; and (B) in subparagraph (C), 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)) ; (2) in paragraph (3)(A), by striking physician-prescribed exercise and inserting exercise prescribed by a physician (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)) ; and (3) in paragraph (5), 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)) . (b) Pulmonary rehabilitation programs Section 1861(fff) of the Social Security Act ( 42 U.S.C. 1395x(fff) ) is amended— (1) in paragraph (2)(A), by striking physician-prescribed exercise and inserting exercise prescribed by a physician (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)) ; 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. 21603. 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