H. R. 2619
IN THE HOUSE OF REPRESENTATIVES
July 8, 2013
Mr. Lewis introduced the following bill; which was referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned
To amend title XVIII of the Social Security Act to provide for Medicare coverage of pulmonary self-management education and training services furnished by a qualified respiratory therapist in a physician practice.
This Act may be cited as the
Medicare Respiratory Therapist Access
Act of 2013
Medicare coverage of pulmonary self-management education and training services furnished by a qualified respiratory therapist in a physician practice
Section 1861 of the Social Security Act ( 42 U.S.C. 1395x ) is amended—
in subsection (s)(2)—
and at the end of subparagraph (EE);
and at the end of subparagraph (FF); and
by adding at the end the following new subparagraph:
pulmonary self-management education and training services (as defined in subsection (iii)(1));
by adding at the end the following new subsection:
Pulmonary Self-Management Education and Training Services; Eligible Individual; Qualified Respiratory Therapist
For purposes of subsection (s)(2)(GG), the term pulmonary self-management education and training services means patient education and training services furnished to an individual diagnosed with a chronic lung disease, including such a disease described in paragraph (2), by a qualified respiratory therapist (as defined in paragraph (3)) in a physician practice but only if the physician who is managing the chronic lung disease of the individual determines, in accordance with a comprehensive plan of care related to the treatment of the individual for the chronic lung disease, that such services are needed to ensure therapy compliance by the individual or to provide the individual with necessary skills and knowledge (including skills related to proper inhaler techniques) to participate in the management of the individual’s chronic lung disease.
For purposes of paragraph (1), a chronic lung disease described in this paragraph is any of the following:
Chronic obstructive pulmonary disease (COPD), including emphysema and bronchitis.
For purposes of paragraph (1), the term qualified respiratory therapist means an individual who—
is credentialed by a national credentialing board recognized by the Secretary;
is licensed to practice respiratory therapy in the State in which the respiratory therapy services are performed; or
in the case of an individual in a State which does not provide for such licensure, is legally authorized to perform respiratory therapy services (in the State in which the individual performed such services) under State law (or the State regulatory mechanism provided by State law);
is a registered respiratory therapist; and
holds at a minimum either a bachelor’s degree or other advanced degree from an accredited school of higher education in a health science field.