National Coverage Analysis (NCA) View Public Comments

Cardiac Rehabilitation (CR) Programs - Chronic Heart Failure

Public Comments

Commenter Comment Information
Desai, Ankit Organization: University of Illinois at Chicago
Date: 12/20/2013
Comment:
I encourage CMS to include heart failure with preserved ejection fraction as an indication for cardiac rehabilitation.
bertrand, linda lea Title: CHF nurse practitioner
Organization: VABoston Medical Center
Date: 12/20/2013
Comment:
I have worked with Heart failure programs for over 20 years. Those who exercise - even walking live longer. I totally support coverage for Heart failure patients for cardiac rehab.
Cody, Robert Title: Vice President / Disease Area Leader-Heart Failure
Organization: Janssen R&D, LLC / Johnson & Johnson
Date: 12/20/2013
Comment:

Dear Dr. Jacques:

On behalf of Janssen Pharmaceuticals, I am pleased to submit our support and comments in response to the proposal to expand coverage for cardiac rehabilitation (CR) services under 42 C.F.R. § 410.49(b)(1)(vii) for beneficiaries with chronic heart failure by the Centers for Medicare & Medicaid Services (CMS) on November 21, 2013. We strongly support the proposal for coverage expansion.

Janssen Pharmaceuticals, Inc., a pharmaceutical company of Johnson

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Kitzman, Dalane Title: Professor of Internal Medicine: Cardiology/Geriatr
Organization: Wake Forest School of Medicine
Date: 12/20/2013
Comment:

The purpose of this letter is to support and suggest clarification of the proposal for reimbursement of cardiac rehabilitation for patients with chronic heart failure with EF < 35% who have been on optimal therapy for at least 6 weeks.

As principal and lead investigators in the HF-ACTION study (Drs. O'Connor, Whellan and Kitzman), we congratulate CMS for utilizing an evidence-based approach, and adhering to the selection criteria utilized in this large, pivotal trial. We agree

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Rockar, Paul Title: President
Organization: American Physical Therapy Association
Date: 12/20/2013
Comment:

December 20, 2013

Joseph Chin, MD, MS
Lead Medical Officer
Michelle Issa
Lead Analyst
Centers for Medicare and Medicaid Services
7500 Security Boulevard
Baltimore, MD 21244

Re: Proposed Decision Memo for Cardiac Rehabilitation Programs – Chronic Heart Failure (CAG-00437N)

Dear Dr. Chin and Ms. Issa:

On behalf of our 85,000 member physical therapists, physical therapist assistants, and students of physical therapy, the

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Maddox, Tom Date: 12/20/2013
Comment:
I strongly urge CMS to cover cardiac rehabilitation for beneficiaries with HFPEF.
Rush, Kimberly Date: 12/20/2013
Comment:
I strongly urge CMS to cover cardiac rehabilitation for beneficiaries with HFPEF.
Wilcox, Jane Organization: Northwestern University Feinberg School of Medicine
Date: 12/20/2013
Comment:
I strongly urge CMS to cover cardiac rehabilitation for beneficiaries with HFPEF.
Cogswell, Rebecca Title: Heart failure physician
Organization: University of minneaota
Date: 12/20/2013
Comment:
I believe strongly that HFpEF patients would benefit from cardiac rehab.
Friedman, MD, Mark Title: MD
Organization: University of Arizona Medical Center
Date: 12/20/2013
Comment:
I strongly urge CMS to cover cardiac rehabilitation for beneficiaries with HFPEF.
Fagan, MS, RCEP, FAACVPR, Barbra Title: President
Organization: AACVPR
Date: 12/20/2013
Comment:

December 20, 2013

Centers for Medicare & Medicaid Services
7500 Security Boulevard
Baltimore, MD 21244

Re: CAG-00437N
Proposed Decision Memo for Cardiac Rehabilitation (CR) Programs-Chronic Heart Failure (CAG-00437N)
Submitted by AACVPR, ACC, AHA, HFSA

Dear Dr. Chin:

The American Association of Cardiovascular & Pulmonary Rehabilitation (AACVPR), the American College of Cardiology (ACC), the American Heart Association (AHA), and the

