What This Bill Does
This bill makes permanent certain temporary changes that allowed heart and lung rehabilitation programs to be delivered in patients' homes using video technology during the COVID-19 pandemic. The bill officially changes Medicare rules to allow these home-based rehabilitation services to continue indefinitely.
Who It Affects
Medicare patients receiving cardiac rehabilitation (heart recovery treatment), intensive cardiac rehabilitation, or pulmonary rehabilitation (lung recovery treatment). Healthcare providers and hospitals that deliver these rehabilitation services. The U.S. Department of Health and Human Services.
Key Provisions
• Patients can receive heart and lung rehabilitation services in their homes through two-way video and audio technology, instead of only in hospitals or outpatient clinics (Sec. 2(a)).
• Healthcare providers including physicians, physician assistants, nurse practitioners, and clinical nurse specialists can supervise rehabilitation programs through two-way video and audio communications (Sec. 2(a)).
• Hospitals can now be paid by Medicare for providing telehealth rehabilitation services, not just individual doctors and practitioners (Sec. 2(b)).
• Geographic requirements that limited where telehealth rehabilitation services could be delivered no longer apply for cardiac rehabilitation, intensive cardiac rehabilitation, or pulmonary rehabilitation programs (Sec. 2(b)).
• The Secretary of Health and Human Services must create rules establishing standards for how homes can be officially recognized as hospital locations for these rehabilitation programs (Sec. 2(c)).
What Changes
If this becomes law, heart and lung rehabilitation programs can permanently be delivered to patients in their homes using video technology. Hospitals can receive Medicare payment for providing these remote rehabilitation services. The previous geographic restrictions on where these services could be delivered are removed.
Important Definitions
The bill does not provide plain language definitions of cardiopulmonary rehabilitation, cardiac rehabilitation, intensive cardiac rehabilitation, or pulmonary rehabilitation. It references existing definitions from Medicare law but does not explain them in simple terms.
Effective Date
The standards for home-based rehabilitation programs become effective on the first day after the end of the COVID-19 emergency period declared by the federal government (Sec. 2(c)(2)).
I
118TH CONGRESS
1ST SESSION H. R. 1406
To amend title XVIII of the Social Security Act to permanently extend
certain in-home cardiopulmonary rehabilitation flexibilities established in
response to COVID–19, and for other purposes.
IN THE HOUSE OF REPRESENTATIVES
MARCH 7, 2023
Mr. JOYCE of Pennsylvania (for himself and Mr. PETERS) introduced the fol-
lowing bill; which was referred to the Committee on Energy and Com-
merce, and in addition to the Committee on Ways and Means, for a pe-
riod to be subsequently determined by the Speaker, in each case for con-
sideration of such provisions as fall within the jurisdiction of the com-
mittee concerned
A BILL
To amend title XVIII of the Social Security Act to perma-
nently extend certain in-home cardiopulmonary rehabili-
tation flexibilities established in response to COVID–
19, and for other purposes.
Be it enacted by the Senate and House of Representa-
1
tives of the United States of America in Congress assembled,
2
SECTION 1. SHORT TITLE.
3
This Act may be cited as the ‘‘Sustainable
4
Cardiopulmonary Rehabilitation Services in the Home
5
Act’’.
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•HR 1406 IH
SEC. 2. CODIFYING IN-HOME CARDIOPULMONARY REHA-
1
BILITATION FLEXIBILITIES ESTABLISHED IN
2
RESPONSE TO COVID–19.
3
(a) IN GENERAL.—Section 1861(eee)(2) of the Social
4
Security Act (42 U.S.C. 1395x(eee)(2)) is amended—
5
(1) in subparagraph (A)(ii), by inserting ‘‘, in-
6
cluding in the home of an individual when furnished
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as a telehealth service through two-way audio-visual
8
communications technology, or when such home is
9
designated as a provider-based location of a hospital
10
outpatient department’’ after ‘‘outpatient basis’’;
11
and
12
(2) in subparagraph (B), by inserting ‘‘, includ-
13
ing through the virtual presence of such physician,
14
physician assistant, nurse practitioner, or clinical
15
nurse specialist, through two-way audio-visual com-
16
munications technology’’ after ‘‘under the program’’.
