,,ii #aac? ,,congress #a/ ,session ,s4 #eif ,,9 ,,! ,,s5ate ,,( ,,! ,,unit$ ,,/ates ,m>* #ah1 #bjac ,mr4 ,?une 7= himself & ,mr4 ,frank57 introduc$ ! foll[+ bill2 :i* 0 read twice & ref]r$ to ! ,committee on ,f9ance ,a ,,bill ,to e/abli% pilot projects "u ! ,m$ic>e program to provide inc5tives = home heal? ag5cies to furni% remote pati5t monitor+ s]vices t r$uce exp5ditures "u su* program4 #a4 ,%ort title2 f9d+s 7a7 ,%ort title ,?is ,act may be cit$ z ! ,fo/]+ ,indep5d5ce ,?r\gh ,te*nology ,act ( #bjac4 7b7 ,f9d+s ,congress makes ! foll[+ f9d+s3 7#a7 ,all[+ s5iors to rema9 9 _! homes long] c delay unnecess>y1 co/ly transf]s to high] acuity c>e sett+s4 7#b7 ,remote pati5t monitor+ provides opportunities to control *ronic conditions & rese>* %[s t approximately #ff p]c5t ( total heal? c>e sp5d+ is associat$ ) c>e = ! ov] "o-9-f\r ,am]icans ) multiple *ronic conditions4 7#c7 ,curr5t remote pati5t monitor+ programs report pati5t satisfaction rates ( ov] #ij p]c5t4 7#d7 ,due to *anges enact$ by ,congress1 hospitals are fac+ paym5t p5alties = pati5ts t are readmitt$ to ! hospital )9 #cj days ( dis*>ge4 7#e7 ,curr5t remote pati5t monitor+ programs t use te*nology to monitor dis*>g$ pati5ts 9 non-invasive ways h exp]i5c$ a r$uction 9 hospital readmissions4 #b4 ,remote pati5t monitor+ & support pilot projects 7a7 ,pilot projects 7#a7 ,9 g5]al ,n lat] ?an #i mon?s aft] ! date ( ! enactm5t ( ?is ,act1 ! ,secret>y ( ,heal? & ,human ,s]vices 79 ?is section ref]r$ to z ! ,secret>y7 %all conduct pilot projects "u title ,,xviii ( ! ,social ,security ,act = ! purpose ( provid+ inc5tives to home heal? ag5cies to furni% remote pati5t monitor+ s]vices t r$uce exp5ditures "u su* title4 7#b7 ,site requirem5ts 7,a7 ,urban & ,rural ,! ,secret>y %all conduct ! pilot projects "u ?is section 9 bo? urban & rural areas4 7,b7 ,site 9 a small /ate ,! ,secret>y %all conduct at lea/ #a ( ! pilot projects 9 a ,/ate ) a population ( less ?an #a1jjj1jjj4 7#c7 ,def9itions ,9 ?is section3 7,a7 ,home heal? ag5cy ,! t]m home heal? ag5cy has ! mean+ giv5 t t]m 9 section #ahfa7o7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #aciex7o774 7,b7 ,remote pati5t monitor+ s]vices 7i7 ,9 g5]al ,! t]m remote pati5t monitor+ s]vices means s]vices furni%$ 9 ! home us+ remote pati5t monitor+ te*nology1 includ+ 9-home te*nology bas$ pr(essional consultations1 pati5t monitor+1 pati5t tra9+ s]vices1 cl9ical obs]vation1 assessm5t1 treatm5t1 & any additional s]vices t utilize te*nologies specifi$ by ! ,secret>y4 7ii7 ,limitation ,! t]m remote pati5t monitor+ s]vices %all n include a telecommunication t consi/s solely ( a telephone audio conv]sation1 facsimile1 or electronic text mail betwe5 a heal? c>e pr(essional & a pati5t4 7,c7 ,remote pati5t monitor+ te*nology ,! t]m remote pati5t monitor+ te*nology means a coord9at$ sy/em t uses "o or m home-bas$ or mobile monitor+ devices t are access$ by a pati5t & automatically transmit cl9ical data & responses to assessm5t que/ions collect$ on ! devices wirelessly or ?r\gh a telecommunications connection to a s]v] t complies ) ! ,f$]al regulations 7conc]n+ ! privacy ( individually id5tifiable heal? in=mation7 promulgat$ "u section #bfd7;c7 ( ! ,heal? ,insurance ,portability & ,acc\ntability ,act ( #aiif1 z "p ( an e/abli%$ plan ( c>e = t pati5t t includes ! review & int]pretation ( t data by a heal? c>e pr(essional4 7b7 ,m$ic>e b5efici>ies )9 ! scope ( projects 7#a7 ,9 g5]al ,! ,secret>y %all specify ! crit]ia = id5tify+ ^? ,m$ic>e b5efici>ies :o %all be consid]$ )9 ! scope ( ! pilot projects "u ?is section = purposes ( ! application ( subsection 7c7 & = ! assessm5t ( ! effectiv5ess ( ! home heal? ag5cy 9 a*iev+ ! objectives ( ?is section4 7#b7 ,! crit]ia specifi$ "u p>agraph 7#a7-- 7,a7 %all include conditions & cl9ical