Blunt Rochester, Smith, with Support of American Heart Association, Introduce Measure to Increase Access to Quality Cardiac Rehabilitation Care

Press Release

Today, Rep. Lisa Blunt Rochester (D-Del.) and Rep. Adrian Smith (R-Neb.) along with Rep. Derek Kilmer (D-Wash.), Rep. Brian Fitzpatrick (R-Pa.), and Rep. Peter Welch (D-Vt.) introduced the Increasing Access to Quality Cardiac Rehabilitation Act of 2021. The bill would authorize physician assistants (PAs), nurse practitioners (NPs), and clinical nurse specialists (CNSs), referred to as advanced practice providers (APPs), to begin supervising patients' day-to-day cardiac and pulmonary rehabilitation care (CR/PR) in 2022 -- rather than 2024 -- as a way to expand patient access to cardiovascular services. In addition, this bill would authorize APPs to order patients to cardiac and pulmonary rehabilitation under Medicare. These important provisions would help increase patient access to cardiovascular care, especially in underserved and rural areas.

"Heart disease is a leading cause of death in Delaware, but we know that reducing barriers to accessing cardiac rehabilitation has direct patient benefits, including the risk of a future cardiac event," said Rep. Blunt Rochester. "I'm proud to join my colleague, Congressman Adrian Smith, and the bill's original cosponsors, in ensuring that patients can receive timely referrals to these critical health care services and benefit from this effective treatment."

"Nebraskans from all parts of the state are affected by heart and lung disease and need access to cardiac and pulmonary rehabilitation programs, which are proven to enhance patients' health and quality of life," said Rep. Smith. "This legislation will increase access for cardiac patients, particularly in rural areas, by expanding who can order and supervise these programs, ensuring patients receive the care they need."

Last year, Congress passed the Improving Access to Cardiac and Pulmonary Rehabilitation Act as part of the Bipartisan Budget Act of 2018 (P.L. 115-123). This legislation would build upon that success by authorizing APPs to provide direct supervision for cardiac and pulmonary rehabilitation beginning in 2022 -- two years earlier than under current law. It would also authorize APPs to order cardiac and pulmonary rehabilitation services.

"Cardiac rehabilitation has real-life benefits for coronary heart disease patients, lowering the risk of CVD-related death by 26 percent," said Nancy Brown, CEO of the American Heart Association. "Despite these benefits, participation in cardiac rehabilitation programs remains low. This legislation would increase access and bridge the gap between referral and the start of CR/PR and help Medicare patients more equitably access proven services to help improve their health outcomes."

"The American College of Cardiology strongly supports the "Increasing Access to Cardiac Rehabilitation Act of 2021.' Cardiac rehabilitation is vital to improving the care, outcomes and quality of life for the more than 900,000 Americans who experience a heart attack each year and this legislation will go a long way to eliminate obstacles and delays that may prevent patients from beginning this critical therapy. Working with Congress, we have made great strides in recent years to increase patient access to this critical medical therapy by expanding use of the cardiovascular care team in prescribing and supervising cardiac rehab and pulmonary rehab services," said American College of Cardiology Health Affairs Committee Chair, Samuel Jones IV, MD, MPH, FACC. "Every day in my practice I work with advanced practice providers who are routinely on the front line in critical care environments and who are highly trained and qualified to provide these safe, effective and vital services. Passage of this critical legislation will go a long way toward eliminating unnecessary obstacles and delays to this life changing -- and life-saving therapy, especially in rural and underserved communities."

"The American Association of Nurse Practitioners would like to thank Representatives Lisa Blunt Rochester and Adrian Smith as well as the Members joining as original cosponsors, for reintroducing the Increasing Access to Quality Cardiac Rehabilitation Care Act. Patients who receive cardiac and pulmonary rehabilitation have more favorable outcomes -- yet Medicare patients lack adequate access to these programs, especially patients in rural and underserved areas," said AANP President, Sophia L. Thomas, DNP, FNP, PNP, FAANP. "By removing the outdated federal barrier that excludes nurse practitioners from being authorized to order or supervise these lifesaving programs, Congress is helping to ensure patients have greater access to the right care at the right time. On behalf of the 290,000 NPs nationwide, we urge Congress to take swift action on this legislation so that our patients can receive the cardiac and pulmonary rehabilitation services they need and without unnecessary delays."

"Cardiac rehab helps many women not only recover, but learn to thrive with heart disease," said Celina Gorre, CEO of WomenHeart. "It's critical that we break down barriers that limit women's enrollment and completion of cardiac rehab. We are grateful to Representatives Lisa Blunt Rochester and Adrian Smith for championing this bill to address some of those barriers and expand access, allowing more women with heart disease to take control of their heart health."

"On behalf of the approximately 150,000 PAs in the United States, the American Academy of PAs would like to thank Representatives Lisa Blunt Rochester and Adrian Smith for their leadership in reintroducing the Increasing Access to Quality Cardiac Rehabilitation Care Act in the 117th Congress," said AAPA President and Chair of the Board Beth R. Smolko, DMSc, MMS, PA-C, DFAAPA. "This legislation will have a major impact on Medicare patients' lives, expanding access to cardiac and pulmonary rehabilitation programs. These programs are vitally important for patients suffering from a wide variety of conditions. Currently these programs are often inaccessible for those who need them most, particularly in rural and medically underserved areas. We urge Congress to pass this legislation as quickly as possible to ensure that more patients are able to access these lifesaving treatment programs."

"Cardiac rehab saves lives," said Dr. Erin Ferranti, PhD, MPH, RN, CDCES, FAHA, FPCNA, FAAN, Advocacy Chair of the Preventive Cardiovascular Nurses Association. "Allowing advanced practice providers to refer patients would mean that more people get the rehabilitation services they need."

The Increasing Access to Quality Cardiac Rehabilitation Act of 2021 is supported by:

American Heart Association
American Association of Cardiovascular & Pulmonary Rehabilitation
American Academy of Cardiology
American Association of Nurse Practitioners
American Association for Respiratory Care
American Nurses Association
WomenHeart
American Academy of PAs
Preventive Cardiovascular Nurses Association

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