[Congressional Record Volume 153, Number 29 (Thursday, February 15, 2007)]
[Senate]
[Pages S2079-S2080]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. COLEMAN
  S. 631. 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; to the Committee on 
Finance.
  Mr. COLEMAN. Mr. President, I ask unanimous consent that the text of 
the bill I introduce today, the Remote Monitoring Access Act of 2007, 
be printed in the Record.
  There being no objection, the text of the bill was ordered to be 
printed in the Record, as follows:

                                 S. 631

       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

[[Page S2080]]

     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.
                                 ______