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Correspondence |

Setting the Record StraightClarification of HR 2619: Part 2: Part 2: Clarification of HR 2619 FREE TO VIEW

Thomas J. Kallstrom, MBA, RRT
Author and Funding Information

From the American Association for Respiratory Care.

CORRESPONDENCE TO: Thomas J. Kallstrom, MBA, RRT, American Association of Respiratory Care, 9425 N MacArthur Blvd, Irving, TX 75063; e-mail: kallstrom@aarc.org


FINANCIAL/NONFINANCIAL DISCLOSURES: Mr Kallstrom is executive director of the American Association for Respiratory Care.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians. See online for more details.


Chest. 2014;146(2):e61. doi:10.1378/chest.14-0481
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To the Editor:

As Executive Director of the American Association for Respiratory Care (AARC), I am writing a follow-on letter to the one presented by AARC President George Gaebler. The issue relates to a recent debate appearing in CHEST (February 2014)1-4 about whether Medicare should allow respiratory therapists (RTs) to practice independently and bill directly for COPD education.

The focus is AARC bill HR 2619, the Medicare Respiratory Therapist Act of 2013, currently before Congress.5 Although Mr Gaebler has clarified the provisions and intent of the bill, I want to address some of the inaccuracies of the Counterpoint Editorial2 because the authors appear to be confusing past AARC legislative initiatives with the present one.

The entire premise of the Counterpoint Editorial2 is based on inaccurate assumptions and statements. For example, the article states that (1) HR 2619 proposes RT independent billing specifically for COPD self-education, (2) the RT’s services would be furnished in the home setting as well as in physicians’ offices, (3) RTs would work under general physician supervision without physical presence of the physician, and (4) RTs can work in the home under general supervision now. None of these statements is correct.

The authors cited HR 2619 as one of their references. A close reading of the bill would show that (1) no reference to independent billing is made; (2) self-management education includes five diseases, not just COPD; (3) only physician practices would be affected; (4) general supervision is not mentioned; and (5) the bill amends Medicare’s “incident to” benefit under §1861(s)(2), which requires direct physician supervision. For services in the home, the one exception allows general supervision only to homebound patients in medically underserved areas where home health services are unavailable.6

We do not intend to address the studies or conclusions drawn by the authors in their article because they are premised on erroneous hypotheses. However, regardless of the divergence of opinions in the point/counterpoint debate, we want to acknowledge and thank the American College of Chest Physicians for going on record as a supporter of HR 2619. In the spirit of fairness, we want to make sure its members have all the facts about the bill and AARC’s desire to use RT skills beyond the walls of the hospital in providing education necessary for better self-management among Medicare beneficiaries with certain chronic lung diseases.

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.
 
Centers for Medicare & Medicaid Services. Chapter 15: covered medical and other health services.. In: Medicare Benefit Policy Manual. Section 60.4. Centers for Medicare & Medicaid Services website. http://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/downloads/bp102c15.pdf. Revised January 2014. 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.
 
Centers for Medicare & Medicaid Services. Chapter 15: covered medical and other health services.. In: Medicare Benefit Policy Manual. Section 60.4. Centers for Medicare & Medicaid Services website. http://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/downloads/bp102c15.pdf. Revised January 2014. Accessed February 25, 2014.
 
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