate
House

Below is a link to the AACVPR site which contains legislative language and various other links and information regarding these important issue.

Click here for the AACVPR Legislative Updates Page

If you have any further questions, feel free to contact Donna Donakowski at 248.609.0122 or donna.donakowski@comcast.net

You can also contact Phil Porte, AACVPR’s legislative consultant 301.718.0202 or pporte@erols.com