,,ii #aahth ,,congress #ast ,session ,s4 #cjba ,,in ,,the ,,senate ,,of ,,the ,,united ,,states ,october #d1 #bjbc,ms4 ,sinema 7for herself1 ,mrs4 ,blackburn1 and ,ms4 ,klobuchar7 introduced the following bill2 which was read twice and referred to the ,committee on ,finance ,a ,,bill ,to amend title ,,xviii of the ,social ,security ,act to permanently extend certain in-home cardiopulmonary rehabilitation flexibilities established in response to ,,covid-#ai1 and for other purposes4 #a4 ,short title ,this ,act may be cited as the ,sustainable ,cardiopulmonary ,rehabilitation ,services in the ,home ,act4 #b4 ,codifying virtual cardiopulmonary rehabilitation flexibilities established in response to ,,covid-#ai 7a7 ,in general ,section #ahfa7;eee77#b7 of the ,social ,security ,act 7#db ,u4,s4,c4 #aciex7eee77#b77 is amended-- 7#a7 in subparagraph 7,a77ii71 by inserting 1 including in the home of an individual when furnished as a telehealth service through audio-visual real-time communications technology1 or when such home is designated as a provider-based location of a hospital outpatient department after outpatient basis2 and 7#b7 in subparagraph 7,b71 by inserting 1 including through the virtual presence of such physician1 physician assistant1 nurse practitioner1 or clinical nurse specialist1 through audio-visual real-time communications technology after under the program4 7b7 ,expanding originating sites ,section #ahcd7m7 of the ,social ,security ,act 7#db ,u4,s4,c4 #aciem7m77 is amended-- 7#a7 in paragraph 7#a71 by striking and 7#i7 and all that follows through 7as defined in paragraph 7#d77;,e77 and inserting 1 7#i71 and 7#aj71 the ,secretary shall pay for telehealth services that are furnished via a telecommunications system by a physician 7as defined in section #ahfa7r77 or a practitioner 7as defined in paragraph 7#d77;,e771 or by a hospital 7as defined in section #ahfa7;e772 7#b7 in paragraph 7#b77;,a71 by striking or practitioner each place that it appears and inserting 1 practitioner1 or hospital2 7#c7 in paragraph 7#d77;,a71 by striking or practitioner and inserting 1 practitioner1 or hospital2 7#d7 in paragraph 7#d77;,c7-- 7,a7 in clause 7i71 by striking and 7#g7 and inserting 7#g71 and 7#aj72 and 7,b7 in clause 7ii77,x71 by striking paragraph 7#g7 and inserting paragraphs 7#g7 and 7#aj72 7#e7 in paragraph 7#d77;,f77i71 by striking paragraph 7#h7 and inserting paragraphs 7#h7 and 7#aj72 and 7#f7 by adding at the end the following new paragraph3 7#aj7 ,treatment of cardiac rehabilitation program1 intensive cardiac rehabilitation program1 and pulmonary rehabilitation program visits furnished through telehealth ,in the case of items and services furnished on or after ,january #a1 #bjbd1 the geographic requirements described in paragraph 7#d77;,c77i7 shall not apply with respect to telehealth services for cardiac rehabilitation programs and intensive cardiac rehabilitation programs 7as such terms are defined in section #ahfa7;eee77 and pulmonary rehabilitation programs 7as defined in section #ahfa7;fff77 at an originating site described in subclauses 7,v7 and 7,x7 of paragraph 7#d77;,c77ii74 4 7c7 ,authority ,to establish standards and allow for certain programs ,to utilize telehealth services 7#a7 ,in general ,not later than #cj days after the date of enactment of this section1 the ,secretary of ,health and ,human ,services shall-- 7,a7 establish standards for the designation of the home of an individual with status as a provider-based organization of a hospital consistent with waivers issued through the ,hospital ,without ,walls program for cardiac rehabilitation1 pulmonary rehabilitation1 and intensive cardiac rehabilitation2 and 7,b7 include items and services furnished under cardiac rehabilitation program or under an intensive cardiac rehabilitation program 7as such terms are defined in section #ahfa7;eee7 of the ,social ,security ,act 7#db ,u4,s4,c4 #aciex7eee771 or under a pulmonary rehabilitation program 7as defined in section #ahfa7;fff7 of such ,act 7#db ,u4,s4,c4 #aciex7fff77 among telehealth services to be specified under section #ahcd7m77#d77;,f7 of such ,act 7#db ,u4,s4,c4 #aciem7m77#d77;,f774 7#b7 ,effective date ,the standards established under paragraph 7#a7 shall apply to items and services furnished on or after ,january #a1 #bjbd4 7d7 ,implementation ,notwithstanding any other provision of the law1 the ,secretary of ,health and ,human ,services may implement the provisions of1 and the amendments made by1 this section by program instruction or otherwise4 7e7 ,effective date ,the amendments made by subsections 7a7 and 7b7 shall apply to items and services furnished on or after ,january #a1 #bjbd4