,i  #aacth ,,congress  #ast ,session    
,h4 ,r4 #bfai  ,,in ,,the ,,house ,,of  
,,representatives  ,july #h1 #bjac ,mr4 
,lewis introduced the following bill2   
which was referred to the ,committee on 
,energy and ,commerce1 and in addition  
to the ,committee on ,ways and ,means1  
for a period to be subsequently         
determined by the ,speaker1 in each case
 for consideration of such provisions as
 fall within the jurisdiction of the    
committee concerned  ,a ,,bill  ,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 practice4  #a4 
,short title ,this ,act may be cited as 
the ,medicare ,respiratory ,therapist   
,access ,act of #bjac4  #b4 ,medicare   
coverage of pulmonary self-management   
education and training services         
furnished by a qualified respiratory    
therapist in a physician practice  7a7  

,in general ,section #ahfa of the       
,social ,security ,act 7#db ,u4,s4,c4   
#aciex7 is amended--  7#a7 in subsection
 7s77#b7--  7,a7 by striking and at the 
end of subparagraph 7,,ee72  7,b7 by    
adding and at the end of subparagraph   
7,,ff72 and  7,c7 by adding at the end  
the following new subparagraph3  7,,gg7 
pulmonary self-management education and 
training services 7as defined in        
subsection 7iii77#a772  2 and  7#b7 by  
adding at the end the following new     
subsection3  7iii7 ,pulmonary           
,self-,management ,education and        
,training ,services2 ,eligible          
,individual2 ,qualified ,respiratory    
,therapist  7#a7 ,for purposes of       
subsection 7s77#b77;,,gg71 the term     
pulmonary self-management education and 
training services means patient         
education and training services         
furnished to an individual diagnosed    
with a chronic lung disease1 including  
such a disease described in paragraph   
7#b71 by a qualified respiratory        

therapist 7as defined in paragraph 7#c77
 in a physician practice but only if the
 physician who is managing the chronic  
lung disease of the individual          
determines1 in accordance with a        
comprehensive plan of care related to   
the treatment of the individual for the 
chronic lung disease1 that such services
 are needed to ensure therapy compliance
 by the individual or to provide the    
individual with necessary skills and    
knowledge 7including skills related to  
proper inhaler techniques7 to           
participate in the management of the    
individual's chronic lung disease4  7#b7
 ,for purposes of paragraph 7#a71 a     
chronic lung disease described in this  
paragraph is any of the following3  7,a7
 ,chronic obstructive pulmonary disease 
7,,copd71 including emphysema and       
bronchitis4  7,b7 ,asthma4  7,c7        
,pulmonary hypertension4  7,d7          
,pulmonary fibrosis4  7,e7 ,cystic      
fibrosis4  7#c7 ,for purposes of        
paragraph 7#a71 the term qualified      

respiratory therapist means an          
individual who--  7,a7 is credentialed  
by a national credentialing board       
recognized by the ,secretary2  7,b7 7i7 
is licensed to practice respiratory     
therapy in the ,state in which the      
respiratory therapy services are        
performed2 or  7ii7 in the case of an   
individual in a ,state which does not   
provide for such licensure1 is legally  
authorized to perform respiratory       
therapy services 7in the ,state in which
 the individual performed such services7
 under ,state law 7or the ,state        
regulatory mechanism provided by ,state 
law72  7,c7 is a registered respiratory 
therapist2 and  7,d7 holds at a minimum 
either a bachelor's degree or other     
advanced degree from an accredited      
school of higher education in a health  
science field4  4