17
(b)
EXPANDING
ORIGINATING
SITES.—Section
18
1834(m) of the Social Security Act (42 U.S.C. 1395m(m))
19
is amended—
20
(1) in paragraph (1), by striking ‘‘and (9)’’
21
through ‘‘(as defined in paragraph (4)(E))’’ and in-
22
serting ‘‘, (9), and (10), the Secretary shall pay for
23
telehealth services that are furnished via a tele-
24
communications system by a physician (as defined in
25
section 1861(r)) or a practitioner (as defined in
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•HR 1406 IH
paragraph (4)(E)), or by a hospital (as defined in
1
section 1861(e))’’;
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(2) in paragraph (2)(A), by striking ‘‘or practi-
3
tioner’’ and inserting ‘‘, practitioner, or hospital’’ in
4
each place that it appears;
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(3) in paragraph (4)(A), by striking ‘‘or practi-
6
tioner’’ and inserting ‘‘, practitioner, or hospital’’;
7
(4) in paragraph (4)(C)—
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(A) in clause (i), by striking ‘‘and (7)’’ and
9
inserting ‘‘(7), and (10)’’; and
10
(B) in clause (ii)(X), by striking ‘‘para-
11
graph (7)’’ and inserting ‘‘paragraphs (7) and
12
(10)’’;
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(5) in paragraph (4)(F)(i), by striking ‘‘para-
14
graph (8)’’ and inserting ‘‘paragraphs (8) and (10)’’;
15
and
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(6) by adding at the end the following new
17
paragraph:
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‘‘(10) TREATMENT OF IN-HOME CARDIAC REHA-
19
BILITATION
PROGRAM, INTENSIVE
CARDIAC
REHA-
20
BILITATION PROGRAM, AND PULMONARY REHABILI-
21
TATION PROGRAM VISITS.—Beginning on the first
22
day following the end of the emergency period de-
23
scribed in section 1135(g)(1)(B), the geographic re-
24
quirements described in paragraph (4)(C)(i) shall
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•HR 1406 IH
not apply with respect to telehealth services for car-
1
diac rehabilitation programs and intensive cardiac
2
rehabilitation programs (as such terms are defined
3
in section 1861(eee)) and pulmonary rehabilitation
4
programs (as defined in section 1861(fff)) at an
5
originating site described in subclauses (V) and (X)
6
of paragraph (4)(C)(ii).’’.
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(c) RULEMAKING TO ESTABLISH STANDARDS AND
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ALLOW
FOR CERTAIN PROGRAMS TO UTILIZE TELE-
9
HEALTH SERVICES.—
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(1) IN GENERAL.—The Secretary of Health and
11
Human Services shall promulgate rules to—
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(A) establish standards for the designation
13
of the home of an individual with status as a
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provider-based organization of a hospital con-
15
sistent with waivers issued through the Hospital
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Without Walls program for cardiac rehabilita-
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tion, pulmonary rehabilitation, and intensive
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cardiac rehabilitation; and
19
(B) include cardiac rehabilitation programs
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and intensive cardiac rehabilitation programs
21
(as such terms are defined in section 1861(eee)
22
of
the
Social
Security
Act
(42
U.S.C.
23
1395x(eee)), and pulmonary rehabilitation pro-
24
grams (as defined in section 1861(fff) of such
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•HR 1406 IH
Act (42 U.S.C. 1395x(fff)) among telehealth
1
services
to
be
specified
under
section
2
1834(m)(4)(F)
of
such
Act
(42
U.S.C.
3
1395m(m)(4)(F)).
4
(2) EFFECTIVE DATE.—The standards estab-
5
lished under paragraph (1) shall take effect on the
6
later of the date on which such standards are issued
7
by the Secretary of Health and Human Services, or
8
on the first day after the end of the emergency pe-
9
riod described in section 1135(g)(1)(B) of the Social
10
Security Act (42 U.S.C. 1320b–5(g)(1)(B)).
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Æ
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