June 28, 2012

For this Health Policy & Reimbursement Update ONLY: Please share this with non-members, as we realize that some issues need to go beyond AACVPR members.


Do you want more flexibility in meeting physician supervision requirements for your pulmonary and cardiac rehabilitation program?

Could you reduce the expense of delivering your program if you were allowed to utilize a non-physician practitioner (NPP) in place of the current Medicare requirement that mandates a physician be immediately available per the Medicare direct physician supervision requirements we now live with?

Is your Critical Access Hospital (CAH) rehab program at risk of closure because you are unable to comply with the Medicare requirement that a physician be immediately physically available at all times your program is in operation? Would the use of a non-physician practitioner for MD supervision in your critical access hospital allow you to keep your program doors open for patients who benefit from our services?


Help AACVPR correct unnecessarily restrictive Medicare regulations for cardiac and pulmonary rehabilitation.

CMS’ restrictive interpretation of the authorizing statute precludes non physician practitioners from supervising pulmonary and cardiac rehabilitation programs. The bureaucratic barriers hospitals face, particularly CAHs, are hindering access to pulmonary and cardiac rehabilitation. In fact, CMS currently allows NPPs to provide aspects of direct physician supervision for all other hospital outpatient services except cardiac and pulmonary rehabilitation.

Senators Schumer (D-NY) and Crapo (R-ID) have introduced S.2057, a technical correction that will clarify Congressional intent and allow hospitals to provide and supervise pulmonary and cardiac rehabilitation services the same way that hospitals provide all other hospital outpatient services.

This is a non-partisan, non-controversial, NO-COST technical correction that will solve the issue by clearly signaling to CMS the actual Congressional intent of the cardiac and pulmonary rehabilitation Medicare legislation. AACVPR is asking that this bill be included as part of an appropriate legislative vehicle that arises later this year. S2057 must have majority support before it will be considered for inclusion in an appropriate legislative vehicle (a larger bill dealing with Medicare) that arises later this year.


Please contact your two U.S. Senators and ask for their support of S.0257. Simply go to the AACVPR DOTH web page where you will find:

  1. Easy click instructions to find the contact information for your two U.S. Senators
  2. A template email to send for your initial contact
  3. Simple follow-up steps to secure co-sponsorship of this bill from your Congressional representative


Congress is not in session for most of the month of August. October will be consumed with election preparation and in November/December Congress will be dealing with the BIG issues that must be resolved before end of year, such as (another) physician fee fix.  Therefore, action at the grassroots level NOW is critical to success.

It is critical that AACVPR achieve majority support for U.S. Senate bill S.2057 before the end of July.