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Correspondence |

Setting the Record StraightClarification of HR 2619: Part 1: Part 1: Clarification of HR 2619 FREE TO VIEW

George Gaebler, MSEd, RRT
Author and Funding Information

From the American Association of Respiratory Care.

CORRESPONDENCE TO: George Gaebler, MSEd, RRT, American Association of Respiratory Care, 9425 N MacArthur Blvd, Irving, TX 75063; e-mail: gaeblerg@upstate.edu


Editor’s Note: Authors are invited to respond to Correspondence that cites their previously published work. Those responses appear after the related letter. In cases where there is no response, the author of the original article declined to respond or did not reply to our invitation.

FINANCIAL/NONFINANCIAL DISCLOSURES: Mr Gaebler is president of the American Association for Respiratory Care.

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Chest. 2014;146(2):e60. doi:10.1378/chest.14-0480
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To the Editor:

As President of the American Association for Respiratory Care, I wish to set the record straight regarding a recent point/counterpoint debate appearing in CHEST (February 2014).1-4 Courtright and Manaker’s2,4 discussion has been clouded with errors, omissions, and misperceptions.

To be perfectly clear, the American Association of Repiratory Care has never submitted legislation to allow respiratory therapists (RTs) to practice independently and bill Medicare directly for their services, nor do we intend to. In fact, HR 2619, the Medicare Respiratory Therapist Access Act,5 does the exact opposite because it would require the physician to provide direct supervision of the RT and for the physician to bill and be paid directly by Medicare for the RT’s services.

What exactly does HR 2619 do?

  • It provides coverage of pulmonary self-management education and training services in physician practices to Medicare beneficiaries with COPD, asthma, pulmonary hypertension, pulmonary fibrosis, and cystic fibrosis when furnished by registered RTs who hold either a bachelor’s or other advanced degree in a health science field.

  • It improves Medicare beneficiaries’ access to RTs when they visit their physician.

  • It establishes a separate benefit for pulmonary patients much like the diabetes outpatient self-management training program established by Congress many years ago.

  • It requires the physician to determine whether patient self-management is needed or whether the patient has the necessary skills to self-manage.

  • It takes the guesswork out of physician reimbursement and gives physicians confidence to add RTs to their team at a time when physician shortages are expected to increase.

Reducing costly hospital readmissions is a critical issue facing the Medicare program. Beginning October 1, 2014, COPD, which is one of the most costly pulmonary diseases, will be added to the list of conditions subject to the hospital readmissions reduction penalty. For patients with chronic lung disease, a key to reducing costly ED visits and hospital admissions or readmissions is to educate and train patients to recognize the symptoms and triggers of their disease to reduce or prevent the onset of acute exacerbations.

Medicare beneficiaries who work with RTs to properly self-manage their chronic lung disease can slow disease progression and improve health status. RTs can bring value to physician practices and assist in preventing short-term readmissions. That is why it is important to gain sponsorship and support for HR 2619.

References

Fuhrman TM, Aranson R. Point: should Medicare allow respiratory therapists to independently practice and bill for educational activities related to COPD? Yes. Chest. 2014;145(2):210-213. [CrossRef] [PubMed]
 
Courtright K, Manaker S. Counterpoint: should Medicare allow respiratory therapists to independently practice and bill for educational activities related to COPD? No. Chest. 2014;145(2):213-216. [CrossRef] [PubMed]
 
Fuhrman TM, Aranson R. Rebuttal from Drs Fuhrman and Aranson. Chest. 2014;145(2):216-217. [CrossRef] [PubMed]
 
Courtright K, Manaker S. Rebuttal from Drs Courtright and Manaker. Chest. 2014;145(2):217-218. [CrossRef] [PubMed]
 
H.R.2619: Medicare Respiratory Therapist Access Act of 2013: 113th Congress (2013-2014). Congress.gov website. http://beta.congress.gov/bill/113th-congress/house-bill/2619. Accessed February 25, 2014.
 

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References

Fuhrman TM, Aranson R. Point: should Medicare allow respiratory therapists to independently practice and bill for educational activities related to COPD? Yes. Chest. 2014;145(2):210-213. [CrossRef] [PubMed]
 
Courtright K, Manaker S. Counterpoint: should Medicare allow respiratory therapists to independently practice and bill for educational activities related to COPD? No. Chest. 2014;145(2):213-216. [CrossRef] [PubMed]
 
Fuhrman TM, Aranson R. Rebuttal from Drs Fuhrman and Aranson. Chest. 2014;145(2):216-217. [CrossRef] [PubMed]
 
Courtright K, Manaker S. Rebuttal from Drs Courtright and Manaker. Chest. 2014;145(2):217-218. [CrossRef] [PubMed]
 
H.R.2619: Medicare Respiratory Therapist Access Act of 2013: 113th Congress (2013-2014). Congress.gov website. http://beta.congress.gov/bill/113th-congress/house-bill/2619. Accessed February 25, 2014.
 
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