New Bill Aims to Enable Virtual Cardiac Rehab for Medicare Patients

Three United States senators have introduced new legislation that would allow Medicare beneficiaries to receive cardiac and pulmonary rehabilitation services at home through telehealth.

During the COVID-19 public health emergency (PHE), in-person care restrictions prevented Americans from receiving needed care. Thus, government agencies, like the Centers for Medicare and Medicaid Services (CMS), enacted numerous flexibilities to ensure continuity of care. One such flexibility temporarily allowed cardiac and pulmonary rehabilitation programs to be reimbursed under Medicare when provided or supervised virtually in patient homes. But this flexibility ended on May 11 with the lifting of the PHE.

On Oct. 4, US Sens. Kyrsten Sinema (I-Arizona), Marsha Blackburn (R-Tennessee), and Amy Klobuchar (D-Minnesota) introduced the Sustainable Cardiopulmonary Rehabilitation Services in the Home Act to make the flexibility permanent. If enacted into law, Medicare will reimburse cardiac and pulmonary rehabilitation services provided at patient homes via telehealth starting Jan. 1, 2024.

“Heart disease is a leading cause of death in the United States, and we must use every tool at our disposal to combat this chronic condition,” said Klobuchar in a press release. “This legislation will do just that by making virtual cardiac rehabilitation services that have been proven to reduce mortality rates available to Medicare patients. Not only will this bill make it easier for patients to get the care they need, it will save lives.”

About 695,000 people in the United States died from heart disease in 2021, which is 17.4 percent of all deaths that year, according to the latest data from the Centers for Disease Control and Prevention (CDC).

Additionally, data from the American Lung Association shows that 12.5 million people, or 5 percent of adults, reported a diagnosis of chronic obstructive pulmonary disease (COPD) in 2020.

“Recent studies show that patients participating in virtual cardiac rehabilitation programs had a significantly lower risk of mortality than patients who opted out of the program,” said Blackburn in the press release. “This legislation to permanently allow patients and providers to access these life-saving programs will ensure access to quality care for heart and lung patients.”

A study published in April 2022 showed that virtual and hybrid cardiac rehabilitation provided similar patient benefits as in-person services.

Published in the Journal of Cardiopulmonary Rehabilitation and Prevention, the study compared care delivery models for cardiac rehab. Researchers from UC San Francisco collected information on patients enrolled in cardiac rehab between October 2019 and May 2021.

They found that hybrid and virtual care methods provided similar clinical benefits to patients as in-person care, with blood pressure control, walking ability, and anxiety levels being similar between the hybrid and virtual care groups and the in-person group.

Further, research shows that home-based cardiac rehab was more effective than center-based cardiac rehab services, lowering hospitalization rates even among medically complex patients.

The study, published in JAMA Network Open in September 2022, included 2,556 cardiovascular disease patients, of which 48.5 percent received home-based cardiac rehab and 51.5 percent received center-based cardiac rehab. Researchers examined 12-month all-cause hospitalization, medication adherence, and cardiovascular risk factor control for both groups.

They found that 4.8 percent of those who received home-based cardiac rehab were hospitalized in the 12 months following the program, compared with 18.1 percent of those who received center-based cardiac rehab. But, medication adherence and cardiovascular risk factor control, including control of blood pressure and LDL-cholesterol, were similar between the two groups.