Marian Benjamin

Great news from Washington, DC! In early March, the US Senate introduced a bill that revises the Medicare law to cover qualified respiratory therapists providing services such as smoking cessation, asthma management, medication education, and inhaler training.

The Medicare Respiratory Therapy Initiative Act of 2008 (S 2704) was introduced by Sen Blanche Lincoln (D-Ark) and Sen Mike Crapo (R-Idaho). Lincoln and Crapo are longtime supporters of respiratory care, and both are members of the Congressional COPD Caucus. They had worked together to introduce S 329, the Cardiac and Pulmonary Rehabilitation Act.

Under the revised Medicare law, “respiratory services” would be considered “physicians’ services” if these services are performed by a respiratory therapist under the general supervision of a physician—in settings other than an acute care hospital—without the physician present.

Payment for these services is not the same as for a physician providing the same services but is either 80% of the actual charge or 85% of the fee schedule amount, whichever is less.

Advocates of this bill claim it will expand patients’ access to respiratory care services—be it at home, an outpatient clinic, or a physician’s office—by providing Medicare coverage services.

S 2704’s Definition of a
Respiratory Therapist

  • Individuals must be credentialed by a national credentialing board.
  • They must be licensed in the state in which they practice.
  • They must be registered respiratory therapists.
  • They must hold a bachelor’s degree.

As I am writing this message, the AARC’s Political Advocacy Contact Team (PACT) is in the capital, visiting senators and representatives to educate them about this bill, which also was introduced in the House of Representatives as HR 3968.

Another group, representatives of the American Association for Cardiovascular and Pulmonary Rehabilitation (AACVR), was on the Hill last February 26-March 1. They were advocating the aforementioned Cardiac and Pulmonary Rehabilitation Act (HR 552 and S 329). The goal was to get as many elected representatives as possible to sign on as cosponsors for the bill, which would make pulmonary rehab a clear-cut Medicare benefit, not the patchwork it is now, with some states covering it and some not. The team members were armed with documentation, evidence, and research that show that pulmonary rehab is effective. According to Carl Willoughby, RRT, RCP, pulmonary rehabilitation coordinator, Mad River Community Hospital, Arcata, Calif, and one of the AACVPR team members, the visit went well: “We are up to 167 representatives and 41 senators,” he told me. PACT will also be advocating for this bill.

Editor’s Note
Read our July 2007 article “Raising the Bar for Respiratory Care.”

PACT comprises two members from each state. They are well trained and knowledgeable, but they can see only a limited number of members of Congress in the time they are in DC. They need the support of all RTs, who can write their representatives and senators urging them to support both of these bills (slated to be parts of a larger Medicare bill that will come up for vote sometime in June). Don’t know what to write? The AARC has a form letter that you can use. You will find it at Just click on Capitol Connection and you can find out who your representatives and senators are. Send them a letter and make a difference.

Marian Benjamin
[email protected]