II 

109TH CONGRESS 

1ST SESSION S. 2022 

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. 

IN THE SENATE OF THE UNITED STATES 

NOVEMBER 16, 2005 

Mr. COLEMAN (for himself and Mr. BINGAMAN) introduced the following bill; 

which was read twice and referred to the Committee on Finance 

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. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Remote Monitoring 

5 Access Act of 2005’’. 
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1 SEC. 2. COVERAGE OF REMOTE PATIENT MANAGEMENT 

2 SERVICES FOR CHRONIC HEALTH CARE CON3 DITIONS. 

4 (a) IN GENERAL.—Section 1861(s)(2) of the Social 

5 Security Act (42 U.S.C. 1395x(s)(2)) is amended— 

6 (1) in subparagraph (Y), by striking ‘‘and’’ at 

7 the end; 

8 (2) in subparagraph (Z), by inserting ‘‘and’’ at 

9 the end; and 

10 (3) by inserting after subparagraph (Z) the fol11 lowing new subparagraph: 

12 ‘‘(AA) remote patient management services 

13 (as defined in subsection (bbb));’’. 

14 (b) SERVICES DESCRIBED.—Section 1861 of the So15 cial Security Act (42 U.S.C. 1395x) is amended by adding 

16 at the end the following new subsection: 

17 ‘‘Remote Patient Management Services 

18 ‘‘(bbb)(1) The term ‘remote patient management 

19 services’ means the remote monitoring and management 

20 of an individual with a covered chronic health condition 

21 (as defined in paragraph (2)) through the utilization of 

22 a system of technology that allows a remote interface to 

23 collect and transmit clinical data between the individual 

24 and the responsible physician or supplier for the purposes 

25 of clinical review or response by the physician or supplier. 
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1 ‘‘(2) For purposes of paragraph (1), the term ‘cov2 ered chronic health condition’ includes— 

3 ‘‘(A) heart failure; 

4 ‘‘(B) diabetes; 

5 ‘‘(C) cardiac arrhythmia; and 

6 ‘‘(D) any other chronic condition determined by 

7 the Secretary to be appropriate for treatment 

8 through remote patient management services. 

9 ‘‘(3)(A) The Secretary, in consultation with appro10 priate physician groups, may develop guidelines on the fre11 quency of billing for remote patient management services. 

12 Such guidelines shall be determined based on medical ne13 cessity and shall be sufficient to ensure appropriate and 

14 timely monitoring of individuals being furnished such serv15 ices. 

16 ‘‘(B) The Secretary, acting through the Agency for 

17 Health Care Research and Quality, shall do the following: 

18 ‘‘(i) Not later than 1 year after the date of en19 actment of the Remote Monitoring Access Act of 

20 2005, develop, in consultation with appropriate phy21 sician groups, a standard of care and quality stand22 ards for remote patient management services for the 

23 covered chronic health conditions specified in sub24 paragraphs (A), (B), and (C) of paragraph (2). 
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1 ‘‘(ii) If the Secretary makes a determination 

2 under paragraph (2)(D) with respect to a chronic 

3 condition, develop, in consultation with appropriate 

4 physician groups, a standard of care and quality 

5 standards for remote patient management services 

6 for such condition within 1 year of such determina7 tion. 

8 ‘‘(iii) Periodically review and update such 

9 standards of care and quality standards under this 

10 subparagraph as necessary.’’. 

11 (c) PAYMENT UNDER THE PHYSICIAN FEE SCHED12 ULE.—Section 1848 of the Social Security Act (42 U.S.C. 

13 1395w–4) is amended— 

14 (1) in subsection (c)(2)— 

15 (A) in subparagraph (B)— 

16 (i) in clause (ii)(II), by striking 

17 ‘‘clause (iv)’’ and inserting ‘‘clauses (iv) 

18 and (v)’’; and 

19 (ii) by adding at the end the following 

20 new clause: 

21 ‘‘(v) BUDGETARY TREATMENT OF

22 CERTAIN SERVICES.—The additional ex23 penditures attributable to services de24 scribed in section 1861(s)(2)(AA) shall not 
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1 be taken into account in applying clause 

2 (ii)(II) for 2006.’’; and 

3 (B) by adding at the end the following new 

4 paragraph: 

5 ‘‘(7) TREATMENT OF REMOTE PATIENT MAN6 AGEMENT SERVICES.—In determining relative value 

7 units for remote patient management services (as 

8 defined in section 1861(bbb)), the Secretary, in con9 sultation with appropriate physician groups, shall 

10 take into consideration— 

11 ‘‘(A) costs associated with such services, 

12 including physician time involved, installation 

13 and information transmittal costs, costs of re14 mote patient management technology (including 

15 devices and software), and resource costs nec16 essary for patient monitoring and follow-up 

17 (but not including costs of any related item or 

18 non-physician service otherwise reimbursed 

19 under this title); and 

20 ‘‘(B) the level of intensity of services pro21 vided, based on— 

22 ‘‘(i) the frequency of evaluation nec23 essary to manage the individual being fur24 nished the services; 
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1 ‘‘(ii) the amount of time necessary 

2 for, and the complexity of, the evaluation, 

3 including the information that must be ob4 tained, reviewed, and analyzed; and 

5 ‘‘(iii) the number of possible diagnoses 

6 and the number of management options 

7 that must be considered.’’; and 

8 (2) in subsection (j)(3), by inserting ‘‘(2)(AA),’’ 

9 after ‘‘(2)(W),’’. 

10 (d) INCENTIVE PAYMENTS.—Section 1833 of the So11 cial Security Act (42 U.S.C. 1395l) is amended by adding 

12 at the end the following new subsection: 

13 ‘‘(v) INCENTIVE FOR MEETING CERTAIN STANDARDS

14 OF CARE AND QUALITY STANDARDS IN THE FURNISHING

15 OF REMOTE PATIENT MANAGEMENT SERVICES.—In the 

16 case of remote patient management services (as defined 

17 in section 1861(bbb)) that are furnished by a physician 

18 who the Secretary determines meets or exceeds the stand19 ards of care and quality standards developed by the Sec20 retary under paragraph (3)(B) of such section for such 

21 services, in addition to the amount of payment that would 

22 otherwise be made for such services under this part, there 

23 shall also be paid to the physician (or to an employer or 

24 facility in cases described in clause (A) of section 

25 1842(b)(6)) (on a monthly or quarterly basis) from the 
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1 Federal Supplementary Medical Insurance Trust Fund an 

2 amount equal to 10 percent of the payment amount for 

3 the service under this part.’’. 

4 (e) EFFECTIVE DATE.—The amendments made by 

5 this section shall apply to services furnished on or after 

6 January 1, 2006. 

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