HR3108-119

What This Bill Does

The RPM Access Act addresses remote patient monitoring payment and quality under Medicare. Its findings say RPM supports coordinated care, improves outcomes, can lower Medicare costs, and is especially important for rural regions where three out of five health professional shortage areas are located and travel distances are longer. For RPM furnished on or after January 1, 2026, the bill sets a floor of 1.00 for the Medicare physician fee schedule practice expense and malpractice geographic indices if they would otherwise be below 1.00, and says the floor is not applied budget neutrally. It also bars Medicare payment for RPM unless a physician, nurse practitioner, clinical nurse specialist, or physician assistant is available in real time to respond to physiologic anomalies, the monitoring system can transmit physiologic data in an EHR-compatible format as needed, and the provider or supplier collects and reports HHS-required data to evaluate Medicare cost savings, unless HHS grants an unreasonable-hardship exemption. Within five years after enactment, HHS must report to Congress on estimated Medicare savings from earlier interventions and fewer hospital days, savings from better medication adherence, and RPM practice expenses including cellular connectivity and technology platform maintenance for the four-year period beginning January 1, 2026.

Who Benefits and How

Rural Medicare beneficiaries benefit if higher RPM payment supports monitoring access in low-index rural states. Medicare patients with heart failure benefit from remote monitoring backed by real-time clinical response. Medicare patients with hypertension benefit if RPM improves medication adherence and earlier intervention. Medicare patients with diabetes benefit from better access to remote monitoring in shortage areas. RPM providers in low-index states benefit from practice-expense and malpractice index floors of 1.00.

Who Bears the Burden and How

CMS must implement non-budget-neutral geographic index floors for RPM beginning January 1, 2026. Providers furnishing RPM must ensure real-time clinician availability, EHR-compatible data transmission, and cost-savings data reporting. RPM suppliers must maintain technology systems capable of physiologic data transmission and reporting. HHS must evaluate hardship exemptions and submit a five-year report to Congress. Medicare may pay more for RPM in areas where practice-expense or malpractice indices were below 1.00.

Key Provisions

• Establishes a 1.00 floor for RPM practice-expense and malpractice geographic indices beginning January 1, 2026.
• Provides that the RPM index floor is not applied in a budget-neutral manner.
• Requires real-time physician, nurse practitioner, clinical nurse specialist, or physician assistant response to physiologic anomalies.
• Requires EHR-compatible RPM data transmission and cost-savings data collection unless hardship is found.
• Directs HHS to report within five years on Medicare savings, medication adherence, hospitalization days, and RPM practice expenses.