119-hr3032

[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[H.R. 3032 Introduced in House

    (IH) ]

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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.
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