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Velez, Mauricio Date: 12/19/2013
Comment:
I strongly urge CMS to extend the benefit of cardiac rehabilitation to patients with heart failure with preserved ejection fraction (HFPEF).
Berlin, Karen Title: RN
Organization: California Pacific Medical Center
Date: 12/19/2013
Comment:
I strongly urge CMS to cover cardiac rehabilitation for beneficiaries with HFPEF.
Thenappan, Thenappan Date: 12/19/2013
Comment:
I strongly urge CMS to cover cardiac rehabilitation for beneficiaries with HFPEF.
Duvernoy, Claire Title: Chief, Cardiology Section
Organization: VA Ann Arbor Healthcare System
Date: 12/19/2013
Comment:
I strongly urge CMS to cover cardiac rehabilitation for beneficiaries with HFPEF.
Janke, David Title: Exercise Physiologist
Organization: CMPC
Date: 12/19/2013
Comment:
I strongly urge CMS to cover cardiac rehabilitation for beneficiaries with HFPEF. Let those who need the help be helped.
Ryan, John Date: 12/19/2013
Comment:
I strongly urge CMS to cover cardiac rehabilitation for beneficiaries with HFPEF.
Forman, Daniel Date: 12/19/2013
Comment:
I strongly urge CMS to cover cardiac rehabilitation for beneficiaries with heart failure with preserved ejection fraction as well as heart failure with reduced ejection fraction.
Dhingra, Ravi Date: 12/19/2013
Comment:
I strongly urge CMS to cover cardiac rehabilitation for beneficiaries with HFPEF
Swinyard, James Date: 12/19/2013
Comment:
I strongly urge CMS to cover cardiac rehabilitation for beneficiaries with HFPEF.
Maurer, Mathew Title: Associate Professor of Medicine
Organization: Columbia University
Date: 12/19/2013
Comment:
I strongly urge CMS to cover cardaic rehabilitation for patients with heeart failure and a preserved ejection fraction.
ward, apn, stacie Title: AdvancedPractice Nurse, Center for Heart Failure
Organization: Northwestern Medicine
Date: 12/19/2013
Comment:
Dear CMS:
I strongly urge CMS to cover cardiac rehabilitation for beneficiaries with HFPEF, any patient with heart failure.
STacie Ward
Freed, Benjamin Date: 12/19/2013
Comment:
I strongly urge CMS to cover cardiac rehabilitation for beneficiaries with HFPEF.
Mitzel, John Title: Quality Manager
Organization: DC Devices, Inc
Date: 12/19/2013
Comment:
I strongly urge CMS to cover cardiac rehabilitation for beneficiaries with HFPEF.
Skrabal, Valerie Organization: DC Devices, Inc
Date: 12/19/2013
Comment:
I strongly urge CMS to cover cardiac rehabilitation for beneficiaries with HFPEF.
Beatty, Alexis Date: 12/19/2013
Comment:
There is also data to support the use of cardiac rehabilitation for patients with heart failure with preserved ejection fraction. I strongly urge CMS to cover cardiac rehabilitation for all beneficiaries with heart failure, regardless of ejection fraction.
Seale, Jennifer Date: 12/19/2013
Comment:
I strongly urge CMS to cover cardiac rehabilitation for beneficiaries with HFPEF.
Rohrbach, Gregory Date: 12/19/2013
Comment:
I strongly urge CMS to cover cardiac rehabilitation for beneficiaries with HFPEF
Ames, Kelly Date: 12/19/2013
Comment:
I strongly urge CMS to cover cardiac rehabilitation for beneficiaries with HFPEF!!!!
Gupta, Deepak Date: 12/19/2013
Comment:
I strongly urge CMS to cover cardiac rehabilitation for beneficiaries with HFPEF.
Fazio, George Date: 12/19/2013
Comment:
I strongly urge CMS to cover cardiac rehabilitation for beneficiaries with HFPEF. These patients suffer from all the same symptoms and share a similar reduced QOL and mortality rate as patients with HFrEF. HFpEF patients represent half of all HF.
Sincerely,
George Fazio
Westerfeldt, Bethany Title: nurse practitioner
Organization: University of Wisconsin Medical Foundation
Date: 12/19/2013
Comment:
I strongly urge CMS to cover cardiac rehabilitation for beneficiaries with HFpEF.
Sweitzer, Nancy Title: Director, Heart Failure and Cardiac Transplantatio
Organization: University of Wisconsin
Date: 12/19/2013
Comment:
I strongly urge CMS to cover cardiac rehabilitation for beneficiaries with heart failure and preserved ejection fraction.
Hasara, Stephanie Date: 12/19/2013
Comment:
I strongly urge CMS to cover cardiac rehabilitation for beneficiaries with HFPEF
Hendrickson, Robert Title: Database Consultant
Organization: Self
Date: 12/19/2013
Comment:
I strongly urge CMS to cover cardiac rehabilitation for beneficiaries with HFPEF.
Shaw, Richard Title: Director of Cardiovascular Research
Organization: California Pacific Medical Center/Sutter Health West Bay Region
Date: 12/19/2013
Comment:
I strongly urge CMS to cover cardiac rehabilitation for beneficiaries with HFPEF. This comprises a sizeable group of patietns who do not meet the current criteria and are in great need of this therapy.
Gordon, Robert Title: MD
Organization: Northwestern Medical Faculty Foundation
Date: 12/19/2013
Comment:
I strongly urge CMS to cover cardiac rehab for beneficiaries with HFPEF
Rich, Jonathan Date: 12/19/2013
Comment:
I strongly urge CMS to cover cardiac rehabilitation for beneficiaries with HFPEF. HFpEF is an epidemic whose main feature is exercise intolerance and for which there are few effective medical therapies. Cardiac rehab for these patients is critical.
Hall, Melissa Date: 12/19/2013
Comment:
I strongly urge CMS to cover cardiac rehabilitation for beneficiaries with HFPEF.
Scherubel, Melody Organization: Iowa City VA Health Care System
Date: 12/19/2013
Comment:
I strongly urge CMS to cover cardiac rehabilitation for beneficiaries with HFPEF. Thank you very much.
Shah, Sanjiv Title: Associate Professor of Medicine
Organization: Northwestern University Feinberg School of Medicine
Date: 12/19/2013
Comment:
I strongly urge CMS to cover cardiac rehabilitation for beneficiaries with heart failure and preserved ejection fraction (HFpEF).
Turakhia, Mintu Organization: VA Palo Alto Health Care System
Date: 12/19/2013
Comment:
I strongly urge CMS to cover cardiac rehabilitation for beneficiaries with HFPEF.
Bryant, DO, Phillip Title: Chair, Reimbursement and Policy Review Committee
Organization: American Academy of Physical Medicine and Rehabilitation (AAPM&R)
Date: 12/19/2013
Comment:

