AACVPR Reimbursement Update 

The Pulmonary and Cardiac Rehabilitation Act is now Law 

Congratulations to the members of AACVPR and the patients they serve.  The Pulmonary and Cardiac Rehabilitation Act has been voted into law.  As you are aware, the President vetoed the Medicare bill, HR 6331, which includes our Pulmonary and Cardiac Rehabilitation provisions in Section 144.  In spite of overwhelming Congressional support for the bill, on Tuesday, July 15th President Bush vetoed this legislation. Both the U.S. Senate and House of Representatives overwhelmingly passed this important legislation and responded swiftly to the Presidential veto.  The House of Representatives and the Senate have responded by voting to override that veto.  The House vote to override that veto was 383-41.  Immediately following that vote, the Senate voted to override the veto by a vote of 70 to 26.  This legislation, now law, includes a provision (Section 144) that establishes both cardiac and pulmonary rehabilitation services as specific Medicare benefit categories that mandate coverage and payment of services.

AACVPR members and leaders are to be congratulated on our monumental achievement.  As an organization, we have been working for almost 10 years for a provision to ensure that pulmonary and cardiac rehabilitation services are included in the Medicare statute.  Inclusion of Section 144 is a reflection of the very hard and persistent work of AACVPR members to garner support of Senators and Congressmen who clearly voted in support of our provisions.   

As we celebrate this important milestone for CR and PR, there is still work to be accomplished.  The process from here forward will include several important, complex actions:

The provisions of the bill have an effective date of 1/1/10 and while it is unlikely that CMS will move forward with an official NCD process for pulmonary rehabilitation in the near future, it would be reasonable to begin the process of engaging MACs and FIs to ensure they understand precisely what Congress has done and offer AACVPR assistance.

The various pulmonary societies will be meeting shortly to explore options for a proposal of code(s) for the AMA CPT Editorial Panel to consider.  While that process may support a simple shift from G codes to identical CPT codes, it is worthy of discussion among the societies because the coding decisions made in the immediate future will impact pulmonary rehabilitation for years to come. 

Thank you and congratulations to the members and leaders who contributed their time and energy to contact their senators and representatives for the passage of this important legislation.  The AACVPR Day on the Hill is an important event and we are committed to working closely with CMS to ensure that the payment for CR and PR services is appropriate and provides the resources needed to support the quality of care that patients deserve.   

As always, AACVPR will be working on behalf of the membership and the field of cardiac and pulmonary rehabilitation.  We will continue to communicate with members with the latest information related to the new bill and its implications for reimbursement for pulmonary and cardiac rehabilitation services.  Please watch for more information related to this important new law.

Your best source of communication regarding this bill is AACVPR, so if you are not an AACVPR member, please consider joining today to keep up-to-date on all the latest information your programs and practices will need!