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SECTION 1. SHORT TITLE.

This Act may be cited as the ''Pulmonary and Cardiac Rehabilitation
Act of 2005''.

SEC. 2. COVERAGE OF ITEMS AND SERVICES UNDER A CARDIAC REHABILITATION
PROGRAM AND A PULMONARY REHABILITATION PROGRAM.

(a) In General.--Section 1861 of the Social Security Act (42 U.S.C.
1395x) is amended--
(1) in subsection (s)(2)--
(A) in subparagraph (Y), by striking ''and'' at the
end;
(B) in subparagraph (Z), by striking the period at
the end and inserting ''; and''; and
(C) by adding at the end the following new
subparagraph:
''(AA) items and services furnished under a cardiac
rehabilitation program (as defined in subsection (bbb))
or under a pulmonary rehabilitation program (as defined
in subsection (ccc)).''; and
(2) by adding at the end the following new subsections:

''Cardiac Rehabilitation Program

''(bbb)(1) The term 'cardiac rehabilitation program' means a
physician-supervised program (as described in paragraph (2)) that
furnishes the items and services described in paragraph (3).
''(2) A program described in this paragraph is a program under
which--
''(A) items and services under the program are delivered--
''(i) in a physician's office;
''(ii) in a physician-directed clinic; or
''(iii) in a hospital on an outpatient basis;
''(B) a physician is immediately available and accessible
for medical consultation and medical emergencies at all times
items and services are being furnished under the program,
except that, in the case of items and services furnished under
such a program in a hospital, such availability shall be
presumed; and
''(C) individualized treatment is furnished under a written
plan established, reviewed, and signed by a physician every 30
days that describes--
''(i) the patient's diagnosis;
''(ii) the type, amount, frequency, and duration of
the items and services furnished under the plan; and
''(iii) the goals set for the patient under the
plan.
''(3) The items and services described in this paragraph are--
''(A) physician-prescribed exercise;
''(B) cardiac risk factor modification, including
education, counseling, and behavioral intervention (to the
extent such education, counseling, and behavioral intervention
is closely related to the individual's care and treatment and
is tailored to the individual's needs);
''(C) psychosocial assessment;
''(D) outcomes assessment; and
''(E) such other items and services as the Secretary may
determine, but only if such items and services are--
''(i) reasonable and necessary for the diagnosis or
active treatment of the individual's condition;
''(ii) reasonably expected to improve or maintain
the individual's condition and functional level; and
''(iii) furnished under such guidelines relating to
the frequency and duration of such items and services
as the Secretary shall establish, taking into account
accepted norms of medical practice and the reasonable
expectation of patient improvement.
''(4) The Secretary shall establish standards to ensure that a
physician with expertise in the management of patients with cardiac
pathophysiology who is licensed to practice medicine in the State in
which a cardiac rehabilitation program is offered--
''(A) is responsible for such program; and
''(B) in consultation with appropriate staff, is involved
substantially in directing the progress of individual patients
in the program.

''Pulmonary Rehabilitation Program

''(ccc)(1) The term 'pulmonary rehabilitation program' means a
physician-supervised program (as described in subsection (bbb)(2) with
respect to a program under this subsection) that furnishes the items
and services described in paragraph (2).
''(2) The items and services described in this paragraph are--
''(A) physician-prescribed exercise;
''(B) education or training (to the extent the education or
training is closely and clearly related to the individual's
care and treatment and is tailored to such individual's needs);
''(C) psychosocial assessment;
''(D) outcomes assessment; and
''(E) such other items and services as the Secretary may
determine, but only if such items and services are--
''(i) reasonable and necessary for the diagnosis or
active treatment of the individual's condition;
''(ii) reasonably expected to improve or maintain
the individual's condition and functional level; and
''(iii) furnished under such guidelines relating to
the frequency and duration of such items and services
as the Secretary shall establish, taking into account
accepted norms of medical practice and the reasonable
expectation of patient improvement.
''(3) The Secretary shall establish standards to ensure that a
physician with expertise in the management of patients with respiratory
pathophysiology who is licensed to practice medicine in the State in
which a pulmonary rehabilitation program is offered--
''(A) is responsible for such program; and
''(B) in consultation with appropriate staff, is involved
substantially in directing the progress of individual patients
in the program.''.
(b) Effective Date.--The amendments made by this section shall
apply to items and services furnished on or after the date of enactment
of this Act.
Output:
Pulmonary and Cardiac Rehabilitation Act of 2005 - Amends title XVIII (Medicare) of the Social Security Act to provide for coverage of items and services furnished under a cardiac rehabilitation or a pulmonary rehabilitation program.