12 2 STA T . 2 54 4 PUBLIC LA W 11 0– 2 7 5 —J UL Y 15 , 200 8SEC.14 4. PAYM E NT AN D C OV E R A G E I MPROVEMENTS F OR PATIENTS W IT H CHRONIC O B STR U CTIVE PU L MONARY DISEASE AND OTHER CONDITIONS. (a)COVERAG EO FPULM O N AR Y AN D CARD I A CR E H A B ILI T ATION .— ( 1 ) I N GENERAL.— Section 1 86 1o f t h e Socia l Sec ur it yA ct ( 42U .S.C. 1 395x ) , a s a m en d ed b y section 1 0 1(a), is amended— (A) in subsection (s)(2)— (i) in sub p ara g raph (AA), by stri k ing ‘ ‘and ’ ’atthe end
(ii) by adding at the end the follo w ing new sub - paragraphs
‘‘(CC) items and ser v ices furnished under a cardiac rehabilitation program (as defined in subsection (eee)(1)) or under a pulmonary rehabilitation program (as defined in subsection (fff)(1)); and ‘‘( D D) items and services furnished under an intensive cardiac rehabilitation program (as defined in subsection (eee)(4));’’; and ( B ) by adding at the end the following new subsections: ‘‘Cardiac Rehabilitation Program; Intensive Cardiac Rehabilitation Program ‘‘(eee)(1) T he term ‘cardiac rehabilitation program’ means a physician-supervised program (as described in paragraph (2)) that furnishes the items and services described in paragraph (3). ‘‘(2) A program described in this paragraph is a program under which— ‘‘(A) items and services under the program are delivered— ‘‘(i) in a physician’s office; ‘‘(ii) in a hospital on an outpatient basis; or ‘‘(iii) in other settings determined appropriate by the Secretary. ‘‘(B) a physician is immediately available and accessible for medical consultation and medical emergencies at all times items and services are being furnished under the program, except that, in the case of items and services furnished under such a program in a hospital, such availability shall be pre- sumed; and ‘‘(C) individuali z ed treatment is furnished under a written plan established, reviewed, and signed by a physician every 30 days that describes— ‘‘(i) the individual’s diagnosis; ‘‘(ii) the type, amount, fre q uency, and duration of the items and services furnished under the plan; and ‘‘(iii) the goals set for the individual under the plan. ‘‘(3) The items and services described in this paragraph are— ‘‘(A) physician-prescribed exercise; ‘‘(B) cardiac risk factor modification, including education, counseling, and behavioral intervention (to the extent such education, counseling, and behavioral intervention is closely related to the individual’s care and treatment and is tailored to the individual’s needs); ‘‘(C) psychosocial assessment; ‘‘(D) outcomes assessment; and ‘‘( E ) such other items and services as the Secretary may determine, but only if such items and services are—
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