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<bill bill-stage="Introduced-in-House" bill-type="olc" dms-id="HC133BDC1A2EC471AAEB1DBDE98D35537" key="H" public-private="public"><metadata xmlns:dc="http://purl.org/dc/elements/1.1/">
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<dc:title>115 HR 4136 IH: Strengthening Medicare Intensive Cardiac Rehabilitation Programs Act</dc:title>
<dc:publisher>U.S. House of Representatives</dc:publisher>
<dc:date>2017-10-25</dc:date>
<dc:format>text/xml</dc:format>
<dc:language>EN</dc:language>
<dc:rights>Pursuant to Title 17 Section 105 of the United States Code, this file is not subject to copyright protection and is in the public domain.</dc:rights>
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<distribution-code display="yes">I</distribution-code><congress display="yes">115th CONGRESS</congress><session display="yes">1st Session</session><legis-num display="yes">H. R. 4136</legis-num><current-chamber>IN THE HOUSE OF REPRESENTATIVES</current-chamber><action display="yes"><action-date date="20171025">October 25, 2017</action-date><action-desc><sponsor name-id="S001195">Mr. Smith of Missouri</sponsor> (for himself, <cosponsor name-id="E000215">Ms. Eshoo</cosponsor>, <cosponsor name-id="M001190">Mr. Mullin</cosponsor>, and <cosponsor name-id="B001287">Mr. Bera</cosponsor>) introduced the following bill; which was referred to the <committee-name committee-id="HIF00">Committee on Energy and Commerce</committee-name>, and in addition to the Committee on <committee-name committee-id="HWM00">Ways and Means</committee-name>, 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</action-desc></action><legis-type>A BILL</legis-type><official-title display="yes">To amend title XVIII of the Social Security Act to strengthen intensive cardiac rehabilitation
			 programs under the Medicare program.</official-title></form>
	<legis-body id="HC074E947867D4CC9A3D7BD2B8380E102" style="OLC">
 <section id="HC4CDDA18F99144AA9BDE81B3B2527BA7" section-type="section-one"><enum>1.</enum><header>Short title</header><text display-inline="no-display-inline">This Act may be cited as the <quote><short-title>Strengthening Medicare Intensive Cardiac Rehabilitation Programs Act</short-title></quote>.</text> </section><section id="HB7C6D009FF6D4204956DD63DFB28F0E7"><enum>2.</enum><header>Revised requirements for Medicare intensive cardiac rehabilitation programs</header><text display-inline="no-display-inline">Section 1861(eee)(4) of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1395x">42 U.S.C. 1395x(eee)(4)</external-xref>) is amended—</text>
 <paragraph id="HD9BBD97D27BF46E4AEA767E3BF334748"><enum>(1)</enum><text>in subparagraph (A)—</text> <subparagraph id="H7C779A21C35D4D82A0BDD38D674B174E"><enum>(A)</enum><text>in the matter preceding clause (i)—</text>
 <clause id="HE3F14EA75BD947D8A9B4609D0BBCBA64"><enum>(i)</enum><text>by striking <quote>physician-supervised program (as described in paragraph (2))</quote> and inserting <quote>program (supervised as described in paragraph (2) for cardiac rehabilitation)</quote>; and</text> </clause><clause id="H8311364925D54E3AB562E32D339AAA34"><enum>(ii)</enum><text>by striking <quote>, in peer-reviewed published research, that it accomplished</quote> and inserting <quote>in peer-reviewed published research specific to the exact program, that, notwithstanding other concurrent therapies, including prescription drugs, by lifestyle changes alone it accomplished</quote>;</text>
 </clause></subparagraph><subparagraph id="HAE04C7A01F314DE78739F58968B54E52"><enum>(B)</enum><text>in clause (i)—</text> <clause id="H2CAAD397BE334104B02D8BF47C11A8FE"><enum>(i)</enum><text>in subclause (I), by striking <quote>positively affected</quote> and inserting <quote>reversed</quote>;</text>
 </clause><clause id="H4ECCFA444D9E47BC94439B5CC509F4B7"><enum>(ii)</enum><text>in subclause (II), by striking <quote>or</quote> and inserting <quote>and</quote>; and</text> </clause><clause id="HB35D13204E4E4A379119E3F18E033CFC"><enum>(iii)</enum><text>by striking subclause (III);</text>
 </clause></subparagraph><subparagraph id="HCD8B26C072D24732A982AF212123870F"><enum>(C)</enum><text>in clause (ii), in the matter preceding subclause (I), by inserting <quote>both a statistically significant increase in the measure of blood flow to the heart when compared to a control group and</quote> before <quote>a statistically significant</quote>; and</text>
 </subparagraph><subparagraph id="H5AA9742280FF43C290D9616698097310"><enum>(D)</enum><text>by adding at the end the following new sentence:</text> <quoted-block display-inline="no-display-inline" id="HC06D6D431514419AB602CD637AE5A66E" style="OLC"> <quoted-block-continuation-text indent="up1" quoted-block-continuation-text-level="subparagraph">Any program that the Secretary approved under this paragraph before the date of the enactment of the <short-title>Strengthening Medicare Intensive Cardiac Rehabilitation Programs Act</short-title> 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.</quoted-block-continuation-text><after-quoted-block>; and</after-quoted-block></quoted-block> </subparagraph></paragraph><paragraph id="H938B7E6CBFAF408CAFBA9E038CA1F1AD"><enum>(2)</enum><text>in subparagraph (B)—</text>
 <subparagraph id="H6FF220CF3EA344FE951FDFB98B112F10"><enum>(A)</enum><text>in clause (v), by striking at the end <quote>or</quote>;</text> </subparagraph><subparagraph id="HC432E055C7E24FC195C5E580410559A4"><enum>(B)</enum><text>in clause (vi), by striking at the end the period; and</text>
 </subparagraph><subparagraph id="H24E50E0CBAD44DBB8A2398E1A99BFAC9"><enum>(C)</enum><text>by adding at the end the following new clauses:</text> <quoted-block display-inline="no-display-inline" id="H65DE59CF12D4438BA0FA95E0559B2056" style="OLC"> <clause id="H7F52D797686B4F789E9B855C5C7F4E77" indent="up1"><enum>(vii)</enum><text display-inline="yes-display-inline">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</text>
 </clause><clause id="H747C2F76D97B4C309B8E06FB34A04091" indent="up1"><enum>(viii)</enum><text display-inline="yes-display-inline">any additional condition for which the Secretary has determined that a cardiac rehabilitation program shall be covered.</text></clause><after-quoted-block>.</after-quoted-block></quoted-block>
				</subparagraph></paragraph></section></legis-body></bill>