circum/ances1 includ+ conge/ive he>t failure1 diabetes1 & *ronic pulmon>y ob/ructive disease1 & o!r conditions det]m9$ appropriate by ! ,secret>y2 & 7,b7 may provide = ! inclusion 9 ! projects ( ,m$ic>e b5efici>ies :o beg9 receiv+ home heal? s]vices "u title ,,xviii ( ! ,social ,security ,act aft] ! date ( ! implem5tation ( ! projects4 7c7 ,inc5tives 7#a7 ,p]=mance t>gets ,! ,secret>y %all e/abli% = ea* home heal? ag5cy p>ticipat+ 9 a pilot project "u ?is section a p]=mance t>get us+ "o ( ! foll[+ me?odologies1 z det]m9$ appropriate by ! ,secret>y3 7,a7 ,adju/$ hi/orical p]=mance t>get ,! ,secret>y %all e/abli% = ! ag5cy-- 7i7 a base exp5diture am\nt equal to ! av]age total paym5ts made "u p>ts ,a1 ,b1 & ,d ( title ,,xviii ( ! ,social ,security ,act = ,m$ic>e b5efici>ies det]m9$ to be )9 ! scope ( ! pilot project 9 a base p]iod det]m9$ by ! ,secret>y2 & 7ii7 an annual p] capita exp5diture t>get = su* b5efici>ies1 reflect+ ! base exp5diture am\nt adju/$ = risk1 *anges 9 co/s1 & gr[? rates4 7,b7 ,comp>ative p]=mance t>get ,! ,secret>y %all e/abli% = ! ag5cy a comp>ative p]=mance t>get equal to ! av]age total paym5ts "u su* p>ts ,a1 ,b1 & ,d dur+ ! pilot project = comp>able individuals 9 ! same geographic area t are n det]m9$ to be )9 ! scope ( ! pilot project4 7#b7 ,paym5t ,subject to p>agraph 7#c71 ! ,secret>y %all pay to ea* p>ticipat+ home c>e ag5cy a paym5t = ea* ye> "u ! pilot project equal to a #ge p]c5t %>e ( ! total ,m$ic>e co/ sav+s realiz$ = su* ye> relative to ! p]=mance t>get "u p>agraph 7#a74 7#c7 ,limitation on exp5ditures ,! ,secret>y %all limit paym5ts "u ?is section 9 ord] to ensure t ! aggregate exp5ditures "u title ,,xviii ( ! ,social ,security ,act 7includ+ paym5ts "u ?is subsection7 d n exce$ ! am\nt t ! ,secret>y e/imates w\ld h be5 exp5d$ if ! pilot projects "u ?is section _h n be5 implem5t$1 includ+ any reasonable co/s incurr$ by ! ,secret>y 9 ! adm9i/ration ( ! pilot projects4 7#d7 ,no duplication 9 p>ticipation 9 %>$ sav+s programs ,a home heal? ag5cy t p>ticipates 9 any ( ! foll[+ %all n be eligible to p>ticipate 9 ! pilot project "u ?is section3 7,a7 ,a model te/$ or exp&$ "u section #aaae;,a t involves %>$ sav+s "u ?is title or any o!r program or demon/ration project t involves su* %>$ sav+s4 7,b7 ,! indep5d5ce at home m$ical practice pilot program "u section #ahff;,e4 7d7 ,waiv] au?ority ,! ,secret>y may waive su* provisions ( titles ,,xi & ,,xviii ( ! ,social ,security ,act z ! ,secret>y det]m9es to be appropriate = ! conduct ( ! pilot projects "u ?is section4 7e7 ,report to ,congress ,n lat] ?an #c ye>s aft] ! date t ! fir/ pilot project "u ?is section is implem5t$1 ! ,secret>y %all submit to ,congress a report on ! projects4 ,su* report %all conta9-- 7#a7 a detail$ description ( ! projects1 includ+ any *anges 9 cl9ical outcomes = ,m$ic>e b5efici>ies "u ! projects1 ,m$ic>e b5efici>y satisfaction "u ! projects1 utilization ( items & s]vices "u ,m$ic>e p>ts ,a1 ,b1 & ,d by ,m$ic>e b5efici>ies "u ! projects1 & ,m$ic>e p]-b5efici>y & ,m$ic>e aggregate sp5d+ "u ! projects2 7#b7 a detail$ description ( issues relat$ to ! expansion ( ! projects "u subsection 7f72 7#c7 recomm5dations = su* legislation & adm9i/rative actions z ! ,secret>y consid]s appropriate2 & 7#d7 o!r items consid]$ appropriate by ! ,secret>y4 7f7 ,expansion ,if ! ,secret>y det]m9es t any ( ! pilot projects "u ?is section enhance heal? outcomes = ,m$ic>e b5efici>ies & r$uce exp5ditures "u title ,,xviii ( ! ,social ,security ,act1 ! ,secret>y %all initiate comp>able projects 9 additional areas4 7g7 ,paym5ts h no effect on o!r ,m$ic>e paym5ts to ag5cies ,a paym5t "u ?is section %all h no effect on ! am\nt ( paym5ts t a home heal? ag5cy w\ld o!rwise receive "u title ,,xviii ( ! ,social ,security ,act = ! provision ( home heal? s]vices4