I 117th CONGRESS 2d Session H. R. 9427 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 permanently extend certain in-home cardiopulmonary rehabilitation flexibilities established in response to COVID–19, and for other purposes.

1. Short title This Act may be cited as the Sustainable Cardiopulmonary Rehabilitation Services in the Home Act . 2. Codifying in-home cardiopulmonary rehabilitation 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 , including 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 , including through the virtual presence of such physician, physician assistant, nurse practitioner, or clinical nurse specialist, through two-way audio-visual communications 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 inserting , (9), and (10), the Secretary shall pay for telehealth services that are furnished via a telecommunications system by a physician (as defined in section 1861(r)) or a practitioner (as defined in paragraph (4)(E)), or by a hospital (as defined in section 1861(e)) ; (2) in paragraph (2)(A), by striking or practitioner and inserting , practitioner, or hospital in each place that it appears; (3) in paragraph (4)(A), by striking or practitioner 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 paragraph (7) and inserting paragraphs (7) and (10) ; (5) in paragraph (4)(F)(i), by striking paragraph (8) and inserting paragraphs (8) and (10) ; and (6) by adding at the end the following new paragraph: (10) Treatment of in-home cardiac rehabilitation program, intensive cardiac rehabilitation program, and pulmonary rehabilitation program visits Beginning on the first day following the end of the emergency period described in section 1135(g)(1)(B), the geographic requirements described in paragraph (4)(C)(i) shall not apply with respect to telehealth services for cardiac 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 telehealth 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 consistent with waivers issued through the Hospital Without Walls program for cardiac rehabilitation, 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 programs (as defined in section 1861(fff) of such 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 established 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 period described in section 1135(g)(1)(B) of the Social Security Act ( 42 U.S.C. 1320b–5(g)(1)(B) ).