Advocacy | Day on the Hill

Sustaining Outpatient Services Act - HR 4838 / S. 4151

Click here to read our 2020 Legislative Priority to be sent with follow-up letters for HR4838 / S.4151

Follow-Up Letter for HR4838

Follow-up Letter on Senate

Introduction Letter to co-sponsor US House Bill HR4838

Introduction Letter to co-sponsor Senate bill S.4151

Many AACVPR members have been diligently requesting this of Congress for the past two years. This bill will exempt certain hospital outpatient services from a drastic reimbursement reduction that are based solely on the location of the hospital outpatient service. As the Legislative Priority explains in depth,the SOS: Sustaining Outpatient Services Act mandates implementation of regulations that create specific financial thresholds. As long as no physician specialty, nationwide, bills for any CPT or HCPCS code under the Medicare Physician Fee Schedule in an aggregate amount greater than $2 million in the previous year for which data are available, that code (or codes) would be exempt from reduced reimbursement requirements for off-campus outpatient services. Cardiac and pulmonary rehabilitation services are in this category and, therefore, would be included in the exemption.

Currently, hospitals that choose to expand or relocate (beyond the 250 yard threshold) CR/PR services must bill at the physician fee schedule rate, thereby creating a very strong disincentive for hospitals to improve access to PR/CR services. (A very limited number of exceptions to this exist.)

CMS recognizes this reality as an “unintended consequence” of Section 603, but the Agency states it has no authority to address our problem. It will take legislation to correct this barrier to expanded patient access to these beneficial services.


AACVPR member, Joan Helfman speaking with Congressman Frank Pallone, Jr. (to her right), Chair of the US House Energy & Commerce Committee.  (Photo taken 3-6-2020 at a press conference on smoking cessation legislation)

AACVPR leaders, Randy Thomas, Larry Hamm, and Murray Low thanking US Representative John Lewis after passage of Public Law 110-275 in 2008.

Another bill to benefit cardiac and pulmonary rehabilitation

HR 3911-Increasing Access to Quality Cardiac Rehabilitation Care Act of 2019 will allow nonphysician practitioners (PA, NP, CNS) to

  1. Meet the direct physician supervision requirement for CR and PR at an earlier date (TBD) than the current 1/2024 date of implementation, previously established with passage of the ACCESS Act in 2018.
  2. Independently order CR and PR services.

AACVPR supports and joins AHA, ACC, and all partner professional organizations in promoting this bill.

Click here to view our Day on the Hill 2019 Facebook album to see more DOTH 2019 moments!

Moments from Day on the Hill 2019


Sen. Cory Booker and the Tri-State Society Delegation

Patty Lake and Susan Bauman with Rep. Pete Visclosky (IN)

Marrion Harris-Barter, Ashleigh Funk (FL) and Karen Lui

The Maryland Delegation with Sen. Chris Van Hollen

Janie Knipper and Karie Martin with Rep. David Young (IA)

The Wisconsin Delegation at the office of Rep. Paul Ryan