,i  #aaeth ,,congress  #ast ,session    
,h4 ,r4 #dacf  ,,in ,,the ,,house ,,of  
,,representatives  ,october #be1        
#bjag,mr4 ,smith of ,missouri 7for      
himself1 ,ms4 ,eshoo1 ,mr4 ,mullin1 and 
,mr4 ,bera7 introduced the following    
bill2 which was referred to the         
,committee on ,energy and ,commerce1 and
 in addition to the ,committee on ,ways 
and ,means1 for a period to be          
subsequently determined by the ,speaker1
 in each case for consideration of such 
provisions as fall within the           
jurisdiction of the committee concerned 
,a ,,bill  ,to amend title ,,xviii of   
the ,social ,security ,act to strengthen
 intensive cardiac rehabilitation       
programs under the ,medicare program4   
#a4 ,short title ,this ,act may be cited
 as the ,strengthening ,medicare        
,intensive ,cardiac ,rehabilitation     
,programs ,act4  #b4 ,revised           
requirements for ,medicare intensive    
cardiac rehabilitation programs ,section
 #ahfa7;eee77#d7 of the ,social         

,security ,act 7#db ,u4,s4,c4           
#aciex7eee77#d77 is amended--  7#a7 in  
subparagraph 7,a7-- 7,a7 in the matter  
preceding clause 7i7--  7i7 by striking 
physician-supervised program 7as        
described in paragraph 7#b77 and        
inserting program 7supervised as        
described in paragraph 7#b7 for cardiac 
rehabilitation72 and  7ii7 by striking 1
 in peer-reviewed published research1   
that it accomplished and inserting in   
peer-reviewed published research        
specific to the exact program1 that1    
notwithstanding other concurrent        
therapies1 including prescription drugs1
 by lifestyle changes alone it          
accomplished2  7,b7 in clause 7i7-- 7i7 
in subclause 7,i71 by striking          
positively affected and inserting       
reversed2  7ii7 in subclause 7,,ii71 by 
striking or and inserting and2 and      
7iii7 by striking subclause 7,,iii72    
7,c7 in clause 7ii71 in the matter      
preceding subclause 7,i71 by inserting  
both a statistically significant        

increase in the measure of blood flow to
 the heart when compared to a control   
group and before a statistically        
significant2 and  7,d7 by adding at the 
end the following new sentence3 ,any    
program that the ,secretary approved    
under this paragraph before the date of 
the enactment of the ,strengthening     
,medicare ,intensive ,cardiac           
,rehabilitation ,programs ,act 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 ,act4 2 and  7#b7 in            
subparagraph 7,b7--  7,a7 in clause 7v71
 by striking at the end or2  7,b7 in    
clause 7vi71 by striking at the end the 
period2 and  7,c7 by adding at the end  
the following new clauses3  7vii7       
stable1 chronic heart failure 7defined  
as patients with left ventricular       
ejection fraction of #ce percent or less

 and ,new ,york ,heart ,association     
7,,nyha7 class ,,ii to ,,iv symptoms    
despite being on optimal heart failure  
therapy for at least #f weeks72 or      
7viii7 any additional condition for     
which the ,secretary has determined that
 a cardiac rehabilitation program shall 
be covered4  4