Strengthening Medicare Intensive Cardiac Rehabilitation Programs Act

To amend title XVIII of the Social Security Act to strengthen intensive cardiac rehabilitation programs under the Medicare program. 1. Short title This Act may be cited as the Strengthening Medicare Intensive Cardiac Rehabilitation Programs Act 2. Revised requirements for Medicare intensive cardiac rehabilitation programs Section 1861(eee)(4) of the Social Security Act ( 42 U.S.C. 1395x(eee)(4) (1) in subparagraph (A)— (A) in the matter preceding clause (i)— (i) by striking physician-supervised program (as described in paragraph (2)) program (supervised as described in paragraph (2) for cardiac rehabilitation) (ii) by striking , in peer-reviewed published research, that it accomplished in peer-reviewed published research specific to the exact program, that, notwithstanding other concurrent therapies, including prescription drugs, by lifestyle changes alone it accomplished (B) in clause (i)— (i) in subclause (I), by striking positively affected reversed (ii) in subclause (II), by striking or and (iii) by striking subclause (III); (C) in clause (ii), in the matter preceding subclause (I), by inserting both a statistically significant increase in the measure of blood flow to the heart when compared to a control group and a statistically significant (D) by adding at the end the following new sentence: Any program that the Secretary approved under this paragraph before the date of the enactment of the Strengthening Medicare Intensive Cardiac Rehabilitation Programs Act ; and (2) in subparagraph (B)— (A) in clause (v), by striking at the end or (B) in clause (vi), by striking at the end the period; and (C) by adding at the end the following new clauses: (vii) stable, chronic heart failure (defined as patients with left ventricular ejection fraction of 35 percent or less and New York Heart Association (NYHA) class II to IV symptoms despite being on optimal heart failure therapy for at least 6 weeks); or (viii) any additional condition for which the Secretary has determined that a cardiac rehabilitation program shall be covered. .

Summary: Strengthening Medicare Intensive Cardiac Rehabilitation Programs Act This bill amends title XVIII (Medicare) of the Social Security Act to revise requirements related the approval of intensive cardiac rehabilitation programs by the Centers for Medicare & Medicaid Services (CMS) for purposes of Medicare coverage. To be approved by the CMS as an intensive cardiac rehabilitation program under current law, a program must show that it: (1) positively affected the progression of coronary heart disease or reduced the need for either coronary bypass surgery or percutaneous coronary interventions, and (2) accomplished a significant reduction in other specified health measures. The bill instead requires a program to show that it: (1) reversed the progression of coronary heart disease or reduced the need for coronary bypass surgery; and (2) accomplished, in addition to a significant reduction in other specified health measures, a significant increase in the measure of blood flow to the heart. The bill further requires a program to show, using research specific to its own program, that these measures were accomplished by lifestyle changes alone. The bill removes the specific requirement that such a program be "physician-supervised" but retains other existing requirements for program supervision. A program that was previously approved by the CMS as an intensive cardiac rehabilitation program shall be deemed to have met these requirements. To be eligible for an intensive cardiac rehabilitation program under current law, an individual must have had one of several specified conditions or interventions. The bill adds to the list of qualifying conditions: (1) stable, chronic heart failure; and (2) any additional condition that the CMS determines shall be covered under such a program.