Section 1 Short title
This Act may be cited as the “Rural Patient Monitoring Access Act” or the “RPM Access Act”.
Rural Patient Monitoring Access Act
A BILL
To amend title XVIII of the Social Security Act with respect to payment for remote patient monitoring under the Medicare program.
Sec. 2 Findings
Congress finds the following:
Remote patient monitoring (in this section referred to as “RPM”) supports highly coordinated care, improves patient outcomes, and can lower costs to the Medicare program.
Three out of five federally designated health professional shortage areas are in rural regions, and rural residents generally must travel farther than urban counterparts to access health care services.
Medicare reimbursement for RPM is lowest in States where the prevalence of heart failure, hypertension, and diabetes are well above the national average.
The practice expenses and malpractice expenses incurred in the delivery of RPM are not lower in rural areas and do not widely vary by State.
Sec. 3 Floor for practice expense and malpractice geographic indices for remote patient monitoring
Section 1848(e)(1) of the Social Security Act (42 U.S.C. 1395w–4(e)(1)) is amended by adding at the end the following new subparagraph:
“(J) Floor for practice expense and malpractice geographic indices for remote patient monitoring—For purposes of payment for remote patient monitoring furnished on or after January 1, 2026, after calculating the practice expense and malpractice geographic indices in clauses (i) and (ii) of subparagraph (A) and in subparagraph (B), the Secretary shall increase any such index to 1.00 if such index would otherwise be less than 1.00. The preceding sentence shall not be applied in a budget neutral manner.”
Sec. 4 Ensuring high-quality remote patient monitoring under Medicare
In general— Section 1834 of the Social Security Act (42 U.S.C. 1395m) is amended by adding at the end the following new subsection:
“(aa) Payment for remote patient monitoring—In the case of remote patient monitoring furnished on or after January 1, 2026, no payment may be made under this part for such monitoring furnished by a provider of services or supplier unless—
“(1) a physician, nurse practitioner, clinical nurse specialist, or physician assistant is available in real time to respond to any physiologic anomaly detected through such monitoring;
“(2) such monitoring is furnished through a system that can transmit physiologic data obtained through such monitoring in a format that is compatible with electronic health records, as needed; and
“(3) the provider or supplier collects and reports such data as the Secretary may require in order to facilitate the evaluation of cost savings to the program under this title that are generated by the use of remote patient monitoring, except that the Secretary may exempt a provider or supplier under this paragraph if the Secretary determines that such collection and reporting of data would result in unreasonable hardship upon such provider or supplier.”
Report—
In general— Not later than 5 years after the date of the enactment of this section, the Secretary of Health and Human Services shall submit to Congress a report that includes the following information, with respect to the 4-year period beginning January 1, 2026:
An analysis of the estimated savings to the Medicare program resulting from earlier interventions and fewer days of hospitalization among Medicare beneficiaries furnished remote patient monitoring (as such term is used for purposes of title XVIII of the Social Security Act (42 U.S.C. 1395 et seq.)) during such period.
An analysis of the estimated savings to the Medicare program resulting from increased adherence to prescription medications among Medicare beneficiaries furnished remote patient monitoring during such period.
An analysis of practice expenses as defined in section 1848(j) of the Social Security Act (42 U.S.C. 1395w–4(j)) related to the furnishing of remote patient monitoring during such period, including expenses related to cellular connectivity and other technology platform maintenance.
Definitions— In this subsection:
Medicare beneficiary— The term Medicare beneficiary means an individual entitled to benefits under part A of title XVIII of the Social Security Act (42 U.S.C. 1395c et seq.) or enrolled under part B of such title (42 U.S.C. 1395j et seq.)
Medicare program— The term Medicare program means the Medicare program under title XVIII of the Social Security Act (42 U.S.C. 1395 et seq.).