Increasing Access to Quality Cardiac Rehabilitation Care Act of 2025 (S.717)

Current Medicare regulations create barriers that prevent advanced practice providers from fully serving patients in need of cardiac and pulmonary rehabilitation services. Causing more than 700,000 deaths per year, heart disease remains the leading cause of death in the United States.1 Additionally, chronic obstructive pulmonary disease (COPD) is the fifth leading cause of death in the United States, with nearly 150,000 deaths per year.2 Despite the proven effectiveness of cardiac and pulmonary rehabilitation programs, less than 25 percent of qualifying patients receive cardiac rehabilitation and fewer than 3 percent of qualifying patients receive pulmonary rehabilitation, with participation rates even lower for female and minority patients, and those who live in rural or economically deprived urban communities.3

While a nurse practitioner (NP) may be the primary care provider for a patient and is oftentimes most familiar with a patient's health care needs, current law requires that NPs refer a patient to a physician to order these services. This creates unnecessary delays and barriers to care, which is particularly problematic given that managing and treating heart disease and related risk factors is estimated to cost the United States over $320 billion annually.4 Even more, COPD is estimated to cost the United States $24 billion annually in medical costs.5 S. 717 was introduced on February 25, 2025, by Senators Shelley Moore Capito (R-WV) and Amy Klobuchar (D-MN) and was referred to the Committee on Finance.

Specifically, this bill:

  • Authorizes physician assistants, nurse practitioners, and clinical nurse specialists to prescribe exercise components of cardiac rehabilitation programs under Medicare;
  • Allows physician assistants, nurse practitioners, and clinical nurse specialists to order cardiac rehabilitation services for Medicare patients;
  • Authorizes physician assistants, nurse practitioners, and clinical nurse specialists to prescribe exercise components of pulmonary rehabilitation programs under Medicare;
  • Allows physician assistants, nurse practitioners, and clinical nurse specialists to order pulmonary rehabilitation services for Medicare patients;
  • Expands the definition of eligible office settings for cardiac rehabilitation programs; and
  • Includes implementation provisions requiring the amendments to apply with respect to items and services furnished on or after 6 months following enactment.

Cardiac and pulmonary rehabilitation programs save lives by reducing deaths and hospital readmissions, yet federal barriers prevent highly trained nurse practitioners, physician assistants, and clinical nurse specialists from ordering these lifesaving services for their patients. We must eliminate these outdated restrictions that create dangerous delays in care, particularly in rural and underserved communities. Empowering these frontline providers to order rehabilitation services will ensure timely, continuous care from providers who know patients best. Read the full text of the bill and contact your legislators today!

References

  1. Dimala, C. A., Reggio, C., Khalife, W., & Donato, A. (2024). Heart disease and heart failure: Trends and disparities in mortality rates in the United States from 2000 to 2020. American heart journal plus : cardiology research and practice, 46, 100459.
  2. Mintz, M., Barjaktarevic, I., Mahler, D. A., Make, B., Skolnik, N., Yawn, B., Zeyzus-Johns, B., & Hanania, N. A. (2023). Reducing the Risk of Mortality in Chronic Obstructive Pulmonary Disease With Pharmacotherapy: A Narrative Review. Mayo Clinic proceedings, 98(2), 301–315. https://doi.org/10.1016/j.mayocp.2022.09.007.
  3. Fleg, J. L., Keteyian, S. J., Peterson, P. N., Benzo, R., Finkelstein, J., Forman, D. E., Gaalema, D. E., Cooper, L. S., Punturieri, A., Joseph, L., Shero, S., & Zieman, S. (2020). Increasing Use of Cardiac and Pulmonary Rehabilitation in Traditional and Community Settings: OPPORTUNITIES TO REDUCE HEALTH CARE DISPARITIES. Journal of cardiopulmonary rehabilitation and prevention, 40(6), 350–355. https://doi.org/10.1097/HCR.0000000000000527.
  4. Birger, M., Kaldjian, A. S., Roth, G. A., Moran, A. E., Dieleman, J. L., & Bellows, B. K. (2021). Spending on Cardiovascular Disease and Cardiovascular Risk Factors in the United States: 1996 to 2016. Circulation, 144(4), 271–282. https://doi.org/10.1161/CIRCULATIONAHA.120.053216.
  5. Association, A. L. (n.d.). COPD trends brief - burden. COPD Trends Brief - Burden | American Lung Association. https://www.lung.org/research/trends-in-lung-disease/copd-trends-brief/copd-burden.