Title: Strengthening Medicare Intensive Cardiac Rehabilitation Programs Act
Policy area: Health

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.

[Congressional Bills 115th Congress]
[From the U.S. Government Publishing Office]
[H.R. 4136 Introduced in House (IH)]

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115th CONGRESS
  1st Session
                                H. R. 4136

To amend title XVIII of the Social Security Act to strengthen intensive 
      cardiac rehabilitation programs under the Medicare program.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                            October 25, 2017

  Mr. Smith of Missouri (for himself, Ms. Eshoo, Mr. Mullin, and Mr. 
    Bera) 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 strengthen intensive 
      cardiac rehabilitation programs under the Medicare program.

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

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Strengthening Medicare Intensive 
Cardiac Rehabilitation Programs Act''.

SEC. 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)) is amended--
            (1) in subparagraph (A)--
                    (A) in the matter preceding clause (i)--
                            (i) by striking ``physician-supervised 
                        program (as described in paragraph (2))'' and 
                        inserting ``program (supervised as described in 
                        paragraph (2) for cardiac rehabilitation)''; 
                        and
                            (ii) by striking ``, in peer-reviewed 
                        published research, that it accomplished'' and 
                        inserting ``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'' and inserting 
                        ``reversed'';
                            (ii) in subclause (II), by striking ``or'' 
                        and inserting ``and''; 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'' before 
                ``a statistically significant''; and
                    (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 as an intensive cardiac 
rehabilitation program according to the requirements under this 
subparagraph as in effect before such date shall be deemed to meet the 
requirements under this subparagraph applied pursuant to the amendments 
made by such 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.''.
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