[Congressional Bills 110th Congress]
[From the U.S. Government Publishing Office]
[S. 631 Introduced in Senate (IS)]







110th CONGRESS
  1st Session
                                 S. 631

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

                           February 15, 2007

  Mr. Coleman 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 
2007''.

SEC. 2. FINDINGS.

    Congress finds the following:
            (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.
            (9) This Act provides physicians with a financial incentive 
        to meet or exceed the standard of care and quality standards.

SEC. 3. 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 (Z), by striking ``and'' at the end;
            (2) in subparagraph (AA), by inserting ``and'' at the end; 
        and
            (3) by inserting after subparagraph (AA) the following new 
        subparagraph:
            ``(BB) remote patient management services (as defined in 
        subsection (ccc));''.
    (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

    ``(ccc)(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;
            ``(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, shall 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 2007, 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 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)--
                    (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 services described in section 
                        1861(s)(2)(BB) shall not be taken into account 
                        in applying clause (ii)(II) for 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 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)(BB),'' after 
        ``(2)(AA),''.
    (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(ccc)) 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 subclause (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, 2008.
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