Northwest Association of Cardiovascular
and Pulmonary Rehabilitation

Washington, Idaho, Alaska

Affiliate Society of AACVPR
American Association of Cardiovascular
 and Pulmonary Rehabilitation


Legislastive Focus

 Senate Bill S. 488
House of Representatives H.R. 3355

  • Legislative action is needed to allow non-physician practitioners such as Physician Assistants, Nurse Practitioners, and Clinical Nurse Specialists to meet the physician supervision requirement for cardiac and pulmonary rehabilitation programs
  • "Technical Correction" is needed to the current statute
  • Important for Critical Access Hospitals, rural programs, and hospitals with limited physician availablity or is cost prohibitive using physicians
  • Not to replace Medical Director requirement
  • Senate Finance Committee is key to passage    
  • Washington and Oregon are important Senators on the Finance Committee


 How Can You Help??

High Co-Pays

  • Medicare MedAdvantage plans can require co-pays between $20-60 per visit (for copays higher than $40 call 1-800-Medicare to report)
  • Affects CR, PR, OT, PT, and Speech Therapy
  • Discourages participation and or limits visits
  • May require legislation at the state level to cap co-pay amounts.
  • PT Association of Washington - opportunity to work together
  • State Senate Bill 6123
    • sponsored by Senator Dammeier
    • asked for CR and PR to be included
    • bill is tabled for this legislative session

Next Steps

  • Continue to work with PT Association for state support
  • Possible letter from Senator Cantwell to CMS
  • Insurance Commissoin Guidance
  • Constituent letters at some point
  • No current strategy from AACVPR at this time
  • For copays higher than $40 per visit - call 1-800-Medicare to report
more questions contact:  Joyce Kratz-Klatt:  or Dana Gunter:
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