; and (2) in paragraph (3), by inserting after physician the following: (as defined in subsection (r)(1)) or a physician assistant, nurse practitioner, or clinical nurse specialist (as those terms are defined in subsection (aa)(5)) . (c) Effective date The amendments made by this section shall apply with respect to items and services furnished on or after January 1, 2021. 3. Expediting access to cardiac rehabilitation programs and pulmonary rehabilitation programs under Medicare program Section 51008(c) of the Bipartisan Budget Act of 2018 (Public Law 115–123; 42 U.S.C. 1395x note) is amended by striking January 1, 2024 and inserting January 1, 2021 .