[Congressional Bills 109th Congress]
[From the U.S. Government Publishing Office]
[S. 2022 Introduced in Senate (IS)]








109th CONGRESS
  1st Session
                                S. 2022

To amend title XVIII of the Social Security Act to provide for coverage 
     of remote patient management services for chronic health care 
                 conditions under the Medicare program.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                           November 16, 2005

  Mr. Coleman (for himself and Mr. Bingaman) introduced the following 
  bill; which was read twice and referred to the Committee on Finance

_______________________________________________________________________

                                 A BILL


 
To amend title XVIII of the Social Security Act to provide for coverage 
     of remote patient management services for chronic health care 
                 conditions under the Medicare program.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Remote Monitoring Access Act of 
2005''.

SEC. 2. COVERAGE OF REMOTE PATIENT MANAGEMENT SERVICES FOR CHRONIC 
              HEALTH 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 (Y), by striking ``and'' at the end;
            (2) in subparagraph (Z), by inserting ``and'' at the end; 
        and
            (3) by inserting after subparagraph (Z) the following new 
        subparagraph:
                    ``(AA) remote patient management services (as 
                defined in subsection (bbb));''.
    (b) Services Described.--Section 1861 of the Social Security Act 
(42 U.S.C. 1395x) is amended by adding at the end the following new 
subsection:

                  ``Remote Patient Management Services

    ``(bbb)(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)) 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; and
            ``(D) 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 
        the Remote Monitoring Access Act of 2005, 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), and (C) of paragraph (2).
            ``(ii) If the Secretary makes a determination under 
        paragraph (2)(D) 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 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 the 
Social Security Act (42 U.S.C. 1395w-4) is amended--
            (1) in subsection (c)(2)--
                    (A) in subparagraph (B)--
                            (i) in clause (ii)(II), by striking 
                        ``clause (iv)'' and inserting ``clauses (iv) 
                        and (v)''; and
                            (ii) by adding at the end the following new 
                        clause:
                            ``(v) Budgetary treatment of certain 
                        services.--The additional expenditures 
                        attributable to services described in section 
                        1861(s)(2)(AA) shall not be taken into account 
                        in applying clause (ii)(II) for 2006.''; 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(bbb)), 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 the 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 subsection (j)(3), by inserting ``(2)(AA),'' after 
        ``(2)(W),''.
    (d) Incentive Payments.--Section 1833 of the Social Security Act 
(42 U.S.C. 1395l) is amended by adding at the end the following new 
subsection:
    ``(v) Incentive for Meeting Certain Standards of Care and Quality 
Standards in the Furnishing of Remote Patient Management Services.--In 
the case of remote patient management services (as defined in section 
1861(bbb)) that are furnished by a physician who the Secretary 
determines meets or exceeds the standards of care and quality standards 
developed by the Secretary under paragraph (3)(B) of such section for 
such services, in addition to the amount of payment that would 
otherwise be made for such services under this part, there shall also 
be paid to the physician (or to an employer or facility in cases 
described in clause (A) of section 1842(b)(6)) (on a monthly or 
quarterly basis) from the Federal Supplementary Medical Insurance Trust 
Fund an amount equal to 10 percent of the payment amount for the 
service under this part.''.
    (e) Effective Date.--The amendments made by this section shall 
apply to services furnished on or after January 1, 2006.
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