Professional Documents
Culture Documents
S.L.C.
114TH CONGRESS
2D SESSION
S. ll
To amend titles XVIII and XI of the Social Security Act to promote cost
savings and quality care under the Medicare program through the use
of telehealth and remote patient monitoring services, and for other purposes.
A BILL
To amend titles XVIII and XI of the Social Security Act
to promote cost savings and quality care under the Medicare program through the use of telehealth and remote
patient monitoring services, and for other purposes.
1
KEL16031
S.L.C.
2
1
(b) TABLE
OF
KEL16031
S.L.C.
TION WAIVERS.
1
2
3
9 1395 et seq.) is amended by adding at the end the fol10 lowing new section:
11
12
TORING
13
TION WAIVERS.
14
15
SERVICES
BRIDGE
DEMONSTRA-
(a) IMPLEMENTATION.
(1) IN
GENERAL.Subject
to the succeeding
16
17
18
19
20
21
22
23
24
25
KEL16031
S.L.C.
4
1
(2) ELIGIBLE
APPLICANT DEFINED.In
this
lowing:
10
1848(q)(1)(C)(i)(I).
11
12
13
14
fessional
15
16
17
providers.
18
19
described
in
section
24
25
KEL16031
S.L.C.
5
1
section; and
10
11
12
(c) WAIVER
OF
LIMITATIONS
FOR
TELEHEALTH
OR
(1) IN
GENERAL.The
15
16
17
18
19
20
21
22
23
24
25
KEL16031
S.L.C.
6
1
(2) GENERAL
SUPERVISION.The
Secretary
applicant.
14
15
16
17
18
19
20
21
22
23
subsection (g).
24
KEL16031
S.L.C.
7
1 tion waiver program under this section to ensure that
2 waivers under the program are being used as intended to
3 furnish telehealth or remote patient monitoring services.
4
(f) IMPLEMENTATION.
10
11
12
13
14
15
the Secretary, if
16
17
18
19
20
21
22
23
24
KEL16031
S.L.C.
8
1
viduals.
8 ber 31, 2020, the Chief Actuary of the Centers for Medi9 care & Medicaid Services shall submit to Congress a report
10 containing an evaluation of the impact of telehealth and
11 remote patient monitoring services under the demonstra12 tion waiver program on
13
14
15
16
17
18
KEL16031
S.L.C.
1
2
3
4
13
14
15
KEL16031
S.L.C.
10
1 provider who may furnish such services (provided the pro2 vider is a Medicare enrolled provider).
3
OF
DATA.A qualifying
(c) NO INCREASE
IN
14 retary determines payments for telehealth or remote pa15 tient monitoring services under this section will increase
16 expenditures under this title, the Secretary shall make ad17 justments to such payments to eliminate such increased
18 expenditures..
19
KEL16031
S.L.C.
11
TITLE
IIIMEDICARE
COVERAGE OF TELEHEALTH AND
REMOTE
PATIENT
MONITORING SERVICES
1
2
3
INDIVIDUALS
HEALTH CONDITIONS.
(a) COVERAGE.
(1) IN
WITH
CERTAIN
GENERAL.Section
CHRONIC
1861(s)(2) of the
10
11
amended
12
13
14
15
16
17
18
19
20
21
(2) COVERAGE
22
23
SERVICES.Section
24
25
KEL16031
S.L.C.
12
1
2
3
4
5
6
10
11
12
13
14
15
16
17
18
19
20
(iii)),.
21
FOR
KEL16031
S.L.C.
13
1
TIONS.(1)(A)
9 means personal medical data transmitted from an applica10 ble individual in one location via electronic communica11 tions technologies to an eligible provider (as defined in
12 subparagraph (D)) in a different location and used by the
13 eligible provider in furnishing remote patient monitoring
14 services to such individual that complies with the Federal
15 regulations (concerning the privacy and security of indi16 vidually identifiable health information) promulgated
17 under section 264(c) of the Health Insurance Portability
18 and Accountability Act of 1996, as part of an established
19 plan of care for that individual that includes the review
20 and interpretation of that data by an eligible provider.