December 19, 2013

Louis Jacques, MD
Director, Coverage and Analysis Group
Centers for Medicare and Medicaid Services
7500 Security Boulevard
Baltimore, MD 21244

Re: Proposed Decision Memorandum for Coverage of Cardiac Rehabilitation (CR) Programs for Chronic Heart Failure (HF)

Dear Dr. Jacques:

As an important member of the physician community, the American Academy of Physical Medicine and Rehabilitation (AAPM&R) appreciates the opportunity to

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Schiller, Nelson Date: 12/18/2013
Comment:
Only half the patients with CHF have a low EF. EF is a poor marker of CHF because a large percentage of patients have preserved EF with heart failure due to diastolic dysfunction. Please reconsider using only EF as an exclusionary criterion.
Whooley MD FACP FAHA FACC, Mary Title: Professor of Medicine, Epidemiology & Biostatistic
Organization: University of California, San Francisco
Date: 12/18/2013
Comment:

I applaud and support the proposed CMS decision to expand coverage for cardiac rehabilitation services to beneficiaries with chronic heart failure (CAG-00437N). However, I am concerned about limiting this coverage to patients with left ventricular ejection fraction of 35% or less. Almost half of heart failure patients have a preserved ejection fraction (HFPEF), and their outcomes are similar to heart failure patients with a reduced ejection fraction (HFREF) (1). In a study of >2000

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Nissen MD MACC, Steven E. Title: Chairman, Department of Cardiovascular Medicine
Organization: Cleveland Clinic Foundation
Date: 12/18/2013
Comment:

