Rehabilitating the Heart of the Nation

Pending legislation before the U.S. Congress represents a opportunity to expand access to cardiac rehabilitation (rehab) for patients in areas of need and to transform secondary prevention of cardiovascular disease across the country.

This legislation would allow advanced practice clinicians (nurse practitioners, physician assistants and clinical nurse specialists) to meet the "direct supervision" requirement under Medicare. Currently, the Medicare Improvements for Patients and Providers Act of 2008 (MIPPA) requires a physician to supervise cardiac rehab programs – a requirement that is inappropriately and unnecessarily more stringent than other outpatient services and limits patient access to cardiac rehab services while adding unnecessary costs for high-quality programs.

According to Linda L. Hart, DNP, RN, ACNP-BC, AACC, a member of ACC’s Health Affairs Committee, and chair of ACC’s Cardiovascular Team Section Advocacy Work Group, “this legislation represents an opportunity for U.S. health care to move away from costly and unnecessary requirements, and provides a model for cardiovascular practices to embrace team-based care in a way that positively impacts our patients and expands access to important programs that prevent repeat cardiovascular events.”

ACC Advocacy worked with other medical specialty societies, including the American Heart Association (AHA) and the American Association of Cardiovascular and Pulmonary Rehabilitation, to get H.R. 3355 introduced in the House after the Senate version was introduced in mid-2015. The ACC, along with AHA, is currently urging the Senate Finance Committee to include S.488 in its upcoming chronic care package.


Learn more about the Prevention of Cardiovascular Disease Section on ACC.org. Visit the Prevention Clinical Topic Collection on ACC.org for the latest clinical news, patient case quizzes and more.

Clinical Topics: Prevention

Keywords: ACC Publications, Cardiology Magazine, Ambulatory Care, American Heart Association, Cardiovascular Diseases, Medicare, Nurse Clinicians, Nurse Practitioners, Outpatients, Physician Assistants, Secondary Prevention, Societies, Medical, Secondary Prevention


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