S 46 — Strengthening Medicare Intensive Cardiac Rehabilitation Programs Act of 2017

Summary

Strengthening Medicare Intensive Cardiac Rehabilitation Programs Act of 2017 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 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 of 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 approved by CMS as an intensive cardiac rehabilitation program prior to August 1, 2015, 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 CMS determines shall be covered under such a program.

Bill Text

• Introduced Introduced in Senate Current html January 05, 2017

Compared against current U.S. Code AI-generated reading aid — verify against the official bill.

The bill amends the requirements for Medicare's intensive cardiac rehabilitation programs to strengthen their standards and coverage conditions.

• 42 U.S.C. 1395x(eee)(4)

  physician-supervised program (as described in paragraph (2)) → program (supervised as described in paragraph (2))

  The change removes the requirement that the program be specifically labeled as 'physician-supervised'.

• 42 U.S.C. 1395x(eee)(4)

  , in peer-reviewed published research, that it accomplished → in peer-reviewed published research of its own program, that by lifestyle changes alone it accomplished

  This modifies the language to emphasize that the program's outcomes are based on its own research focused on lifestyle changes.

• 42 U.S.C. 1395x(eee)(4)

  positively affected → reversed

  This alters the requirement regarding patient health outcomes from 'positively affected' to 'reversed', indicating a stronger standard.

• 42 U.S.C. 1395x(eee)(4)

  or → and

  This change requires that both specified health outcomes be present, indicating a stricter criteria.

• 42 U.S.C. 1395x(eee)(4)

  subclause (III)

  This removes the third criterion for program approval, potentially simplifying the requirements.

• 42 U.S.C. 1395x(eee)(4)

  both a statistically significant increase in the measure of blood flow to the heart when compared to a control group and

  This addition requires new programs to demonstrate a significant increase in blood flow to the heart in comparison to a control group.

• 42 U.S.C. 1395x(eee)(4)

  Programs that the Secretary approved under this paragraph before August 1, 2015, as intensive cardiac rehabilitation programs according to the requirements under this subparagraph before the date of the enactment of the Strengthening Medicare Intensive Cardiac Rehabilitation Programs Act of 2017 shall be deemed to meet the requirements under this subparagraph applied pursuant to the amendments made by such Act.

  This provision ensures that previously approved programs are grandfathered in under the new requirements.

• 42 U.S.C. 1395x(eee)(4)

  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)

  This adds a new condition for coverage under cardiac rehabilitation programs, expanding eligibility.

• 42 U.S.C. 1395x(eee)(4)

  any additional condition for which the Secretary has determined that a cardiac rehabilitation program shall be covered.

  This allows for flexibility in coverage, enabling the inclusion of additional conditions as determined by the Secretary.

Action History

1. January 05, 2017

   Introduced in Senate

2. January 05, 2017

   Read twice and referred to the Committee on Finance.

Sponsors

• Dean Heller · Primary

Subjects