Legislative Update
Posted October 17, 2008
The year of 2008 has been a landmark year for those of us working in Cardiac and
Pulmonary Rehabilitation! On July 15, 2008, our efforts during Day on the Hill
and our grassroots letter writing campaigns finally paid off. The Cardiac and
Pulmonary Rehabilitation Act (H552 & S329), part of the bill called the Medicare
Improvements for Patients and Providers Act of 2008, now called Public Law
110-275, passed. This bill includes a provision which creates specific benefit
categories for both cardiac and pulmonary rehabilitation, and will remove the
“incident to” requirement that currently burdens cardiac rehabilitation
programs. The bill will take effect on January 1st, 2010. At first I was very
disappointed with the long date for implementation of this bill. After attending
the National AACVPR meeting last month, I understand that this may really be a
short date. AACVPR is busy working to try to structure how we want the Pulmonary
Rehab codes and regulations to look. The hope is that the G Codes will be out,
and new wording will be adopted that removes the time limits involved in the
codes we currently use. The first version of the new codes is due to the
Medicare Committee by February, 2009. The AACVPR is also helping to write the
new NCD (National Coverage Determination) for Pulmonary Rehabilitation and
define who can perform these services, thus eliminating the concern now existing
for Exercise Physiologists. We will strive to keep you updated on the MOKSACVPR
website of changes as they occur. You can also find legislative updates at
www.AACVPR.org.
The other huge change affecting healthcare in 2008 is the creation of MAC’s,
Medicare Administrative Contractors. These contractors have replaced the FI’s,
Fiscal Intermediaries, who previously managed Medicare regulation and
interpretation. The United States has been divided into 15 jurisdictions by
state. Missouri and Kansas are in Jurisdiction 5, called J5, with Iowa and
Nebraska. Our assigned MAC is Wisconsin Physician Service (WPS). A committee has
been established to communicate with the medical director of WPS and Candi
Steele is the J5 committee chairperson. If you have questions about Medicare
coverage for cardiac or pulmonary rehab from WPS, we ask that you contact a
member of the committee rather than approaching WPS directly. This allows us to
maintain clear and open communication with the medical director and prevents
raising red flags for coverage issues. Lynn Hegvik and Susan Hansen from the
MOKSACVPR board are on the J5 committee. The good news is that WPS has a history
of being very friendly to Cardiac Rehabilitation and has been very cooperative
and approachable as we have met with them to discuss interpretation of the
Medicare guidelines. We will also keep you updated on the progress with WPS on
the MOKSACVPR website.
This is all very exciting news and I am privileged to have been your President
this past year.
Sincerely,
Lynn Hegvik RN, BSN
President, MOKSACVPR
For more information, please visit the link
www.aacvpr.org.
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