H.R. 1406 details

Cardiac Rehab (CR) delivered by a hospital has stopped, effective May 11, 2023.  CR is a standard of care, and plenty of data has supported virtual CR, including recent studies with a 40% reduction in death rates for cardiac patients.  

The below is a technical bill summary of H.R. 1406. Click here for H.R. 1406 on Congress.gov.

 “Sustainable Cardiopulmonary Rehabilitation Services in the Home Act”

This bill extends what is currently in place with respect to virtual cardiac and pulmonary rehabilitation.  

• Section 1861 (eee)(2)(A)(ii):  Allows for virtual cardiac (CR) and intensive cardiac (ICR) to be furnished via “two-way audio-visual communications” (virtual).  Any modifications to Section 1861(eee) also are mirrored for pulmonary rehabilitation (PR), as referenced in the current statute of Section 1861(fff).

• For hospital outpatient departments, this was allowed during the PHE, so the bill resumes and protects this flexibility.  One drawback with the flexibility (Hospital Without Walls) required hospital departments to request for each and every patient an extraordinary circumstances request from the Medicare Administrative Contractor to perform this service virtually.  To reduce this administrative burden, the bill also adds virtual CR/ICR/PR as a specific program that can be performed via telehealth.

• Section 1861 (eee)(2)(B):  Allows the virtual presence of a provider to supervise a virtual CR/ICR/PR program, whether this program is delivered from a physician’s office or a hospital-based outpatient department.  No new provider types are added to this bill, as non-physician providers listed will already be added to statute, effective January 1, 2024. 

• Section 1834(m):  Allows virtual CR/ICR/PR to be performed via telehealth, whether out of a physician’s/practitioner’s office or a hospital.  

• Section 1834(m)(10):  After the PHE, this new section specifically carves out the ability for virtual CR/ICR/PR to be performed via telehealth in the same manner that mental health services are carved out in Section 1834(m)(7).