This bill, the Expanding Remote Monitoring Access Act, requires the Department of Health and Human Services to ensure that certain remote monitoring services paid under Medicare are payable when at least 2 days of patient data are collected within a 30-day period. That 2-day payment rule would apply during the two-year period starting on the date the bill becomes law. The bill directs the Secretary to submit a report to Congress within one year that summarizes past experience with a 2-day minimum, recommends a reimbursement model that accounts for patient acuity and cost, analyzes place-of-service and supervision rules for non-clinical staff, and estimates savings from earlier interventions and fewer hospital days. The bill defines "remote monitoring" to include remote physiologic monitoring and remote therapeutic monitoring and lists many clinical situations in which fewer than 16 days of monitoring may be clinically meaningful. The bill also lists the types of entities the Secretary must consult when preparing the report.
For Medicare patients and clinicians: during the two-year period after the bill becomes law, Medicare would pay for remote physiologic and therapeutic monitoring when at least 2 days of data are collected in a 30-day period, regardless of COVID-19 status. The Secretary will study current practice, talk with many stakeholders, and recommend how reimbursement, supervision, and place-of-service rules should work going forward. The bill does not itself make permanent changes beyond the two-year payment rule.
No publicly available information on expected costs to Medicare or the federal budget is included in the bill text. The bill does require the Secretary to produce an analysis of estimated savings from earlier interventions and fewer hospital days as part of the required report.
The bill text states that remote monitoring can help patients manage conditions at home, improve health outcomes, reduce long-term costs, and increase care options. It notes the VA found large reductions in bed days and hospital admissions for veterans in remote monitoring programs. The bill argues the previous Medicare rule requiring 16 days of data in a 30-day period can limit use of remote monitoring and that clinical examples exist where fewer than 16 days are sufficient. It points to a temporary CMS COVID-19-era policy that used a 2-day minimum as evidence that shorter durations can be appropriate.
The bill text records that when CMS considered lowering the 16-day minimum previously, CMS did not revise the rule because it said it had not received "specific clinical examples" showing when fewer days would be medically reasonable and necessary. The text does not provide other opponent statements or opposition analyses.