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The Latest in COPD Public Policy

Posted on August 31, 2016   |   
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Jamie Sullivan

This PRAXIS Nexus post was authored by Jamie Sullivan, MPH. Jamie works in the COPD Foundation's DC office and serves as the Vice President of Public Policy & Outcomes.

Oxygen Access Update

Individuals with COPD and all those affected by lung health conditions continue to experience a variety of challenges related to the use of supplemental oxygen therapy. As many of you know, the COPD Foundation (COPDF) has advocated for the need to pass legislation that will stop the growing access crisis. We hear from patients on COPD360Social and through the C.O.P.D. Information Line reporting issues such as refusal to provide liquid oxygen to new users, removal of liquid oxygen from existing users, refusal to provide the needed number of tanks or difficulties with service and supply issues.

In 2016, the areas of the country that do not fall into a competitive bidding region (primarily rural areas) are now subject to steep rate cuts aimed at bringing prices in line with those used in the competitive bidding regions. These rate cuts may worsen the access crisis, especially those in largely rural areas.

Two pieces of the solution:

The Patient Access to Durable Medical Equipment Act (PADME) HR 5210: introduced in the House and the Senate in May. The PADME Act’s main purpose is to delay the next phase of reimbursement cuts for rural areas by 15 months (October 1, 2017). In addition it addressed a number of technical issues related to competitive bidding and required a monthly report by CMS to monitor the impact of the cuts on Medicare beneficiary access. HR 5210 was passed in the House.

S2736 was passed in the Senate a short time later. Unfortunately, the two bills did not contain the same language, though both agreed on the need to delay reimbursement cuts; however, there is still a chance that Congress will move to ensure two identical bills are passed before the end of the year.

What you can do. If you have patients who are experiencing issues with oxygen access, please encourage them to:

  1. Call the C.O.P.D. Information Line at 866-316-2673 to complete a brief form. In some cases we are able to help those experiencing issues that are clear violations of Medicare rules to resolve the solution but can only do so for those who reach out to us!
  2. Report the issue to 1-800-MEDICARE.

The COPD National Action Plan Update

The National Heart, Lung & Blood Institute (NHLBI) hosted the first COPD Town Hall Meeting in early 2016. More than 100 stakeholders convened to discuss the various issues associated with COPD and to provide recommendations for strategies to include in the first-ever COPD National Action Plan.

Thank you for the feedback you gave us on the National Action Plan goals through a variety of avenues, including PRAXIS Nexus posts like these. The NHLBI team took all the recommendations into account and drafted the first version of the National Action Plan.

What you can do. The full draft of the National Action Plan will be made available for public comment in the near future. We will let you know when that happens and look forward to your submissions for NHLBI consideration. This critical juncture in the process requires everyone’s attention as the plan addresses issues spanning prevention, awareness, diagnosis, treatment, education, research and policy, and includes suggested roles for all types of stakeholders within the COPD community.

Pulmonary Rehabilitation Rates Revised-Comments Pending

In July 2016, the Centers for Medicare & Medicaid Services released proposed regulatory rules that include specifics as to how outpatient medical services are paid. The proposed rates for hospital-based pulmonary rehabilitation programs rose dramatically. While the rates may not be as high as proposed when the rules are finalized, this is a big step in the right direction. Unfortunately, the pulmonary rehabilitation programs that are based within a physician practice or other community-based setting did not see such rate increases and we expect to comment on this issue when formal comment letters are due in early September.

What you can do. If you have patients who have participated in pulmonary rehabilitation in a doctor’s office or in a setting that was outside of a hospital, encourage them to email us at jsullivan@COPDFoundation.org and let us know. We may follow up to discuss their experiences to help inform the comments we submit.

We will continue to keep you apprised of policy developments and thank you for your advocacy in improving the lives of all with COPD!

2 Comments



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  • Just wanted to update everyone to stay tuned later today as the National Action Plan will officially be out for public comment!

    Reply
  • Excited to see the updated plan, Jamie! Thanks for keeping us in the loop.
    Reply

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