December 18, 2013

Centers for Medicare & Medicaid Services
Department of Health and Human Services
P.O. Box 8013
Baltimore MD 21244–1850

RE: Proposed Decision Memo for Cardiac Rehabilitation (CR) Programs - Chronic Heart Failure (CAG-00437N)

Submitted electronically via: CMS.gov

Cleveland Clinic (CC) is a not-for-profit, integrated healthcare system dedicated to patient care, teaching and research. Our health system is comprised of a

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Karl, Rhonda Title: Cardiopulmonary Rehabilitation Coordinator
Organization: Union Hospital
Date: 12/17/2013
Comment:
Heart failure is one of our leading hospital admissions. We feel that cardiac rehabilitation can help patients with heart failure by educating them on diet, weight management, medication compliance and activities of daily living. The exercise component of the rehab will help the patients stength and endurance as well. We feel that by coming to a cardiac rehab program, patients will be able to stay out of the hospital longer which will save medicare, hospitals, and the patient money.
Quast, Whitney Date: 12/17/2013
Comment:

We are writing regarding the Proposed Decision Memo to include Chronic Heart Failure as a covered diagnosis for Cardiac Rehabilitation. We agree with CMS’ proposal to include patients with HF, however, we feel that the proposal leaves out several important items that should be included in the final National Coverage Determination (NCD).

  1. Using such a low EF criteria of =35% eliminates entire groups of patients that would benefit from these services. The current

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Lee, Teresa Date: 12/17/2013
Comment:

I am writing regarding the Proposed Decision Memo to include Chronic Heart Failure as a covered diagnosis for Cardiac Rehabilitation. I agree with CMS’ proposal to include patients with HF, however, I feel that the proposal leaves out several important items that should be included in the final National Coverage Determination (NCD).

  1. Using such a low EF criteria of =35% eliminates entire groups of patients that would benefit from these services. The current

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Inkster, John Title: Reimbursement Committee Chair
Organization: Minnesota Assoc of Cardiovascular and Pulmonary Rehabilitation
Date: 12/17/2013
Comment:

On behalf of the Board of Director's for the Minnesota Associaton of Cardiovascular and Pulmonary Rehabilitation, we are writing regarding the Proposed Decision Memo to include Chronic Heart Failure as a covered diagnosis for Cardiac Rehabilitation. We agree with CMS’ proposal to include patients with HF, however, we feel that the proposal leaves out several important items that should be included in the final National Coverage Determination (NCD).

  1. Using such a low

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Pelzel, MD, FACC, Jamie Title: Medical Director, Heart Failure Management
Organization: CentraCare Heart and Vascular Center
Date: 12/17/2013
Comment:

We are writing regarding the Proposed Decision Memo to include Chronic Heart Failure as a covered diagnosis for Cardiac Rehabilitation. We agree with CMS’ proposal to include patients with HF, however, we feel that the proposal leaves out several important items that should be included in the final National Coverage Determination (NCD).

  1. Using such a low EF criteria of =35% eliminates entire groups of patients that would benefit from these services. The current

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Crowthers, Gary Title: Director Cardiopulmonary Services
Organization: Union Hospital
Date: 12/16/2013
Comment:
I am very much in favor of including Chronic Heart Failure coverage for payment of cardiac rehabilation services. I bellieve the compoents of patient education, supervised and monitored exercise, dietary education and medication usage educaton provided in the cardiac rehabilitation setting would be of great benifit to this patient population and servce to redcue the number of hospital readmissons. We have seen a dramatic reduction on ED visits, hospital admisssions, and lenght of stay for

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Patel, Mahesh Date: 12/07/2013
Comment:

I strongly support the CMS proposal to expand cardiac rehabilitation services to beneficiaries with chronic heart failure with left ventricular ejection

