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[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[H.R. 3032 Introduced in House (IH)]
<DOC>
119th CONGRESS
1st Session
H. R. 3032
To ensure appropriate access to remote monitoring services furnished
under the Medicare program.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
April 28, 2025
Mr. Balderson (for himself, Mr. Dunn of Florida, and Mr. Murphy)
introduced the following bill; which was referred to the Committee on
Energy and Commerce, and in addition to the Committee on Ways and
Means, for a period to be subsequently determined by the Speaker, in
each case for consideration of such provisions as fall within the
jurisdiction of the committee concerned
_______________________________________________________________________
A BILL
To ensure appropriate access to remote monitoring services furnished
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 ``Expanding Remote Monitoring Access
Act''.
SEC. 2. FINDINGS.
The Congress finds the following:
(1) Remote monitoring is an option that can help patients
manage their health conditions from their homes with oversight
from their health care providers, which can improve patient
health outcomes, reduce long-term health costs, and increase
care options for patients.
(2) The Department of Veterans Affairs (VA) saw such
results in a 2019 report. Veterans enrolled in remote patient
monitoring had a 53 percent decrease in VA bed days of care and
a 33 percent decrease in VA hospital admissions.
(3) Providers are currently required by Medicare to collect
16 days of patient data over a 30-day period in order to bill
Medicare for remote monitoring services, even in cases where
this full duration is not medically necessary to ensure the
health and safety of the patient. This can limit the use of
remote monitoring in instances where it can promote patient
health and safety and where it can reduce the overall cost on
the health system.
(4) In the 2021 Physician Fee Schedule, the Centers for
Medicare and Medicaid Services (CMS) issued an interim policy
to lower the duration required by Medicare to bill for remote
monitoring services from 16 days to 2 days within a 30-day
period, but only for individuals who had been diagnosed with,
or were suspected of having, COVID-19. This short-term
flexibility called attention to the long-term need to reassess
the minimum duration required for providers to bill for remote
monitoring.
(5) As part of issuing the 2021 Physician Fee Schedule, CMS
studied comments in support of permanently lowering the minimum
required duration of remote monitoring for all patients, not
just those with COVID-19.
(6) CMS concluded that ``we agree that a full 16 days of
monitoring may not always be reasonable and necessary'' but did
not revise the 16 day per 30-day period minimum duration for
all patients because CMS did not believe they had received
``specific clinical examples'' to allow for ``understanding
under what clinical circumstances fewer days of monitoring
would be medically reasonable and necessary and allow a
practitioner to establish clinically meaningful care''.
(7) Clinical evidence shows numerous instances in which
fewer than sixteen days of monitoring within a 30-day period
establishes clinically meaningful care. These include:
(A) Sixteen days of monitoring per 30-day period
may not be required to establish that a patient has
sleep apnea.
(B) A patient prescribed a narcotic for pain may
require their breathing to be monitored only while on
the medication.
(C) A patient with a chronic condition like
diabetes, congestive heart failure, or obesity may have
their weight monitored over a longer period of time,
but it is not clinically appropriate to have such
patient step on a scale 16 or more times in each 30-day
period.
(D) A patient whose blood pressure or oxygen levels
are monitored during physical therapy may not
necessitate 16 days of monitoring in each 30-day period
given physical therapy is often ordered twice weekly.
(E) A patient who wears a heart monitor to measure
palpitations may wear the monitor continuously, but the
data only needs to be collected when the individual is
experiencing symptoms.
(F) A patient with hypertension is often monitored
for long-term management of this condition on more of a
weekly basis, only needing more frequent data
collection for active monitoring with changes in
medication or dosages.
(G) A patient who suffers from Muscular Sclerosis
or Muscular Dystrophy may benefit from a provider
tracking the patient's exercise between visits to
monitor certain physiologic parameters such as muscle
movement but may not produce 16 days of data in a 30-
day period.
(H) A patient who needs a total joint replacement
may simply need pre-testing for surgery baselines,
including to establish gait, force, activity, heart
rate and other factors and then compare pre-surgery and
post-surgery function.
(I) For a patient with urologic dysfunction, male
urine flow data obtained from the patient can be
collected in two to four consecutive days.
