Political Action Update
Joe Dwan, MS, RRT, PACT co-chairOregon
National Public Radio's (NPR) "Report on Tobacco Settlement" states that most states have not allocated the tobacco settlement monies for tobacco prevention, sadly, including Oregon. Due to the recession and economy, Florida has just cut 40% of their tobacco prevention program money.Gov. John Kitzhaber was requested to sign a proclamation that October is "COPD Awareness" month but it was not signed. We will pursue this next year.
10/4/01 Representative Ethridge (D-North Carolina) tried to amend the Farm Security Act (HR2646) to make leaf tobacco eligible for $200 million in subsidies to promote tobacco sales overseas. Oregon's own Earl Blumenauer (D-OR) had this amendment removed (I sent Rep Blumenauer a thank you letter, you could too).
National
September 11th changed everything in Washington. Congressional priorities have shifted dramatically. Things like prescription health benefit have faded away and it is uncertain when things will get back to normal….COPD Awareness Month was scheduled for October 2001, to coincide with RC Week. However, following the events of 9/11, the AARC decided to postpone COPD Awareness Month to Oct 2002. Please start planning early in 2002 for COPD Awareness month, such events as PF screening for consumers (Know your Numbers), smoking cessation, and anything that will promote COPD and the services RCPs provide to this underserved population. Contact your OSRC Regional Director, Janet (Sale) Holloway, or myself for ideas. The President did sign a proclamation that Nov was "COPD Awareness" month on November 24th. Kitzhaber has not signed a similar proclamation in OR.
Email your congressman/woman (www.aarc.org then go to "Advocacy" then "Capital Connection" and enter your zip code to automatically pull up your congressman/woman's address). The issues: COPD patients should have access to highly qualified RCPs in their homes; COPD pts on home oxygen need access to retesting (home O2 evaluations) since CMS (new HCFA name) requires it, and Pts on life support ventilators should not be moved to a classification/category that may end pt monitoring by a qualified health care professional (like licensed RCPs)(the Office of Inspector General suggesting re-categorizing home vent pts to save $$$.
Bioterrorism response plans for health care providers has been both a national issue and state issue. Colorado passed legislation already. Congressional legislation includes 1) create & fund preparedness, 2) extend grants focusing on the ability to respond, 3) fund demonstration programs on bioterrorism which include training, coordination, and readiness.
ACLS: Florida House Bill 19B now requires RCPs to be ACLS certified in order to be licensed! There has been a lot of controversy over this new legislative mandate and the associated costs, necessity, pros/cons….
CHIP or Children's Health Insurance Program is a national topic that talks about Medicare and the uninsured. This was expected to be addressed by Congress, but everything is on hold due to 9/11.
OIG or Office of Inspector General will be recovering $134 million in 'overpayments' in Region C (Oregon/WA is in Region X). This is making all regions nervous, as the OIG will probably try this elsewhere. Overpayments for things like home oxygen, ventilators, treatments, both inpatient and outpatient, among other things…
CMS (formerly HCFA) issued a 'Decision Memo' on the use of CPAP for OSA. Currently CPAP is covered for adults with moderate or severe OSA. According to the 10/30 Memo, CPAP will be covered under Medicare for OSA if either of the criteria are met (AHI 15 or AHI 5-14 with documented excessive daytime sleepiness, impaired cognition mood disorders or insomnia, HTN, ischemic heart disease or hx of stroke. This policy will become final when it appears in the Medicare Coverage Issues Manual (section 60-17)!!
Oct 2nd the AARC sent CMS a letter about the classification of Bi-Level respiratory assist devices (RAD) with Back-up Rates (like Respironics BiPAP ST modes). In June, the OIG recommended moving Bi-Level devices with back-up rates from the 'frequent and substantial service' payment category to the capped rental category. The AARC obviously opposes this, as should you.
Hot Off the Press.(Co chair Janet (Sale) Holloway & I attended the PACT meeting at the AARC San Antonio conference). Competency of people providing respiratory care is a hot topic the AARC is pushing for…We are trying to develop coalitions with organizations serving our patient populations, such as Better Breathers, AARP, Cystic Fibrosis and asthma associations, so we can promote that these people deserve high quality care by qualified health care professionals. If you know contacts in any of these groups, please let me know! LMRPs, think of these as Medicare rules established by each region (we're Region X), are now open to public comment, which is good news.