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Jones RN BSN, Melinda Title: RN BSN Cardiac Rehabilitation
Organization: Sebasticook Valley Health
Date: 12/07/2013
Comment:
As a registered nurse who has spent the majority of my career in cardiac and cardiac rehab nursing, I am THRILLED to hear this announcement! Bravo to CMS for recognizing the benefit of cardiac rehabilitation for this particular group of patients. It will benefit them immensely, help educate them, give them confidence to continue to be active, and prolong their genral health and well-being.
DeKraai, Craig Title: Sr Manager Cardiovascular Institute
Organization: North Colorado Medical Center
Date: 12/05/2013
Comment:
I am submitting this comment in support of the coverage for Cardiac Rehabilitation for heart failure patients. I believe that the literature is clear regarding the clinical benefits to the patient as well as the potential for cost savings from decreased readmissions and or lengths of stay.
Dunleavy PT MS, James Title: Director, Rehabilitation Services
Organization: Trinitas Regional Medical Center
Date: 12/05/2013
Comment:
We are pleased to see this proposed change. We have a very socially, economically and racially diverse patient population that dissproprotinately suffers from heart disease, especially CHF. this new ruling will allow those who have been turned away from effective treatment to now get that treatment. In addition, along with nutritional and other educational components, this population will be less at risk for emergency room visits and inpatient admissions. A Win Win!
Steahr, Gregg Title: PA-C, MMSc
Organization: Northside Hospital
Date: 12/04/2013
Comment:
I whole heartedly agree with your proposal to cover heart failure patients in cardiac rehab. As a clinical provider in a heart failure program, I see many patents that benefit from structured exercise and the lifestyle reinforcement that cardiac rehabilitation provides. At present, of course, our patients must pay out of pocket and many are unable to do so. I encourage you to provide cardiac rehabilitation coverage for heart failure patients using the criteria you propose.
Thank You.
Traynor RN MS FAACVPR, Kate Organization: Massachusetts General Hospital
Date: 12/03/2013
Comment:
I am in full support of expanding Cardiac Rehabilitation Services to include patients with Chronic Heart Failure and applaud CMS for their decision in this regard. The time is right and the time is now to formally support and offer a low cost, low tech, high touch intervention with demonstrated efficacy for the chronic heart faiiure population. The science is solid, the evidence is clear and the need is great.
Hall, Sharon Title: coordinator
Organization: Cardiac Rehab Ozarks Medical Center
Date: 11/26/2013
Comment:
I feel like Chronic Heart Failure should be add to Cardiac Rehabilitation Referrals CHF is a major readment for most Patients and going through a CR program would help keep them healther and out of the hospital.
MacKay, James Title: Medical director
Organization: Providence Health Plans
Date: 11/26/2013
Comment:
exercise is good for heart failure but there is no need for a formal expensive program with monitoring. A good cardiologist or primary doctor can advise on walking within the limits of the cardiac output for an individual patient. A CR rehabilitation program would only increase costs without any medical gains.
Berman, MIchelle Title: Registered Dietitian Nutritionist/Owner
Organization: The Nutrition Professionals
Date: 11/26/2013
Comment:
I am a Registered Dietitian Nutritionist. I support the proposal to offer cardiac rehab to Medicare beneficiaries. I urge you to add Medical Nutrition Therapy provided by Registered Dietitian Nutritionists to the rehab protocol. Nutrition is an important component of cardiac health. Patients who recieve MNT from RDNs, have better outcomes. No cardiac rehab program would be complete if Medical Nutrition Therapy provided by Registered Dietitian Nutritionists were not included.
Wirth, Elizabeth Title: Advanced Practice Nurse/Heart Failure Program
Organization: Riverside Medical Center
Date: 11/26/2013
Comment:
I am an APRN who leads an Outpatient Heart Failure Clinic at Riverside Medical Center in Kankakee, Illinois. The clients I see in the Clinic have been referred to me by community physicians to monitor for worsening heart failure and teach regarding self-management of heart failure/cardiovascular disease. In the two years in this role, I have seen my clients who exercise experience improved quality-of-life, including dramatically reduced hospital readmissions. A Cardiac Rehab program would

