Joint ATS/CHEST Clinical Practice Committee

CO-Chair - ATS Omar Hussain, DO, MS Melrose Park, IL
Staff Gary Ewart, MHS Washington, DC

The Joint ATS/CHEST Clinical Practice Committee monitors public and private payment, billing, and regulatory matters that affect the clinical practice of pulmonary, sleep and critical care medicine in the United States. It drafts comments that represent ATS/CHEST positions on payment, billing, and practice regulations to inform leadership, membership, relevant agencies, and the public on important issues as they arise, and educates leaders and membership on the above. The committee meets with appropriate parties, including industry, to ensure that codes for pulmonary, critical care and sleep procedure reflect current technology. The committee actively participates in the AMA CPT and AMA RUC processes. It coordinates ATS/CHEST strategies and efforts to influence payment, billing and coding policy at the AMA CPT, AMA RUC and federal health insurance programs (Medicare)and where appropriate, private health insurance. The Committee responds to member inquiries on coding and billing matters and conducts member education through sessions, webinars, newsletter and other educational products on correct coding and billing procedures.

Benchmarks, 2023-2024:
 Regularly attend and engage in the AMA CPT and AMA RUC meetings;
 As appropriate, revise CPT codes used by ATS members and engaging with industry to ensure codes represent current technology;
 Periodically publish information and educate members on billing, coding, and regulatory compliance for ATS members;
 Consider developing expertise in the hospital payment side of reimbursement, beginning with evaluating the current expertise of committee members. Develop a white paper proposal on how to address this need for leadership review; consider adding language to include tele-medicine. Collect data on economic makeup of membership.
 Keep members and leadership informed regarding legislative changes in health care insurance that affect the practice of Pulmonary, Critical Care and Sleep Medicine;
 Produce comments for leadership’s review on key regulatory proposals that impact Pulmonary, Critical Care, and Sleep Medicine for reports at each ATS Board meeting;
 Determine additional educational activities including editorials in journals, updates on the ATS Website or content at the international conference;
 Monitor developments in treatments/technology in pulmonary, critical care and sleep medicine to ensure CPT coding nomenclature appropriately reflects these changes by interacting with regulatory agencies;
 As needed, compose and conduct member surveys to ensure appropriate valuation for pulmonary, critical care and sleep clinical services for reimbursement.
 Develop webinars, core curriculum for fellows so that they understand coding; could be attached to something of value (certificate, recognition). Consider creating a year-round PG course on billing and coding. Could be promoted for divisions chiefs, administrators, practitioners, in addition to fellows.
 Nominate a diverse slate of candidates for ATS Respiratory Health Awards.
 This committee is responsible for reviewing content it has previously posted to the ATS website to determine if it should be updated and moved to the new site or archived/deleted. Using parameters established by the ATS Digital Content Committee as a guideline, committee members will make necessary modifications to ensure the content is accurate and conforms with established ATS standards. Reviews are to be completed by December 1, 2023.