“ 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. ”

“ Topics.—The topics specified in this subparagraph, for the study under subparagraph (A) concerning the competitive acquisition program, are the following: `` (i) Beneficiary access to items and services under the program, including the impact on such access of awarding contracts to bidders that— `` (I) did not have a physical presence in an area where they received a contract; or `` (II) had no previous experience providing the product category they were contracted to provide. `` (ii) Beneficiary satisfaction with the program and cost savings to beneficiaries under the program. ”

“ Subject to clause (ii) , beginning in 2012, the Secretary shall annually increase payment amounts established under this paragraph by an ESRD market basket percentage increase factor for a bundled payment system for renal dialysis services that reflects changes over time in the prices of an appropriate mix of goods and services included in renal dialysis services minus 1.0 percentage point. ”

“ In general.—The Secretary shall establish pilot projects to— `` (1) increase public and medical community awareness (particularly of those who treat patients with diabetes and hypertension) regarding chronic kidney disease, focusing on prevention; `` (2) increase screening for chronic kidney disease, focusing on Medicare beneficiaries at risk of chronic kidney disease; and `` (3) enhance surveillance systems to better assess the prevalence and incidence of chronic kidney disease. ”

“ Exception.—In the case of a specified area or medical topic determined appropriate by the Secretary for which a feasible and practical measure has not been endorsed by the entity with a contract under section 1890 (a) , the Secretary may specify a measure that is not so endorsed as long as due consideration is given to measures that have been endorsed or adopted by a consensus organization identified by the Secretary. ”

“ Initial disclosure.—Not later than 10 days after the date a supplier enters into a contract with the Secretary under this section, such supplier shall disclose to the Secretary, in a form and manner specified by the Secretary, the information on— `` (I) each subcontracting relationship that such supplier has in furnishing items and services under the contract; and `` (II) whether each such subcontractor meets the requirement of section 1834 (a) (20) (F) (i) , if applicable to such subcontractor. ”

“ Speech-Language Pathology Services. (a) In General.— Section 1861 (ll) of the Social Security Act (42 U.S.C. 1395x (ll) ) is amended— (1) by redesignating paragraphs (2) and (3) as paragraphs (3) and (4) , respectively; and (2) by inserting after paragraph (1) the following new paragraph:
`` (2) The term ‘outpatient speech-language pathology services’ has the meaning given the term ‘outpatient physical therapy services’ in subsection (p) , except that in applying such subsection— `` (A) ‘speech-language pathology’ shall be substituted for ‘physical therapy’ each place it appears ”

“ To be eligible for an intensive cardiac rehabilitation program, an individual must have— `` (i) had an acute myocardial infarction within the preceding 12 months; `` (ii) had coronary bypass surgery; `` (iii) stable angina pectoris ”