(J) Remote monitoring may allow a provider to
assess a patient's adherence, range of motion, and
response to physical therapy and occupational therapy
regimens even though many such regimens are less than
16 days per month.
(K) Monitoring cognitive behavioral therapy for
less than 16 days in a 30-day period may provide
clinically meaningful care while moderating a patient's
anxiety and other symptoms.
(L) A patient with respiratory issues may not
require a full 16 days of monitoring of inhaler usage
to get clinical benefits from remote monitoring.
(8) A two-day minimum duration would permit Medicare
coverage of the full range of remote monitoring services that
can be beneficial to a patient without precluding the
differential reimbursement of individual remote monitoring
services based on patient acuity and cost.
SEC. 3. ENSURING APPROPRIATE ACCESS TO REMOTE MONITORING SERVICES
FURNISHED UNDER THE MEDICARE PROGRAM.
(a) In General.--Notwithstanding any other provision of law, the
Secretary of Health and Human Services (in this section referred to as
the ``Secretary'') shall ensure that remote monitoring services
furnished under title XVIII of the Social Security Act (42 U.S.C. 1395
et seq.) during the period beginning on the date of the enactment of
this Act and ending on the date that is 2 years after such date of
enactment are payable for a minimum of 2 days of data collection over a
30-day period, regardless of whether the individual receiving such
services has been diagnosed with, or is suspected of having, COVID-19.
(b) Report.--
(1) In general.--Not later than 1 year after the date of
the enactment of this Act, the Secretary shall, after
consulting with entities specified in paragraph (2), submit to
Congress a report that includes the following:
(A) A summary and analysis of previous experience
with such remote monitoring services being payable
under such title for a minimum of 2 days of data
collection over a 30-day period.
(B) Recommendations for implementing a
reimbursement model that takes into account patient
acuity and cost of providing remote monitoring
services, including potentially creating differential
reimbursements for periods with different durations,
such as fewer than and more than 16 days.
(C) An analysis and justification for the
appropriate place of service and supervision
requirements for non-clinical staff reviewing and
escalating patient data and provide recommendations.
(D) An analysis of the estimated savings resulting
from earlier interventions and fewer days of
hospitalizations among patients furnished remote
monitoring services.
(2) Specified entities.--For purposes of paragraph (1), the
entities specified in this paragraph are the following:
(A) Relevant agencies within the Department of
Health and Human Services (including, with respect to
issues relating to waste, fraud, or abuse, the
Inspector General of such Department).
(B) The Department of Veterans Affairs (including
the Office of Connected Care of such Department).
(C) Licensed and practicing osteopathic and
allopathic physicians, anesthesiologists, physician
assistants, and nurse practitioners.
(D) Hospitals, health systems, academic medical
centers, and other medical facilities, such as acute
care hospitals, cancer hospitals, psychiatric
hospitals, hospital emergency departments, facilities
furnishing urgent care services, ambulatory surgical
centers, Federally qualified health centers, rural
health clinics, and post-acute care and long-term care
facilities.
(E) Medical professional organizations and medical
specialty organizations.
(F) Organizations with expertise in the development
of or operation of innovative remote physiologic
monitoring services technologies.
(G) Beneficiary advocacy organizations.
(H) The American Medical Association Current
Procedural Terminology Editorial Panel.
(I) Commercial payers.
(J) Any other entity determined appropriate by the
Secretary.
(c) Definitions.--In this section:
(1) Remote monitoring.--The term ``remote monitoring''
means remote physiologic monitoring and remote therapeutic
monitoring.
(2) Remote physiologic monitoring.--The term ``remote
physiologic monitoring'' means non-face-to-face monitoring and
analysis of physiologic factors used to understand a patient's
health status, including the collection and analysis of patient
physiologic data that are used to develop and manage a
treatment plan related to chronic or acute conditions.
(3) Remote therapeutic monitoring.--The term ``remote
therapeutic monitoring'' means the use of medical devices to
monitor a patient's health or response to treatment using non-
physiological data.
<all>
Introduced in House
Introduced in House
Referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
Referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
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