Short title

This Act may be cited as the

Rural Patient Monitoring (RPM) Access Act

Findings

Congress finds the following:(1)Remote physiologic monitoring (referred to in this section as RPM) supports highly coordinated care, improves patient outcomes, and can lower costs to the Medicare program.(2)Three out of five federally designated health professional shortage areas are in rural regions, and rural residents generally must travel farther than urban counterparts to access health care services.(3)Medicare reimbursement for RPM is lowest in States where the prevalence of heart failure, hypertension, and diabetes are well above the national average.(4)The practice expenses and malpractice expenses incurred in the delivery of RPM are not lower in rural areas and do not widely vary by State.

Practice expense index floor

Section 1848(e)(1) of the Social Security Act (42 U.S.C. 1395w–4(e)(1)) is amended by adding at the end the following

(J)

Floor for practice expense and malpractice geographic indices for remote physiologic monitoring services

(i)

In general

For purposes of payment for remote physiologic monitoring services furnished on or after January 1, 2026, after calculating the practice expense and malpractice geographic indices, the Secretary shall increase any such index to 1.00 if such index would otherwise be less than 1.00. (ii)

Non-budget neutrality

Clause (i) shall not be applied in a budget neutral manner.

Ensuring high-quality services for Medicare beneficiaries

(a)

In general

Section 1848 of the Social Security Act (42 U.S.C. 1395w–4) is amended by adding at the end the following:

(u)

Ensuring high-Quality services for Medicare beneficiaries

(1)

In general

The Secretary shall ensure that remote physiologic monitoring services furnished under this title meet the following requirements:(A)Providers of remote physiologic monitoring must be capable of responding to data anomalies detected by the monitoring service through clinical support. This capability may be offered directly or through a contracted partner.(B)Providers of remote physiologic monitoring must be capable of transmitting all relevant captured vitals and treatment management notes to the electronic health record of the supervising provider as needed for effective care management.(C)Providers of remote physiologic monitoring must collect and report data required by the Secretary in order to facilitate the evaluation of cost savings to the Medicare program generated by the proliferation of remote physiologic monitoring services. (2)

Exceptions for small practices

The Secretary shall establish exceptions to the requirements under paragraph (1) for small medical practices as the Secretary determines appropriate.(3)

Definition of remote physiologic monitoring

For purposes of this section, the term remote physiologic monitoring means non-face-to-face monitoring and analysis of physiologic factors used to understand a patient’s health status, including the collection and analysis of patient physiologic data that are used to develop and manage a treatment plan related to chronic or acute conditions.

(b)

Report

Not later than 2 years after the date of the enactment of this Act, the Secretary of Health and Human Services shall submit to Congress a report that includes the following:(1)An analysis of the estimated savings to the Medicare program under title XVIII of the Social Security Act (42 U.S.C. 1395 et seq.) resulting from earlier interventions and fewer days of hospitalizations among beneficiaries furnished remote physiologic monitoring services.(2)An analysis of the estimated savings to the Medicare program resulting from greater medication adherence among beneficiaries furnished remote physiologic monitoring services.(3)An analysis of practice expenses related to the furnishing of remote physiologic monitoring services, including cellular connectivity and other technology platform maintenance.