Medicare Respiratory Therapist Access Act
This year, the AARC will start lobbying in earnest for House Resolution 2619; the Medicare Respiratory Therapist Access Act, known as HR 2619. It is a part of a long-term strategy to improve the presence of respiratory therapists on Capitol Hill and in a hospital, DME, or doctor's office near you.
I spoke with Sheryl West of the AARC about some issues; some on the record and some off. She is highly intelligent, well-read, open to discussion, and extremely articulate in her support not only of this bill, but of our profession. I thank her for the hour I took up on what I am sure was a busy Monday morning.
One of the misperceptions that I had, and I think many CRTs have, is that the AARC is working overtime to push us out of the field of respiratory therapy. Not true. The AARC has gone to extremes not only to protect the CRTs, but to allow them to continue working. What, then, is the bill about? It's about projecting respiratory therapy in the same light other disciplines in the hospital are projected, such as radiology, physical therapy, occupational therapy, and others.
So here's a wake-up call for every CRT working; the AARC is not the end of your career. Sadly, only a little over a third of us working in respiratory therapy are members of the only professional group that is lobbying for us, and may perceive HR 2619 as a threat to their jobs. Again, not true. HR 2619 seeks to get recognition for the unique and specialized work respiratory therapists do, both in and out of the hospital. That is it in a nutshell, as I understand it. I have heard from so many who hold the CRT credential (like me) that this is the equivalent of the apocolypse for CRTs, and another slap in the face for the CRT, and it really is not. It is true that unless you hold the RRT credential and a bachelor's degree in a medical discipline that there could be some tasks that you cannot perform, particularly outside of the hospital walls, and receive payment for. You can still do the task, you and your employer just may not be reimbursed all you could be with the CRT credential as opposed to the RRT.
You have to understand a little about politics. Any MBA will tell you that politicians and businesses in general care about three things: how to save money, how to maximize profits, and how to pay for your new idea. Studies are underway to determine a cost benefit for having those with advanced credentials and advanced degrees provide some, and the key word is"some," medical care. This in no way has an effect on the CRT doing his or her work in the hospital, rehab facility, DME, or other areas. Even those hired by physicians in the office will not be put out of a job based on this legislation, though the physician may decide to find an RRT to maximize their ability to get paid by Medicare. That is an employer decision, and not a ramification of HR 2619. Other insurance companies, such as Blue Cross Blue Shield, Aetna, etc, will likely follow the tracks of Medicare, as they always have.
One of the misperceptions I held until talking with Ms. West is that the AARC wants to divide up the CRTs and the RRTs. I wrongly perceived this bill as yet another attempt at doing just that. I was wrong. hat is done enough at the respiratory care manager level, who seek to hire only RRT's, or at the state level, as in the case of California where CRTs are unwelcome.
Even though I do not like this, I do understand that it is an organizational responsibility to look out for the welfare of the people, the patients, and the organization at whatever level you find yourself prominent in. Though I may not agree with you, if you are a respiratory manager who feels that hiring only RRTs or those
who will get their RRT in the next six months raises your level of care, you owe it to yourself and your organization to use that as a basis for hiring only RRTs.
CRTs, myself included, have had opportunities to go on with schooling and get the RRT credential. Whatever reason a CRT uses to avoid doing that (mine was serving in the military; no opportunity for school) is the bed you have made. Now you must lie in it. This is not a new trend; the push for elevating the profile of respitarory therapists has been around for a while, so if you ignored it or just chose to live in denial, then shame on you.
What HR 2619 does is specify that work done by a "qualified respiratory therapist" can be reimbursed at a higher rate than than it is when performed by someone that is not "qualified" according to Medicare standards. Some RRTs will be affected, too; not all RRTs have a bachelors degree in a health related field that Medicare will decide is acceptable under the term "qualified." The point is this is not a bill that excludes the CRT; it does not address the work of the CRT at all.
In the past, I have been critical of the AARC for dividing up the profession, waging an "us and them" war behind the scenes. I was wrong. The AARC,
as our only professional representative on Capitol Hill, is trying to use the playing field they have in front of them, Washington D. C., in the best manner
to advance all of respiratory care.
In my opinion, all respiratory therapists need to show their support for HR 2619 by writing their politicians. The AARC has graciously offered an FAQ page on their website (http://www.aarc.org/, look under governmental affairs) which addresses not only concerns from CRTs, but also provides a good case for why this is a good bill for all of us. Even if, for whatever reason, you are not a member of the AARC, you can log on and read the FAQ's. Even if you are not a member, you can have your say about your profession with your politicians; the AARC even has a template you can use and a list of politicians representing you on their website. Politicians are supposed to represent us. If you decide to have no voice, you cannot complain when your voice is not heard.
Use your voice, support HR 2619, join the AARC, and do some homework on issues that present you challenges both on the AARC website, and on your own through congressional and senatorial websites, watchdogs, and by keeping up with professional news. It is through excellence and continued education that we get respiratory therapy the respect it deserves and secure our futures.
That's just my opinion,
Jim Thacker, MBA, MHA, CRT, AE-C