II
119THCONGRESS
1
STSESSION S. 248
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.
IN THE SENATE OF THE UNITED STATES
JANUARY24, 2025
Mrs. B
LACKBURN(for herself and Ms. KLOBUCHAR) introduced the following
bill; which was read twice and referred to the Committee on Finance
A BILL
To amend title XVIII of the Social Security Act to perma-
nently extend certain in-home cardiopulmonary rehabili-
tation flexibilities established in response to COVID–
19, and for other purposes.
Be it enacted by the Senate and House of Representa-1
tives of the United States of America in Congress assembled, 2
SECTION 1. SHORT TITLE. 3
This Act may be cited as the ‘‘Sustainable 4
Cardiopulmonary Rehabilitation Services in the Home 5
Act’’. 6
VerDate Sep 11 2014 21:42 Feb 19, 2025 Jkt 059200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\S248.IS S248
kjohnson on DSK7ZCZBW3PROD with $$_JOB 2
•S 248 IS
SEC. 2. CODIFYING VIRTUAL CARDIOPULMONARY REHA-1
BILITATION FLEXIBILITIES ESTABLISHED IN 2
RESPONSE TO COVID–19. 3
(a) I
NGENERAL.—Section 1861(eee)(2) of the Social 4
Security Act (42 U.S.C. 1395x(eee)(2)) is amended— 5
(1) in subparagraph (A)(ii), by inserting ‘‘, in-6
cluding in the home of an individual when furnished 7
as a telehealth service through audio-visual real-time 8
communications technology, or when such home is 9
designated as a provider-based location of a hospital 10
outpatient department’’ after ‘‘outpatient basis’’; 11
and 12
(2) in subparagraph (B), by inserting ‘‘, includ-13
ing through the virtual presence of such physician, 14
physician assistant, nurse practitioner, or clinical 15
nurse specialist, through audio-visual real-time com-16
munications technology’’ after ‘‘under the program’’. 17
(b) E
XPANDING ORIGINATING SITES.—Section 18
1834(m) of the Social Security Act (42 U.S.C. 1395m(m)) 19
is amended— 20
(1) in paragraph (1), by striking ‘‘and (9)’’ and 21
all that follows through ‘‘(as defined in paragraph 22
(4)(E))’’ and inserting ‘‘, (9), and (10), the Sec-23
retary shall pay for telehealth services that are fur-24
nished via a telecommunications system by a physi-25
cian (as defined in section 1861(r)) or a practitioner 26
VerDate Sep 11 2014 21:42 Feb 19, 2025 Jkt 059200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\S248.IS S248
kjohnson on DSK7ZCZBW3PROD with $$_JOB 3
•S 248 IS
(as defined in paragraph (4)(E)), or by a hospital 1
(as defined in section 1861(e))’’; 2
(2) in paragraph (2)(A), by striking ‘‘or practi-3
tioner’’ each place that it appears and inserting ‘‘, 4
practitioner, or hospital’’; 5
(3) in paragraph (4)(A), by striking ‘‘or practi-6
tioner’’ and inserting ‘‘, practitioner, or hospital’’; 7
(4) in paragraph (4)(C)— 8
(A) in clause (i), by striking ‘‘and (7)’’ and 9
inserting ‘‘(7), and (10)’’; and 10
(B) in clause (ii)(X), by striking ‘‘para-11
graph (7)’’ and inserting ‘‘paragraphs (7) and 12
(10)’’; 13
(5) in paragraph (4)(F)(i), by striking ‘‘para-14
graph (8)’’ and inserting ‘‘paragraphs (8) and (10)’’; 15
and 16
(6) by adding at the end the following new 17
paragraph: 18
‘‘(10) T
REATMENT OF CARDIAC REHABILITA -19
TION PROGRAM, INTENSIVE CARDIAC REHABILITA -20
TION PROGRAM, AND PULMONARY REHABILITATION 21
PROGRAM VISITS FURNISHED THROUGH TELE -22
HEALTH.—In the case of items and services fur-23
nished on or after January 1, 2026, the geographic 24
requirements described in paragraph (4)(C)(i) shall 25
VerDate Sep 11 2014 21:42 Feb 19, 2025 Jkt 059200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\S248.IS S248
kjohnson on DSK7ZCZBW3PROD with $$_JOB 4
•S 248 IS
not apply with respect to telehealth services for car-1
diac rehabilitation programs and intensive cardiac 2
rehabilitation programs (as such terms are defined 3
in section 1861(eee)) and pulmonary rehabilitation 4
programs (as defined in section 1861(fff)) at an 5
originating site described in subclause (V) or (X) of 6
paragraph (4)(C)(ii).’’. 7
(c) A
UTHORITYTOESTABLISHSTANDARDS AND 8
A
LLOW FOR CERTAINPROGRAMSTOUTILIZETELE-9
HEALTHSERVICES.— 10
(1) I
N GENERAL.—Not later than 30 days after 11
the date of enactment of this section, the Secretary 12
of Health and Human Services shall— 13
(A) establish standards for the designation 14
of the home of an individual with status as a 15
provider-based organization of a hospital con-16
sistent with waivers issued through the Hospital 17
Without Walls program for cardiac rehabilita-18
tion, pulmonary rehabilitation, and intensive 19
cardiac rehabilitation; and 20
(B) include items and services furnished 21
under a cardiac rehabilitation program or under 22
an intensive cardiac rehabilitation program (as 23
such terms are defined in section 1861(eee) of 24
the Social Security Act (42 U.S.C. 1395x(eee)), 25
VerDate Sep 11 2014 04:26 Feb 21, 2025 Jkt 059200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\S248.IS S248
kjohnson on DSK7ZCZBW3PROD with $$_JOB 5
•S 248 IS
or under a pulmonary rehabilitation program 1
(as defined in section 1861(fff) of such Act (42 2
U.S.C. 1395x(fff)) among telehealth services to 3
be specified under section 1834(m)(4)(F) of 4
such Act (42 U.S.C. 1395m(m)(4)(F)). 5
(2) E
FFECTIVE DATE.—The standards estab-6
lished under paragraph (1) shall apply to items and 7
services furnished on or after January 1, 2026. 8
(d) I
MPLEMENTATION.—Notwithstanding any other 9
provision of the law, the Secretary of Health and Human 10
Services may implement the provisions of, and the amend-11
ments made by, this section by program instruction or oth-12
erwise. 13
(e) E
FFECTIVEDATE.—The amendments made by 14
subsections (a) and (b) shall apply to items and services 15
furnished on or after January 1, 2026. 16
Æ
VerDate Sep 11 2014 21:42 Feb 19, 2025 Jkt 059200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6301 E:\BILLS\S248.IS S248
kjohnson on DSK7ZCZBW3PROD with $$_JOB