March 2016 Summary - Janie Knipper and Susan Flack

Prior to DOTH, Senators Grassley and Ernst were already co-sponsors of S.488, and Representative Loebsack (District 2) was a cosponsor of HR3355.  Janie and Susan personally met with Representative Young from District 3, and he was very receptive to our “ask”.  So much so that he signed on as a co-sponsor later that day!  The meetings with Legislative Aids in the offices of Representative Blum (District 1) and Representative King (District 4) were also well-received, and we are continuing dialogue with them.  We are hopeful that they, too, will sign on as co-sponsors.  Thank you to all who sent letters to the Congressmen.  The letters were hand-delivered to the offices by Janie and Susan.

Medicare Regulations for Cardiac & Pulmonary Rehabilitation: Meeting Compliance in 2016

The Individualized Treatment Plan

Washington, D.C.

March 23, 2016

 There have been several audits of cardiac rehabilitation (CR) and pulmonary rehabilitation (PR) programs over the last few years.  The audits have helped provide clarification in some areas, but also raise questions regarding Medicare regulations for CR and PR.  The information included in this summary will highlight the recommendations as discussed at the AACVPR conference held in conjunction with AACVPR Day on the Hill in Washington, D.C., March 23, 2016.  The conference also addressed the individualized treatment plan (ITP), as a Medicare requirement as well as the ITP requirements for AACVPR program certification.  This information is also summarized below.

 The most recent audit of CR and PR was not requested by the Centers for Medicare and Medicaid Services (CMS), but rather was conducted by the Office of Inspector General (OIG).  The OIG is under Congressional mandate to audit and investigate numerous government branches.  The OIG Audit Report, published in December 2015, reviewed 100 random claims for CR and PR in one hospital in New Jersey over a 2-year period.  There were 46 claims found to be out of compliance with Medicare requirements, many of which were related to the individualized treatment plan (ITP).  In fact, the only CR/PR document the OIG seemed to be interested in was the ITP. 

Click here to learn what must be in the ITP for either PR or CR to meet Medicare regulations in 2016.