I 
117TH CONGRESS 
2D SESSION 
H. R. 9427 
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 
DECEMBER 5, 2022 
Mr. JOYCE of Pennsylvania (for himself, Mr. O’HALLERAN, Mr. PANETTA, 
and Mr. DUNN) 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 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-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Sustainable 
Cardiopulmonary Rehabilitation Services in the Home 
Act’’. 
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SEC. 2. CODIFYING IN-HOME CARDIOPULMONARY REHA-
BILITATION FLEXIBILITIES ESTABLISHED IN 
RESPONSE TO COVID–19. 
(a) IN GENERAL.—Section 1861(eee)(2) of the Social 
Security Act (42 U.S.C. 1395x(eee)(2)) is amended— 
(1) in subparagraph (A)(ii), by inserting ‘‘, in-
cluding in the home of an individual when furnished 
as a telehealth service through two-way audio-visual 
communications technology, or when such home is 
designated as a provider-based location of a hospital 
outpatient department’’ after ‘‘outpatient basis’’; 
and 
(2) in subparagraph (B), by inserting ‘‘, includ-
ing through the virtual presence of such physician, 
physician assistant, nurse practitioner, or clinical 
nurse specialist, through two-way audio-visual com-
munications technology’’ after ‘‘under the program’’. 
(b) 
EXPANDING
ORIGINATING
SITES.—Section 
1834(m) of the Social Security Act (42 U.S.C. 1395m(m)) 
is amended— 
(1) in paragraph (1), by striking ‘‘and (9)’’ 
through ‘‘(as defined in paragraph (4)(E))’’ and in-
serting ‘‘, (9), and (10), the Secretary shall pay for 
telehealth services that are furnished via a tele-
communications system by a physician (as defined in 
section 1861(r)) or a practitioner (as defined in 
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paragraph (4)(E)), or by a hospital (as defined in 
section 1861(e))’’; 
(2) in paragraph (2)(A), by striking ‘‘or practi-
tioner’’ and inserting ‘‘, practitioner, or hospital’’ in 
each place that it appears; 
(3) in paragraph (4)(A), by striking ‘‘or practi-
tioner’’ and inserting ‘‘, practitioner, or hospital’’; 
(4) in paragraph (4)(C)— 
(A) in clause (i), by striking ‘‘and (7)’’ and 
inserting ‘‘(7), and (10)’’; and 
(B) in clause (ii)(X), by striking ‘‘para-
graph (7)’’ and inserting ‘‘paragraphs (7) and 
(10)’’; 
(5) in paragraph (4)(F)(i), by striking ‘‘para-
graph (8)’’ and inserting ‘‘paragraphs (8) and (10)’’; 
and 
(6) by adding at the end the following new 
paragraph: 
‘‘(10) TREATMENT OF IN-HOME CARDIAC REHA-
BILITATION
PROGRAM, INTENSIVE
CARDIAC
REHA-
BILITATION PROGRAM, AND PULMONARY REHABILI-
TATION PROGRAM VISITS.—Beginning on the first 
day following the end of the emergency period de-
scribed in section 1135(g)(1)(B), the geographic re-
quirements described in paragraph (4)(C)(i) shall 
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not apply with respect to telehealth services for car-
diac rehabilitation programs and intensive cardiac 
rehabilitation programs (as such terms are defined 
in section 1861(eee)) and pulmonary rehabilitation 
programs (as defined in section 1861(fff)) at an 
originating site described in subclauses (V) and (X) 
of paragraph (4)(C)(ii).’’. 
(c) RULEMAKING TO ESTABLISH STANDARDS AND 
ALLOW
FOR CERTAIN PROGRAMS TO UTILIZE TELE-
HEALTH SERVICES.— 
(1) IN GENERAL.—The Secretary of Health and 
Human Services shall promulgate rules to— 
(A) establish standards for the designation 
of the home of an individual with status as a 
provider-based organization of a hospital con-
sistent with waivers issued through the Hospital 
Without Walls program for cardiac rehabilita-
tion, pulmonary rehabilitation, and intensive 
cardiac rehabilitation; and 
(B) include cardiac rehabilitation programs 
and intensive cardiac rehabilitation programs 
(as such terms are defined in section 1861(eee) 
of 
the 
Social 
Security 
Act 
(42 
U.S.C. 
1395x(eee)), and pulmonary rehabilitation pro-
grams (as defined in section 1861(fff) of such 
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Act (42 U.S.C. 1395x(fff)) among telehealth 
services 
to 
be 
specified 
under 
section 
1834(m)(4)(F) 
of 
such 
Act 
(42 
U.S.C. 
1395m(m)(4)(F)). 
(2) EFFECTIVE DATE.—The standards estab-
lished under paragraph (1) shall take effect on the 
later of the date on which such standards are issued 
by the Secretary of Health and Human Services, or 
on the first day after the end of the emergency pe-
riod described in section 1135(g)(1)(B) of the Social 
Security Act (42 U.S.C. 1320b–5(g)(1)(B)). 
Æ 
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