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Kubo, Spencer Title: Physician Lead, Heart Failure Service Line
Organization: Allina Health - United Heart and Vascular Clinic
Date: 11/25/2013
Comment:
We are 100% supportive of the change in CMS policy. We believe it will be a signficant help to our patients with Heart failure, based on many clinical studies and our own experience. We believe that patients who are discharged from the hospital, who are at risk for readmission, are prime candidates to start cardiac rehab. In our experience, the early use of rehab can reduce re-hospitalizations.
Evans, Karen Title: staff RN '
Organization: Flagstaff Medical Center
Date: 11/25/2013
Comment:
I work in a Cardiac Rehabilitation program and see patients both in the hospital and in our gym with a variety of cardiac diagnoses. The goal with patients with heart failure is to help them get the tools they need to manage their chronic condition, improve their well being and prevent re-admissions. In Cardiac Rehabilitation programs these patients receive close supervision of their activity, monitoring and counseling and education which all contribute to their success. It has been

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Lewis, Cathy Title: RN, BSN, Director of Cardiac Reahbilitation
Organization: Breckinridge Memorial Hospital
Date: 11/25/2013
Comment:
I am the Director of a rural Cardiac Rehabilitation program. I think that it would behoove CMS to provide for CHF care in Cardiac rehab. It would even be better if the EF cutoff was 40%. I have several patients that have HF as a secondary diagnosis and know how much the education helps them. These patients usually don't have repeat readmits due to the education and the nurse following in rehab. Thank you for your time and consideration into adding this much needed service.
Cinardo, Jillian Title: Assistant Executive Director
Organization: American Association of Heart Failure Nurses
Date: 11/25/2013
Comment:

On Behalf of the American Association of Heart Failure Nurses (AAHFN) Advocacy Committee:

Statement of support from AAHFN Advocacy Committee: This is a very important step in helping to care for patients with Heart Failure. Most of these patients can benefit from cardiac rehab but without recent documentation of coronary artery disease with interventional or medical management these patients have to pay out of pocket which is frequently a burden on the patient and prohibits them

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Anderson, Kelley Date: 11/25/2013
Comment:
Dear CMS thank you for your consideration of the above referenced policy change. As an advanced practice nurse caring for individuals with cardiac conditions and a member of the American Association of Heart Failure Nurses, I fully support the recommendation of adding cardiac rehabilitation in the option of care of patients with chronic heart failure. I would also ask that you consider changing the language from "physician prescribed" to "provider prescribed" or "physician and advanced

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Semigran, Marc Date: 11/25/2013
Comment:
This coverage is essential to the optimal care of heart fialure patients. Consideration should be given to covering HFpEF patients as well.
Lisk, Stella Title: MSN,FNP-BC CHFN
Date: 11/24/2013
Comment:
This will be a great and essential addition to the HF tx options for patients. Many of us have been finding ways to get HF patient to get exercised in controlled and monitored environments - often we jave to get very creative or else get very frustrated trying to get this much needed therapy for this pt population. Even without reserach standard evidence has pointed to significant improvement in HF pts who are able to get started on mod/controled exercise. Being able to have CR covered for

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Newton-Cheh, Christopher Title: Physician
Organization: Massachusetts General Hospital
Date: 11/24/2013
Comment:
It is critically important that you fund cardiac rehabilitation for patients with chronic heart failure. I am a heart failure cardiologist. My patients struggle daily with shortness of breath and difficulty breathing. Cardiac rehabilitation allows them to build up their cardiorespiratory strength and allows them to breathe more easily when exerting themselves.
Dr. Christopher Newton-Cheh
Massachusetts General Hospital
Januzzi, James Date: 11/24/2013
Comment:

To Whom it May Concern,

I would like to weigh in heavily not only as an experienced clinical trialist with an extensive background in chronic heart failure therapy, but also as a very busy clinician who well recognizes the importance of a multidisciplinary approach to heart failure care.