21 Such term includes those services furnished in a Federally
22 qualified health center or a rural health clinic
23
24 vidual
KEL16031
S.L.C.
14
1
2
ceding 12 months.
11 which eligible providers who furnish remote patient moni12 toring services are required to annually submit data on
13 applicable quality measures under sections 1848 and
14 1833(z).
15
19
20
1848(b)(8); and
21
22
specify.
23
KEL16031
S.L.C.
15
1 of the term covered chronic condition under such sub2 paragraph will result in increased expenditures under this
3 title, the Secretary shall make adjustments to such defini4 tion to eliminate such increased expenditures.
5
6 applicable remote patient monitoring services for individ7 uals with certain chronic health conditions furnished to
8 an applicable individual during a period of up to 90 days
9 (beginning with the commencement of such services) and
10 such additional period as provided for under subparagraph
11 (B).
12
13 (A), with respect to an applicable individual, may be re14 newed by the eligible provider who provides chronic care
15 management services to such individual if the individual
16 has had one or more hospitalizations, not including emer17 gency room visits, related to the covered chronic conditions
18 of the individual described in paragraph (1)(C) since the
19 beginning of such period..
20
(c) PAYMENT.
21
(1) IN
GENERAL.Section
1848(j)(3) of the
22
23
24
assessment),.
KEL16031
S.L.C.
16
1
(2) RURAL
(aa) PAYMENT
FOR
OR A
BY A
RURAL
KEL16031
S.L.C.
17
1
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
KEL16031
S.L.C.
18
1 ing paragraph (3)(A) and inserting paragraph
2 (3)(A)(i).
3
10
11
PAYMENT.
(a)
STROKE
EVALUATION
SITES.Section
TELEHEALTH
SERV-
19
ICES.The
20
21
22
23
24
KEL16031
S.L.C.
19
1
2
NATIVE
AMERICAN
HEALTH
10
SERVICE FACILITIES.The
11
12
13
14
15
16
17
18
19
20
21
22
23
24
originating site
KEL16031
S.L.C.
20
1
FOR
NEW
13
14
DISTANT SITES.
15
18
19
20
21
22
23
24
25
KEL16031
S.L.C.
21
1
10
11
12
13
14
15
16
an eligible individual.
17
21
22
TORING SERVICES.
23
KEL16031
S.L.C.
22
1
denting appropriately;
4
5
(i) IN
7
8
9
10
GENERAL.Subject
to clause
GAPS IN MEASURES
11
12
MONITORING
13
14
15
16
17
18
19
20
21
22
23
measures..
SERVICES.Consistent
with
KEL16031
S.L.C.
23
1
2
3
4
12
13
14
15
section:
16
(m) USE
OF
TELEHEALTH
17 MONITORING SERVICES
TO
AND
REMOTE PATIENT
18 For plan year 2017 and subsequent plan years, the fol19 lowing shall apply:
20
(1) IN
GENERAL.An
21
22
23
24
25
conditions.
KEL16031
S.L.C.
24
1
(2)
WAIVER
OF
LIMITATIONS.Notwith-
10
11
12
13
14
15
(3) TREATMENT
AS BASIC BENEFITS.In
the
16
17
18
19
20
21
this part.
22
(4) AVAILABILITY
OF BENEFITS IN PERSON.
23
24
KEL16031
S.L.C.
25
1
(5) PROVISION
OF DATA.An
MA plan that
10
IN
BID
11 AMOUNT.Section 1854(a)(6)(A)(ii)(I) of the Social Se12 curity Act (42 U. S.C. 1395w24(a)(6)(A)(ii)(I)) is
13 amended by inserting , including, for plan year 2017 and
14 subsequent plan years, the use of telehealth or remote pa15 tient monitoring services to provide such benefits as de16 scribed in section 1852(m) before the semicolon at the
17 end.
18
(c) RULE
OF
KEL16031
S.L.C.
26
1
2
3
4
REMOTE
PATIENT
MONITORING
TECH-
17
18
19
20
21