,,ii #aacth ,,congress #ast ,session ,s4 #eif ,,in ,,the ,,senate ,,of ,,the ,,united ,,states ,march #ah1 #bjac ,mr4 ,thune 7for himself and ,mr4 ,franken7 introduced the following bill2 which was read twice and referred to the ,committee on ,finance ,a ,,bill ,to establish pilot projects under the ,medicare program to provide incentives for home health agencies to furnish remote patient monitoring services that reduce expenditures under such program4 #a4 ,short title2 findings 7a7 ,short title ,this ,act may be cited as the ,fostering ,independence ,through ,technology ,act of #bjac4 7b7 ,findings ,congress makes the following findings3 7#a7 ,allowing seniors to remain in their homes longer can delay unnecessary1 costly transfers to higher acuity care settings4 7#b7 ,remote patient monitoring provides opportunities to control chronic conditions and research shows that approximately #ff percent of total health care spending is associated with care for the over one-in-four ,americans with multiple chronic conditions4 7#c7 ,current remote patient monitoring programs report patient satisfaction rates of over #ij percent4 7#d7 ,due to changes enacted by ,congress1 hospitals are facing payment penalties for patients that are readmitted to the hospital within #cj days of discharge4 7#e7 ,current remote patient monitoring programs that use technology to monitor discharged patients in non-invasive ways have experienced a reduction in hospital readmissions4 #b4 ,remote patient monitoring and support pilot projects 7a7 ,pilot projects 7#a7 ,in general ,not later than #i months after the date of the enactment of this ,act1 the ,secretary of ,health and ,human ,services 7in this section referred to as the ,secretary7 shall conduct pilot projects under title ,,xviii of the ,social ,security ,act for the purpose of providing incentives to home health agencies to furnish remote patient monitoring services that reduce expenditures under such title4 7#b7 ,site requirements 7,a7 ,urban and ,rural ,the ,secretary shall conduct the pilot projects under this section in both urban and rural areas4 7,b7 ,site in a small state ,the ,secretary shall conduct at least #a of the pilot projects in a ,state with a population of less than #a1jjj1jjj4 7#c7 ,definitions ,in this section3 7,a7 ,home health agency ,the term home health agency has the meaning given that term in section #ahfa7o7 of the ,social ,security ,act 7#db ,u4,s4,c4 #aciex7o774 7,b7 ,remote patient monitoring services 7i7 ,in general ,the term remote patient monitoring services means services furnished in the home using remote patient monitoring technology1 including in-home technology based professional consultations1 patient monitoring1 patient training services1 clinical observation1 assessment1 treatment1 and any additional services that utilize technologies specified by the ,secretary4 7ii7 ,limitation ,the term remote patient monitoring services shall not include a telecommunication that consists solely of a telephone audio conversation1 facsimile1 or electronic text mail between a health care professional and a patient4 7,c7 ,remote patient monitoring technology ,the term remote patient monitoring technology means a coordinated system that uses one or more home-based or mobile monitoring devices that are accessed by a patient and automatically transmit clinical data and responses to assessment questions collected on the devices wirelessly or through a telecommunications connection to a server that complies with the ,federal regulations 7concerning the privacy of individually identifiable health information7 promulgated under section #bfd7;c7 of the ,health ,insurance ,portability and ,accountability ,act of #aiif1 as part of an established plan of care for that patient that includes the review and interpretation of that data by a health care professional4 7b7 ,medicare beneficiaries within the scope of projects 7#a7 ,in general ,the ,secretary shall specify the criteria for identifying those ,medicare beneficiaries who shall be considered within the scope of the pilot projects under this section for purposes of the application of subsection 7c7 and for the assessment of the effectiveness of the home health agency in achieving the objectives of this section4 7#b7 ,the criteria specified under paragraph 7#a7-- 7,a7 shall include conditions and clinical circumstances1 including congestive heart failure1 diabetes1 and chronic pulmonary obstructive disease1 and other conditions determined appropriate by the ,secretary2 and 7,b7 may provide for the inclusion in the projects of ,medicare beneficiaries who begin receiving home health services under title ,,xviii of the ,social ,security ,act after the date of the implementation of the projects4 7c7 ,incentives 7#a7 ,performance targets ,the ,secretary shall establish for each home health agency participating in a pilot project under this section a performance target using one of the following methodologies1 as determined appropriate by the ,secretary3 7,a7 ,adjusted historical performance target ,the ,secretary shall establish for the agency-- 7i7 a base expenditure amount equal to the average total payments made under parts ,a1 ,b1 and ,d of title ,,xviii of the ,social ,security ,act for ,medicare beneficiaries determined to be within the scope of the pilot project in a base period determined by the ,secretary2 and 7ii7 an annual per capita expenditure target for such beneficiaries1 reflecting the base expenditure amount adjusted for risk1 changes in costs1 and growth rates4 7,b7 ,comparative performance target ,the ,secretary shall establish for the agency a comparative performance target equal to the average total payments under such parts ,a1 ,b1 and ,d during the pilot project for comparable individuals in the same geographic area that are not determined to be within the scope of the pilot project4 7#b7 ,payment ,subject to paragraph 7#c71 the ,secretary shall pay to each participating home care agency a payment for each year under the pilot project equal to a #ge percent share of the total ,medicare cost savings realized for such year relative to the performance target under paragraph 7#a74 7#c7 ,limitation on expenditures ,the ,secretary shall limit payments under this section in order to ensure that the aggregate expenditures under title ,,xviii of the ,social ,security ,act 7including payments under this subsection7 do not exceed the amount that the ,secretary estimates would have been expended if the pilot projects under this section had not been implemented1 including any reasonable costs incurred by the ,secretary in the administration of the pilot projects4 7#d7 ,no duplication in participation in shared savings programs ,a home health agency that participates in any of the following shall not be eligible to participate in the pilot project under this section3 7,a7 ,a model tested or expanded under section #aaae;,a that involves shared savings under this title or any other program or demonstration project that involves such shared savings4 7,b7 ,the independence at home medical practice pilot program under section #ahff;,e4 7d7 ,waiver authority ,the ,secretary may waive such provisions of titles ,,xi and ,,xviii of the ,social ,security ,act as the ,secretary determines to be appropriate for the conduct of the pilot projects under this section4 7e7 ,report to ,congress ,not later than #c years after the date that the first pilot project under this section is implemented1 the ,secretary shall submit to ,congress a report on the projects4 ,such report shall contain-- 7#a7 a detailed description of the projects1 including any changes in clinical outcomes for ,medicare beneficiaries under the projects1 ,medicare beneficiary satisfaction under the projects1 utilization of items and services under ,medicare parts ,a1 ,b1 and ,d by ,medicare beneficiaries under the projects1 and ,medicare per-beneficiary and ,medicare aggregate spending under the projects2 7#b7 a detailed description of issues related to the expansion of the projects under subsection 7f72 7#c7 recommendations for such legislation and administrative actions as the ,secretary considers appropriate2 and 7#d7 other items considered appropriate by the ,secretary4 7f7 ,expansion ,if the ,secretary determines that any of the pilot projects under this section enhance health outcomes for ,medicare beneficiaries and reduce expenditures under title ,,xviii of the ,social ,security ,act1 the ,secretary shall initiate comparable projects in additional areas4 7g7 ,payments have no effect on other ,medicare payments to agencies ,a payment under this section shall have no effect on the amount of payments that a home health agency would otherwise receive under title ,,xviii of the ,social ,security ,act for the provision of home health services4