109 HR 6063 IH: Remote Monitoring Access Act of U.S. House of Representatives 2006-09-13 text/xml EN Pursuant to Title 17 Section 105 of the United States Code, this file is not subject to copyright protection and is in the public domain.

I 109th CONGRESS 2d Session H. R. 6063 IN THE HOUSE OF REPRESENTATIVES September 13, 2006 Mr. Pickering (for himself, Ms. Eshoo, Mr. Hayworth, and Mr. Tanner) introduced the following bill; which was referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned A BILL To amend title XVIII of the Social Security Act to provide for coverage of remote patient management services under part B of the Medicare Program.

1.

Short title

This Act may be cited as the Remote Monitoring Access Act of 2006.

2.

Findings

The Congress finds as follows: (1)Remote patient monitoring can make chronic disease management more effective and efficient for patients and the health care system. (2)By collecting, analyzing, and transmitting clinical health information to a health care practitioner, remote monitoring technologies allow patients and physicians to manage the patient’s condition in a consistent and real-time fashion. (3)Utilization of these technologies not only improves the quality of care given to patients, it also reduces the need for frequent physician office appointments, costly emergency room visits, and unnecessary hospitalizations. (4)Monitoring a patient’s disease from the home reduces the need for face-to-face physician interactions, thereby minimizing unnecessary travel and missed work and providing particular value to individuals residing in rural or underserved communities who would otherwise face potentially significant access barriers to receiving needed care. (5)Four major areas in which remote management technologies are emerging in health care are the treatment of congestive heart failure, diabetes, cardiac arrhythmia, and sleep apnea (sleep disordered breathing). Prompt transmission of clinical data on each of these conditions, to the physician or the patient as appropriate, are essential to providing timely and appropriate therapeutic interventions which can then reduce expensive hospitalizations. (6)Despite these innovations, remote management technologies have failed to diffuse rapidly. A significant barrier to wider adoption is the relative lack of payment mechanisms in fee-for-service Medicare to reimburse for remote, non-face-to-face management. (7)This Act will eliminate this barrier to new technologies by requiring Medicare to reimburse doctors for time spent analyzing data transmitted to them by remote patient management technologies. (8)This Act also promotes high quality care by requiring the Secretary of Health and Human Services to consult with physician groups to create a standard of care and a quality standard for remote patient management services for the covered chronic conditions.

3.

Coverage of remote patient management services for chronic care conditions

(a)

In general

Section 1861(s)(2) of the Social Security Act (42 U.S.C. 1395x(s)(2)) is amended— (1)in subparagraph (Z), by striking “and” at the end; (2)by adding and at the end of subparagraph (AA); and (3)by adding after subparagraph (AA) the following new subparagraph: (BB)remote patient management services (as defined in subsection (ccc)). . (b)

Services described

Section 1861 of such Act (42 U.S.C. 1395x) is amended by adding at the end the following new subsection: (ccc)

Remote Patient Management Services for Chronic Conditions

(1)The term “remote patient management services” means the remote monitoring and management of an individual with a covered chronic health condition (as defined in paragraph (2)) or through the utilization of a system of technology that allows a remote interface to collect and transmit clinical data between the individual and the responsible physician or supplier for the purposes of clinical review or response by the physician or supplier. (2)For purposes of paragraph (1), the term ‘covered chronic health condition’ includes— (A)heart failure; (B)diabetes; (C)cardiac arrhythmia; (D)sleep apnea; and (E)any other chronic condition determined by the Secretary to be appropriate for treatment through remote patient management services. (3)(A)The Secretary, in consultation with appropriate physician groups, may develop guidelines on the frequency of billing for remote patient management services. Such guidelines shall be determined based on medical necessity and shall be sufficient to ensure appropriate and timely monitoring of individuals being furnished such services. (B)The Secretary, acting through the Agency for Health Care Research and Quality, shall do the following: (i)Not later than 1 year after the date of enactment of this subsection, develop, in consultation with appropriate physician groups, a standard of care and quality standards for remote patient management services for the covered chronic health conditions specified in subparagraphs (A), (B), (C), and (D) of paragraph (2). (ii)If the Secretary makes a determination under paragraph (2)(E) with respect to a chronic condition, develop, in consultation with appropriate physician groups, a standard of care and quality standards for remote patient management services for such condition within 1 year of the date of such determination. (iii)Periodically review and update such standards of care and quality standards under this subparagraph as necessary. . (c)

Payment under the physician fee schedule

Section 1848 of such Act (42 U.S.C. 1395w–4) is amended— (1)in subsection (c)— (A)in paragraph (2)(B)— (i)in clause (ii)(II), by striking “and (v)” and inserting “, (v), and (vi)”; and (ii)by adding at the end the following new clause: (vi)

Budgetary treatment of certain services

The additional expenditures attributable to section 1861(s)(2)(BB) shall not be taken into account in applying clause (ii)(II) for review: 2008. ; and (B)by adding at the end the following new paragraph: (7)

Treatment of remote patient management services

In determining relative value units for remote patient management services (as defined in section 1861(ccc)), the Secretary, in consultation with appropriate physician groups, shall take into consideration— (A)costs associated with such services, including physician time involved, installation and information transmittal costs, costs of remote patient management technology (including devices and software), and resource costs necessary for patient monitoring and follow-up (but not including costs of any related item or non-physician service otherwise reimbursed under this title); and (B)the level of intensity of services provided, based on— (i)the frequency of evaluation necessary to manage the individual being furnished the services; (ii)the amount of time necessary for, and complexity of, the evaluation, including the information that must be obtained, reviewed and analyzed; and (iii)the number of possible diagnoses and the number of management options that must be considered. ; and (2)in section (j)(3), by inserting “(2)(BB),” after “(2)(AA),”. (d)

Effective date

The amendments made by this section shall apply to services furnished on or after January 1, 2008.