It has been shown that when cardiac rehabilitation is delivered in an effective manner, it benefits those with chronic heart failure substantially. Additionally, unmeasured benefits

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Albert, Nancy Title: Associate CNO, Nursing Inst; Research & Innovation
Organization: Cleveland Clinic
Date: 11/24/2013
Comment:
I am hopeful the cardiac rehab rules will be revised to include chronic HF-rEF in NYHA FC II-IV. In my own prospective, multicenter quantitative research (writing up results now) on predictors of activity and exercise, we learned that self-confidence was a key facilitator of exercise, as was knowledge and understanding of benefits. In qualitative research, we learned that physicians do a poor job of explaining exercise expectations (their messages were vague and were interpreted by patients to

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McCloskey, Cathy Date: 11/23/2013
Comment:
Why should only the ill have personal trainers when everyone would benefit. A short time of training and then do it on their own. If they can't help them selves they have chosen their destiny
Bacon, James Title: MD
Organization: Mid Ohio Heart Clinic
Date: 11/23/2013
Comment:
This would be tremendous for a large patient cohort, likely reduce hospitalizations and reduce costs in the long term. I sincerely hope it is approved.
Thanks
Bottini, Sharon Date: 11/22/2013
Comment:
I hope this happens. It is definitely needed. I am a recently retired BSN, RN of 45 years. Over the last several many cutbacks were made. I sa a direct relationship to cut back in services to peopple with this condition and rehospitalization.
Dyo, Melissa Title: Assistant Professor
Organization: California State University Long Beach
Date: 11/22/2013
Comment:
As a nurse practitioner and researcher working with patients with heart failure, I strongly support Medicare coverage of cardiac rehabilitation for this patient population.
Beall, Heather Title: BSN, RN, PCCN, CWON
Organization: Mission Hospital. St Joseph Health System
Date: 11/22/2013
Comment:
This is a much needed service for heart failure patients. The Heart Failure patient population would greatly benefit from the additional support, education, and supervision that cardiac rehab currently offers for AMI and Heart Surgery patients. This would optimize their quality of life and minimize costly hospital readmissions
Westlake, Cheryl Title: Professor and Associate Dean
Organization: Azusa Pacific University
Date: 11/22/2013
Comment:

As a previous AHA supported post doctoral fellow in Exercise and HF at UCLA, I strongly support the inclusion of CR for HF patients. CR has been shown to reduce HF re-hospitalization and mortality rates and improve exercise capacity (for some), and health-related quality of life (HRQoL) for patients with HF.

An additional study for consideration conducted by our group is provided here.

Dracup K, Evangelista LS, Hamilton MA, Erickson V, Hage A, Moriguchi J, Canary C,

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Anderson, Allen Title: Medical Director, Center for Heart Failure
Organization: Bluhm Cardiovascular Institute of Northwestern
Date: 11/22/2013
Comment:
As an academic Heart Failure/Transplant specialist, I support the inclusion of HF as an indication for outpatient cardiac rehab covered by CMS. While HF ACTION was designed to answer this question but didn't, limitations of that study perhaps obscures the benefits of programmed exercise. The Cocharane data on reduced hospitalizations is significant and there is a need for more strategies to reduce hospitalizations. The rehab setting can provide an excellent opportunity not only for exercise

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Pedersen, James Title: Heart Failure Coordinator
Organization: Cape Fear Valley Health
Date: 11/22/2013
Comment:

I am pleased to hear that you are considering expanding coverage of cardiac rehab to some of our heart failure patients. Cardiac rehav programs have an excellent track record at decreasing readmissions and increasing pt understanding of self management. Our health system has an excellent cardiac rehab program, and if we were able to send our heart failure patients that could significantly increase the quality of care we are able to provide, decrease 30 day readmissions and decrease over

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Bartholomew, Julie Date: 11/22/2013
Comment:
I am in support of providing Cardiac Rehab to patient with Chronic heart failure. This service will make a difference in the quality of life for these individuals.
Lengel, Patricia Title: Director of Cardiac Services
Organization: Sentara Healthcare
Date: 11/22/2013
Comment:
Cardiac rehab provides emotional support for those struggling with HF. Participating in rehab with others experiencing the same disease allows a supportive environement and motivates others to manage disease better. Increases knowledge of disease, improves quality of life through increasing activity levels. Overall improve in outlook related to their health and wellness. Allows them to take control and be accountable for a better state of health.
Huff, Jane Title: RN,CCM
Organization: NW Community Care Network
Date: 11/22/2013
Comment:
Regarding Cardiac Rehab program.

I may have misunderstood, but will the patient have ongoing CR without a time limit ?

Holland, Sharron Title: CFO
Organization: Baptist Memorial Hospital - Huntingdon
Date: 11/21/2013
Comment:
I support this proposal.