CALL FOR ACTION -- SUPPORT FOR HR 6376 (10/21/2010)

A bill has been introduced in the House of Representatives that will correct a misguided interpretation of the cardiac and pulmonary rehabilitation Medicare provisions enacted by Congress in July, 2008 and effective January 1, 2010.

As the Centers for Medicare and Medicaid Services moved forward with implementation of Section 144 of PL 110-275 (new statutory coverage of cardiac and pulmonary rehabilitation programs), it made a very narrow, strict interpretation of the statute, declaring that:

1. Only physicians could actually supervise a cardiac or pulmonary rehabilitation program, precluding the role of non physician practitioners (NPPs) such as physician assistants and nurse practitioners filling that role, despite a broad change in the 2010 rules for hospital outpatient services that now permit  NPPs to provide direct supervision of certain hospital outpatient therapeutic services because those services are analogous to physicians’ services; 
2. In critical access hospitals (CAHs), where NPPs can fill in for physicians in the Emergency Department, CAHs that provide either cardiac or pulmonary rehabilitation services must have physician supervision; 

The practical effect of these interpretations means that other hospital outpatient services that permit NPPs to meet the physician supervision requirement of Medicare do not apply to either cardiac or pulmonary rehabilitation.  Likewise, even though CAHs may have an Emergency Department staffed by NPPs, such hospitals must have a physician supervise a cardiac or pulmonary rehabilitation outpatient program.

The plan is for HR 6376 to be included as part of a larger “physician fee fix” bill that Congress will need to adopt to forgo major cuts to physician payments slated for later this year.  Hence, the “legislative vehicle” for HR 6376 will be the legislation addressing a physician fee fix. This will only happen if we get strong support from our US House congressional members for HR 6376.

ACTION TO BE TAKEN:  Write to your Congressman/Congresswoman today and urge him to sign on as a co-sponsor to HR 6376.  A letter has been provided at the link below for you to send to the US Representative in your District. THIS IS A VERY EASY LETTER SUBMISSION PROCESS AND WILL TAKE ONLY MINUTES OF YOUR TIME. The successful passage of HR 6376 will provide flexibility for cardiac and pulmonary rehabilitation programs in meeting physician supervision requirements.

You should include the NPs/PAs in your institution in this effort-it very directly affects their role in the hospital setting.

Physician supervision is an issue of concern for providers of the services, not for patients. Please do not include a patient letter campaign.

CLICK HERE TO TAKE ACTION!