Technology-Enabled Care in the Home (TECH) Act
Bill: S.3793 | Sponsor: Sen. Scott, Tim (R-SC)
Policy area: Health

Summary:
Technology-Enabled Care in the Home (TECH) Act
This bill provides for the Center for Medicare and Medicaid Innovation to test a model for furnishing at-home telehealth, remote patient monitoring, and other technology-enabled care interventions for chronically ill individuals who are enrolled in certain Medicare Advantage plans. The model must test the effect of such technology on Medicare Advantage spending and the overall quality of care for beneficiaries.
The bill also repeals provisions that prohibit the correction of earnings records for purposes of Social Security benefits after certain time limitations expire and determinations become final.

To amend title XI of the Social Security Act to recommend that the 
    Center for Medicare and Medicaid Innovation test the effect of 
 technology-enabled care interventions in the home to coordinate care 
  over time and across settings, improve quality, and lower costs for 
   certain Medicare Advantage beneficiaries, and for other purposes.

    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 ``Technology-Enabled Care in the Home 
(TECH) Act''.

SEC. 2. CENTER FOR MEDICARE AND MEDICAID INNOVATION TESTING OF MEDICARE 
              ADVANTAGE TELEHEALTH, REMOTE PATIENT MONITORING, AND 
              OTHER TECHNOLOGY-ENABLED CARE INTERVENTIONS IN THE HOME 
              DEMONSTRATION PROJECT.

    Section 1115A of the Social Security Act (42 U.S.C. 1315a) is 
amended--
            (1) in subsection (b)(2)(B), by adding at the end the 
        following new clause:
                            ``(xxviii) Furnishing telehealth, remote 
                        patient monitoring, and other technology-
                        enabled care interventions in the home to 
                        eligible individuals as described in subsection 
                        (h).''; and
            (2) by adding at the end the following new subsection:
    ``(h) Medicare Advantage Telehealth, Remote Patient Monitoring, and 
Other Technology-Enabled Care Interventions in the Home Demonstration 
Project (TECH Demonstration Project).--
            ``(1) Description of demonstration project and 
        requirements.--
                    ``(A) In general.--The demonstration project 
                described in this subsection (referred to in this 
                subsection as the `TECH demonstration project)' is a 
                demonstration project to test the use of telehealth 
                services, remote patient monitoring, and other 
                technology-enabled care interventions in the home for 
                eligible enrollees authorized under Medicare Advantage 
                organizations under part C of title XVIII and 
                restricted to such organizations that are participating 
                in the CMI's Value-Based Insurance Design model in 
                2023. The demonstration project will test the 
                effectiveness of these technology-enabled interventions 
                on--
                            ``(i) the provision of care in homes and 
                        congregate care settings for the management of 
                        disease progression, patient health, care 
                        quality, patient care experience, and caregiver 
                        well-being; and
                            ``(ii) reducing spending under part C of 
                        title XVIII without reducing quality of care.
                    ``(B) Voluntary participation.--Participation under 
                the TECH demonstration project shall be voluntary with 
                respect to both eligible enrollees and Medicare 
                Advantage organizations.
            ``(2) Duration.-- The TECH demonstration project shall be 
        implemented for a 3-year period, beginning not later than 18 
        months after the date of the enactment of this subsection.
            ``(3) Enrollment.--The TECH demonstration project shall 
        establish a comparison group and enroll sufficient numbers of 
        eligible enrollees to achieve statistically significant 
        findings on quality and cost for the demonstration project and 
        for specific sub-populations, including those based on 
        geography, socioeconomic status, age, race, and ethnicity.
            ``(4) Definitions.--In this subsection:
                    ``(A) Eligible enrollee.--The term `eligible 
                enrollee' means a chronically ill enrollee (as defined 
                in section 1852(a)(3)(D)(iii)).
                    ``(B) Remote patient monitoring.--The term `remote 
                patient monitoring' means connected digital 
                technologies and mobile medical devices that collect 
                clinical grade, patient-generated health data from 
                individuals in one location and electronically transmit 
                that information securely to a care team in a different 
                location for assessment and intervention.
                    ``(C) Telehealth services.--The term `telehealth 
                services' means telehealth services (as defined in 
                subparagraph (F) of section 1834(m)(4), but without 
                regard to geographic or other originating site 
                requirements described in subparagraph (C) of such 
                section).
                    ``(D) Other technology-enabled care 
                interventions.-- The term `technology-enabled care 
                interventions' means mobile, digital, or electronic 
                health services and systems that enable the remote, 
                secure exchange of information primarily between a 
                health or care provider and a patient in a home or 
                congregate care setting for the purpose of diagnosing 
                or managing a health condition.
            ``(5) Funding.--Out of amounts appropriated under 
        subsection (f)(1)(C) for the 10-year fiscal period beginning 
        with fiscal year 2020, $25,000,000 shall be made available to 
        carry out this subsection.''.

SEC. 3. CHANGES TO THE ADMINISTRATIVE FINALITY POLICY OF THE SOCIAL 
              SECURITY ADMINISTRATION.

    (a) In General.--Section 205(c) of the Social Security Act (42 
U.S.C. 401(c)) is amended--
            (1) by striking paragraphs (4) and (5) and inserting the 
        following:
            ``(4) The Commissioner of Social Security may, if it is 
        brought to the Commissioner's attention that any entry of wages 
        or self-employment income in the Commissioner's records for a 
        year is erroneous or that any item of wages or self-employment 
        income for such year has been omitted from such records, 
        correct such entry or include such omitted item in the 
        individual's records, as the case may be. After the expiration 
        of the time limitation following any year--
            ``(A) the Commissioner's records (with changes, if any, 
        made pursuant to such regulations as the Commissioner shall 
        establish) of the amounts of wages paid to, and self-employment 
        income derived by, an individual during any period in such year 
        shall be conclusive for the purposes of this title;
            ``(B) the absence of an entry in the Commissioner's records 
        as to the wages alleged to have been paid by an employer to an 
        individual during any period in such year shall be presumptive 
        evidence for the purposes of this title that no such alleged 
        wages were paid to such individual in such period; and
            ``(C) the absence of an entry in the Commissioner's records 
        as to the self-employment income alleged to have been derived 
        by an individual in such year shall be conclusive for the 
        purposes of this title that no such alleged self-employment 
        income was derived by such individual in such year unless it is 
        shown that the individual filed a tax return of the 
        individual's self-employment income for such year before the 
        expiration of the time limitation following such year, in which 
        case the Commissioner of Social Security shall include in the 
        Commissioner's records the self-employment income of such 
        individual for such year.'';
            (2) by redesignating paragraphs (6) through (9) as 
        paragraphs (5) through (8), respectively; and
            (3) in paragraph (5), as so redesignated, by striking 
        ``under paragraph (4) or (5)'' and inserting ``made by the 
        Commissioner of Social Security in accordance with such 
        regulations as the Commissioner shall establish''.
    (b) Requiring SSA To Adjust Administrative Finality Policy.--Not 
later than 6 months after the date of enactment, the Commissioner of 
Social Security shall promulgate regulations establishing processes and 
criteria for correcting the Commissioner's records of the wages and 
self-employment income of individuals for purposes of title II of the 
Social Security Act (42 U.S.C. 401 et seq.) in accordance with section 
205(c)(4) of such Act, as amended by subsection (a).
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