12 2 STA T . 2 54 5 PUBLIC LA W 11 0– 2 7 5 —J UL Y 15 , 200 8‘ ‘ (i)reason a bl ean d ne c essar yf or th e dia g nosis or acti v e treat m ent of the individ u al ’ s condition
‘‘(ii) reasonably e xp ected to improve or maintain the individual’s condition and functional level; and ‘‘(iii) furnished under such guidelines relating to the fre q uency and duration of such items and services as the S ecretary shall establish , ta k ing into account accepted norms of medical practice and the reasonable expectation of improvement of the individual . ‘‘( 4 )( A ) T he term ‘intensive cardiac rehabilitation program’ means a physician - supervised program (as described in paragraph ( 2 )) that furnishes the items and services described in paragraph ( 3 ) and has sho w n, in peer-reviewed published research, that it accomplished — ‘‘(i) one or more of the following
‘‘( I ) positively affected the progression of coronary heart disease; or ‘‘(II) reduced the need for coronary bypass surgery; or ‘‘(III) reduced the need for percutaneous coronary inter- ventions; and ‘‘(ii) a statistically significant reduction in 5 or more of the following measures from their level before receipt of cardiac rehabilitation services to their level after receipt of such serv- ices: ‘‘(I) low density lipoprotein; ‘‘(II) triglycerides; ‘‘(III) body mass index; ‘‘(I V ) systolic blood pressure; ‘‘(V) diastolic blood pressure; or ‘‘(VI) the need for cholesterol, blood pressure, and diabetes medications. ‘‘( B ) To be eligible for an intensive cardiac rehabilitation pro- gram, an individual must have— ‘‘(i) had an acute myocardial infarction within the preceding 1 2 months; ‘‘(ii) had coronary bypass surgery; ‘‘(iii) stable angina pectoris; ‘‘(iv) had heart valve repair or replacement; ‘‘(v) had percutaneous transluminal coronary angioplasty ( P T C A) or coronary stenting; or ‘‘(vi) had a heart or heart-lung transplant. ‘‘(C) An intensive cardiac rehabilitation program may be pro- vided in a series of 7 2 one-hour sessions (as defined in section 1 8 48(b)(5)), up to 6 sessions per day, over a period of up to 18 weeks. ‘‘(5) The Secretary shall establish standards to ensure that a physician with expertise in the management of individuals with cardiac pathophysiology who is licensed to practice medicine in the State in which a cardiac rehabilitation program (or the intensive cardiac rehabilitation program, as the case may be) is offered— ‘‘(A) is responsible for such program; and ‘‘(B) in consultation with appropriate staff, is involved substantially in directing the progress of individual in the program. Stand a r d s.
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