Updated 07/25/05: Because of recent communications from members, the AACVPR leadership wants to make sure that all members understand the distinctions between two pending issues. 

Legislative Initiative:  This effort focuses on changing the Medicare statute to establish specific benefit categories for both cardiac and pulmonary rehabilitation.  When this is accomplished, the issue of “incident to” basically disappears but it is important to know that our proposed legislation does have specific requirements for physician involvement and supervision that are similar to current requirements.  Critically important is a provision that states the physician supervision requirement is presumed to met when the service is provided by a hospital.  Now that the bill, S.1440 has been introduced by Senator Crapo (R-ID) and sponsored by Blanche Lincoln (D-AR), our grassroots letterwriting campaign has begun. When a companion bill is introduced in the House of Representatives, a parallel letter writing campaign will be triggered.

Regulatory Initiative:  CMS recently announced that it was once again opening its review of cardiac rehab, the expanded diagnoses, the role of the physician, and “incident to” issues.  Apparently CMS has decided that it will not wait for the final OIG report, literally closing the long standing policy review and starting anew.  A coordinated response is involved, with the AACVPR, ACC, and AHA (Amer Hosp Assn) all involved in providing input and review into one final document.  Although the CMS website encourages public comment, the AACVPR is fearful that broad public comment might provide CMS with differing information, particularly as it pertains to the role of a physician in cardiac rehabilitation.  If CMS receives a broad range of comments on that topic alone, they could use it as an argument that there is no consensus regarding physician involvement and, therefore, they could modify (reduce) payment for cardiac rehabilitation.  

AACVPR strongly encourages its members to write letters to members of Congress, now that a bill has been formally introduced in the Senate, and when the bill is formally introduced in the House.   We will notify you when this occurs.  Also AACVPR does NOT encourage individual members to write letters to CMS in response to its website posting to limit the possibility of confusing and contradictory statements regarding clinical indications for cardiac rehab and the role of a physician in cardiac rehabilitation.