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 following bill; which was referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, 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 permanently extend certain in-home cardiopulmonary rehabilitation flexibilities established in response to COVID– 

19, and for other purposes. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Sustainable 

5 Cardiopulmonary Rehabilitation Services in the Home 

6 Act’’. 


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1 SEC. 2. CODIFYING IN-HOME CARDIOPULMONARY REHA2 BILITATION FLEXIBILITIES ESTABLISHED IN 

3 RESPONSE TO COVID–19. 

4 (a) IN GENERAL.—Section 1861(eee)(2) of the Social 

5 Security Act (42 U.S.C. 1395x(eee)(2)) is amended— 

6 (1) in subparagraph (A)(ii), by inserting ‘‘, in7 cluding in the home of an individual when furnished 

8 as a telehealth service through two-way audio-visual 

9 communications technology, or when such home is 

10 designated as a provider-based location of a hospital 

11 outpatient department’’ after ‘‘outpatient basis’’; 

12 and 

13 (2) in subparagraph (B), by inserting ‘‘, includ14 ing through the virtual presence of such physician, 

15 physician assistant, nurse practitioner, or clinical 

16 nurse specialist, through two-way audio-visual com17 munications technology’’ after ‘‘under the program’’. 

18 (b) EXPANDING ORIGINATING SITES.—Section 

19 1834(m) of the Social Security Act (42 U.S.C. 1395m(m)) 

20 is amended— 

21 (1) in paragraph (1), by striking ‘‘and (9)’’ 

22 through ‘‘(as defined in paragraph (4)(E))’’ and in23 serting ‘‘, (9), and (10), the Secretary shall pay for 

24 telehealth services that are furnished via a tele25 communications system by a physician (as defined in 

26 section 1861(r)) or a practitioner (as defined in 


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1 paragraph (4)(E)), or by a hospital (as defined in 

2 section 1861(e))’’; 

3 (2) in paragraph (2)(A), by striking ‘‘or practi4 tioner’’ and inserting ‘‘, practitioner, or hospital’’ in 

5 each place that it appears; 

6 (3) in paragraph (4)(A), by striking ‘‘or practi7 tioner’’ and inserting ‘‘, practitioner, or hospital’’; 

8 (4) in paragraph (4)(C)— 

9 (A) in clause (i), by striking ‘‘and (7)’’ and 

10 inserting ‘‘(7), and (10)’’; and 

11 (B) in clause (ii)(X), by striking ‘‘para12 graph (7)’’ and inserting ‘‘paragraphs (7) and 

13 (10)’’; 

14 (5) in paragraph (4)(F)(i), by striking ‘‘para15 graph (8)’’ and inserting ‘‘paragraphs (8) and (10)’’; 

16 and 

17 (6) by adding at the end the following new 

18 paragraph: 

19 ‘‘(10) TREATMENT OF IN-HOME CARDIAC REHA20 BILITATION PROGRAM, INTENSIVE CARDIAC REHA21 BILITATION PROGRAM, AND PULMONARY REHABILI22 TATION PROGRAM VISITS.—Beginning on the first 

23 day following the end of the emergency period de24 scribed in section 1135(g)(1)(B), the geographic re25 quirements described in paragraph (4)(C)(i) shall 


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1 not apply with respect to telehealth services for car2 diac rehabilitation programs and intensive cardiac 

3 rehabilitation programs (as such terms are defined 

4 in section 1861(eee)) and pulmonary rehabilitation 

5 programs (as defined in section 1861(fff)) at an 

6 originating site described in subclauses (V) and (X) 

7 of paragraph (4)(C)(ii).’’. 

8 (c) RULEMAKING TO ESTABLISH STANDARDS AND

9 ALLOW FOR CERTAIN PROGRAMS TO UTILIZE TELE10 HEALTH SERVICES.— 

11 (1) IN GENERAL.—The Secretary of Health and 

12 Human Services shall promulgate rules to— 

13 (A) establish standards for the designation 

14 of the home of an individual with status as a 

15 provider-based organization of a hospital con16 sistent with waivers issued through the Hospital 

17 Without Walls program for cardiac rehabilita18 tion, pulmonary rehabilitation, and intensive 

19 cardiac rehabilitation; and 

20 (B) include cardiac rehabilitation programs 

21 and intensive cardiac rehabilitation programs 

22 (as such terms are defined in section 1861(eee) 

23 of the Social Security Act (42 U.S.C. 

24 1395x(eee)), and pulmonary rehabilitation pro25 grams (as defined in section 1861(fff) of such 


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1 Act (42 U.S.C. 1395x(fff)) among telehealth 

2 services to be specified under section 

3 1834(m)(4)(F) of such Act (42 U.S.C. 

4 1395m(m)(4)(F)). 

5 (2) EFFECTIVE DATE.—The standards estab6 lished under paragraph (1) shall take effect on the 

7 later of the date on which such standards are issued 

8 by the Secretary of Health and Human Services, or 

9 on the first day after the end of the emergency pe10 riod described in section 1135(g)(1)(B) of the Social 

11 Security Act (42 U.S.C. 1320b–5(g)(1)(B)). 

Æ 


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