HD25 - Report of the Boards of Health Professions and Health on Need to Regulate Outpatient Cardiovascular and Pulmonary Rehabilitation Facilities in the Commonwealth of Virginia

Executive Summary:
House Joint Resolution 223 of the 1994 General Assembly called for the Board of Health Professions and the Board of Health to study the need to regulate outpatient programs for cardiovascular and pulmonary rehabilitation.

The Boards reviewed the professional literature, current regulations in other states, consumer complaint informational sources, and public comment. The fundamental criterion employed by the Boards was the risk for harm to the consumer resulting from the unregulated practices of these programs. In assessing public risk, the Boards considered the characteristics of the clients served, the setting and supervisory arrangements for the delivery of the health service, as well as combinations of these factors. Further, the study revealed that:

• National voluntary accreditation standards for the facilities will become available soon -- the American Association of Cardiovascular and Pulmonary Rehabilitation is devising guidelines which are to be published in October 1994 and the Commission of Rehabilitation Accreditation is revising its outpatient standards to encompass some pulmonary rehabilitation facilities as of July 1, 1995;

• Voluntary standards and third-party payors also currently require licensure of the health care providers of these rehabilitation programs, thus, the public has regulatory recourse against unprofessional conduct of the licensees through the respective licensing boards;

• Nationally recognized specialization certification for health care providers in the facilities currently exists as a further safeguard for the public; and

• The sole rationale for other states which regulate these programs is their failure to receive third-party payor reimbursement without state regulation. This problem does not exist in Virginia.

The results of the study revealed no evidence of risk to the public which could not be remedied more readily through currently existing means. There is no justification for state regulation of outpatient cardiovascular and pulmonary rehabilitation facilities.