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SECTION 1. SHORT TITLE.

This Act may be cited as the ''Remote Monitoring Access Act of
2005''.

SEC. 2. COVERAGE OF REMOTE PATIENT MANAGEMENT SERVICES FOR CHRONIC
HEALTH CARE CONDITIONS.

(a) In General.--Section 1861(s)(2) of the Social Security Act (42
U.S.C. 1395x(s)(2)) is amended--
(1) in subparagraph (Y), by striking ''and'' at the end;
(2) in subparagraph (Z), by inserting ''and'' at the end;
and
(3) by inserting after subparagraph (Z) the following new
subparagraph:
''(AA) remote patient management services (as
defined in subsection (bbb));''.
(b) Services Described.--Section 1861 of the Social Security Act
(42 U.S.C. 1395x) is amended by adding at the end the following new
subsection:

''Remote Patient Management Services

''(bbb)(1) The term 'remote patient management services' means the
remote monitoring and management of an individual with a covered
chronic health condition (as defined in paragraph (2)) through the
utilization of a system of technology that allows a remote interface to
collect and transmit clinical data between the individual and the
responsible physician or supplier for the purposes of clinical review
or response by the physician or supplier.
''(2) For purposes of paragraph (1), the term 'covered chronic
health condition' includes--
''(A) heart failure;
''(B) diabetes;
''(C) cardiac arrhythmia; and
''(D) any other chronic condition determined by the
Secretary to be appropriate for treatment through remote
patient management services.
''(3)(A) The Secretary, in consultation with appropriate physician
groups, may develop guidelines on the frequency of billing for remote
patient management services. Such guidelines shall be determined based
on medical necessity and shall be sufficient to ensure appropriate and
timely monitoring of individuals being furnished such services.
''(B) The Secretary, acting through the Agency for Health Care
Research and Quality, shall do the following:
''(i) Not later than 1 year after the date of enactment of
the Remote Monitoring Access Act of 2005, develop, in
consultation with appropriate physician groups, a standard of
care and quality standards for remote patient management
services for the covered chronic health conditions specified in
subparagraphs (A), (B), and (C) of paragraph (2).
''(ii) If the Secretary makes a determination under
paragraph (2)(D) with respect to a chronic condition, develop,
in consultation with appropriate physician groups, a standard
of care and quality standards for remote patient management
services for such condition within 1 year of such
determination.
''(iii) Periodically review and update such standards of
care and quality standards under this subparagraph as
necessary.''.
(c) Payment Under the Physician Fee Schedule.--Section 1848 of the
Social Security Act (42 U.S.C. 1395w-4) is amended--
(1) in subsection (c)(2)--
(A) in subparagraph (B)--
(i) in clause (ii)(II), by striking
''clause (iv)'' and inserting ''clauses (iv)
and (v)''; and
(ii) by adding at the end the following new
clause:
''(v) Budgetary treatment of certain
services.--The additional expenditures
attributable to services described in section
1861(s)(2)(AA) shall not be taken into account
in applying clause (ii)(II) for 2006.''; and
(B) by adding at the end the following new
paragraph:
''(7) Treatment of remote patient management services.--In
determining relative value units for remote patient management
services (as defined in section 1861(bbb)), the Secretary, in
consultation with appropriate physician groups, shall take into
consideration--
''(A) costs associated with such services,
including physician time involved, installation and
information transmittal costs, costs of remote patient
management technology (including devices and software),
and resource costs necessary for patient monitoring and
follow-up (but not including costs of any related item
or non-physician service otherwise reimbursed under
this title); and
''(B) the level of intensity of services provided,
based on--
''(i) the frequency of evaluation necessary
to manage the individual being furnished the
services;
''(ii) the amount of time necessary for,
and the complexity of, the evaluation,
including the information that must be
obtained, reviewed, and analyzed; and
''(iii) the number of possible diagnoses
and the number of management options that must
be considered.''; and
(2) in subsection (j)(3), by inserting ''(2)(AA),'' after
''(2)(W),''.
(d) Incentive Payments.--Section 1833 of the Social Security Act
(42 U.S.C. 1395l) is amended by adding at the end the following new
subsection:
''(v) Incentive for Meeting Certain Standards of Care and Quality
Standards in the Furnishing of Remote Patient Management Services.--In
the case of remote patient management services (as defined in section
1861(bbb)) that are furnished by a physician who the Secretary
determines meets or exceeds the standards of care and quality standards
developed by the Secretary under paragraph (3)(B) of such section for
such services, in addition to the amount of payment that would
otherwise be made for such services under this part, there shall also
be paid to the physician (or to an employer or facility in cases
described in clause (A) of section 1842(b)(6)) (on a monthly or
quarterly basis) from the Federal Supplementary Medical Insurance Trust
Fund an amount equal to 10 percent of the payment amount for the
service under this part.''.
(e) Effective Date.--The amendments made by this section shall
apply to services furnished on or after January 1, 2006.
Output:
Remote Monitoring Access Act of 2005 - Amends title XVIII (Medicare) of the Social Security Act to provide for coverage of remote patient management services for chronic health care conditions.