1.This Act may be cited as
the Remote Monitoring Access Act of
2007
.
2.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.
3.Coverage of
remote patient management services for chronic health care conditions
(a)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)Section 1861 of the Social Security Act (42 U.S.C.
1395x) is amended by adding at the end the following new subsection:
(ccc)Remote patient management services (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 scheduleSection 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 servicesThe 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 servicesIn 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)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 servicesIn 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)The amendments made by this section shall apply to services
furnished on or after January 1, 2008.