RPM Access Act

Summary#

This bill, the "Rural Patient Monitoring Access Act" (RPM Access Act), changes how Medicare pays for remote patient monitoring (RPM). It sets a minimum geographic payment index of 1.00 for RPM practice-expense and malpractice adjustments for items paid under section 1848(e)(1) of the Social Security Act, effective January 1, 2026. The bill also requires that Medicare will not pay for RPM furnished on or after January 1, 2026 unless: (1) a physician, nurse practitioner, clinical nurse specialist, or physician assistant is available in real time to respond to physiologic anomalies detected by the monitoring; (2) the monitoring system can transfer physiologic data in a format compatible with electronic health records as needed; and (3) the provider collects and reports data the Secretary of HHS requires to help evaluate program cost savings, with exemptions allowed for unreasonable hardship. Finally, the bill directs HHS to report to Congress within five years, analyzing estimated Medicare savings from earlier interventions and increased medication adherence among RPM users, and to analyze RPM-related practice expenses (including cellular connectivity and platform maintenance) for the four-year period beginning January 1, 2026.

What it means for you#

  • If you are a Medicare beneficiary using RPM: Medicare will only pay for RPM after January 1, 2026 when real-time clinical response, EHR-compatible data transmission, and required reporting are in place.
  • If you are a health care provider or supplier offering RPM: You must ensure a qualified clinician is available in real time, use systems that can transmit data compatible with electronic health records, and collect and report data as required (unless exempted for hardship).
  • If you are in a State with low current geographic payment indices for RPM: The bill raises practice-expense and malpractice indices to at least 1.00, which means higher Medicare payments for RPM services in those areas starting January 1, 2026.

Expenses#

No publicly available information on total cost estimates is included in the bill text or metadata. The bill states that any geographic index below 1.00 for RPM will be increased to 1.00 and that this adjustment "shall not be applied in a budget neutral manner," which indicates payments to some providers will rise, but it does not provide dollar amounts. The bill also requires HHS to report on estimated Medicare savings from RPM and on RPM-related practice expenses (including cellular connectivity and platform maintenance) for the specified period.

Proponents' View#

The bill text includes findings that supporters rely on: RPM supports coordinated care, improves patient outcomes, and can lower Medicare costs; many health professional shortage areas are in rural regions where patients travel farther for care; Medicare reimbursement for RPM is lowest in States with high rates of heart failure, hypertension, and diabetes; and RPM practice and malpractice expenses are not lower in rural areas nor do they widely vary by State. These findings explain why proponents seek a payment floor and quality and reporting requirements.

Opponents' View#

No publicly available information about opponents' views or formal objections appears in the bill text or the provided metadata.