Proposed Legislation Could Benefit Heart Patients

By Jane Farrell

At last, something Republicans and Democrats may agree on: Bipartisan federal legislation introduced in the House of Representatives would expand patient access to critical cardiac and pulmonary rehabilitation programs in Medicare.

The Increasing Access to Quality Cardiac Rehabilitation Care Act of 2019 (H.R. 3911) was introduced by Representatives John Lewis (D-GA) and Adrian Smith (R-NE).

Research has found that women are 12 percent less likely than men to be referred to rehabilitation programs.

American Heart Association (AHA) CEO Nancy Brown welcomed the measure, saying in a statement that “Congress took a major step in 2018 when it included provisions in the Bipartisan Budget Act that authorized physician assistants, nurse practitioners and clinical nurse specialists, referred to as advanced practice providers (APPs), to begin supervising patients’ day-to-day cardiac and pulmonary rehabilitation care (CR/PR). This bill would move the effective date of those provisions to 2020 from 2024, bringing the benefits of these services to more patients sooner. Additionally, patients are facing long wait times in receiving referrals, and the longer patients wait to start cardiac rehab, the less likely they are to enroll. This bill would authorize qualified AAPs to order patients to receive these services, allowing for quicker referrals of patients.

“Significant barriers for Americans with heart disease and stroke were removed in the Bipartisan Budget Act, and this legislation goes further to help patients across the country. Coronary heart disease patients who enroll in cardiac rehabilitation have a 26 percent lower risk of cardiovascular disease-related death and an 18 percent lower risk of readmission at 1-year follow-up compared to those who don’t enroll. Despite these benefits, participation in cardiac rehabilitation programs remains low.

“The lack of and delayed referrals are contributing to low patient enrollment in CR/PR. Research has found that women are 12 percent less likely to be referred than men, and black, Hispanic, and Asian patients are 20 percent, 36 percent and 50 percent less likely, respectively, to be referred than white patients. The steps this legislation takes would bridge the gap between referral and the start of CR/PR, and help patients access proven services to help improve their health outcomes.

“We are grateful to Reps. Lewis and Smith for their continued work to improve the health of patients with cardiovascular disease. This legislation expands upon previous legislative victories to help wipe out the burden of heart disease and stroke in our nation.”