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Pulmonary Rehabilitation: S. 329 the Cardiac and Pulmonary Rehabilitation Act and house companion legislation H.R. 552 will provide a national coverage policy that will ensure that Medicare beneficiaries will not be denied or limited access to pulmonary rehabilitation. In July the Centers for Medicare and Medicaid Services (CMS) released their final rule on Pulmonary rehabilitation stating that National Coverage would not be given because they did not have the statutory authority leaving the impetus on Congress. The bill was left out of the House Ways and Means Medicare Package which passed as the CHAMPS Act. The Senate stripped Medicare reform from their version of the CHAMPS bill known as SCHIP, leaving the door open for another round of negotiation on Medicare reform before the end of the year. The opportunity now is to have S. 329 included in a Medicare package that goes from the Senate to the House and to have the House ready to receive this provision. To promote pulmonary rehabilitation and a national coverage policy Grace Anne Dorney Koppel and her husband Ted Koppel made personal visits to members of the Senate Finance Committee and congressional staff. This effort was lead by John W. Walsh and members of the US COPD Coalition including Sam Giordano, AARC and Gary Ewart, ARS. I had the privilege of coordinating these meetings for the Koppel’s and am working with the US COPD Coalition policy group and executive committee on the upcoming Congressional COPD Briefing on November 8, 2007. One of the outcomes of the Koppel’s visits was a commitment from Senator Grassley to have the Congressional Budget Office (CBO) evaluate a cost saving idea developed by AARC, ATS, AACVPR, NAMDARC and ACCP. The so called “pay-for” would provide a mechanism for individuals on Medicare who are discharged from the hospital with supplemental oxygen to be re-evaluated on a timely basis. A review of hospital discharge data which was paid for by the above mentioned group showed that approximately 85% of those discharged on supplemental oxygen were not re-evaluated. Many questions remain open-ended about re-evaluation including who, where, and when which will need to be negotiated. The presumed cost savings to the system could “pay for” the cost of pulmonary rehabilitation which is estimated will cost the federal government $120 million over five years. Finding a way to pay for S. 329 significantly enhances the chances that it will be a successful in passage.
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