,i  #aai? ,,congress  #a/ ,session  ,h4 
,r4 #cajh  ,,9 ,,! ,,h\se ,,(           
,,repres5tatives  ,april #cj1 #bjbe,mr4 
,ku/(f 7= himself1 ,mr4 ,bald]son1 ,mr4 
,davis ( ,nor? ,c>ol9a1 & ,mr4 ,pocan7  
introduc$ ! foll[+ bill2 :i* 0 ref]r$ to
 ! ,committee on ,en]gy & ,comm]ce1 & 9 
addition to ! ,committee on ,ways &     
,means1 = a p]iod to be subsequ5tly     
det]m9$ by ! ,speak]1 9 ea* case =      
consid]ation ( su* provisions z fall )9 
! jurisdiction ( ! committee conc]n$  ,a
 ,,bill  ,to am5d title ,,xviii ( !     
,social ,security ,act ) respect to     
paym5t = remote pati5t monitor+ "u !    
,m$ic>e program4  #a4 ,%ort title  ,?is 
,act may be cit$ z ! ,rural ,pati5t     
,monitor+ ,access ,act or ! ,,rpm       
,access ,act4  #b4 ,f9d+s ,congress f9ds
 ! foll[+3 7#a7 ,remote pati5t monitor+ 
79 ?is section ref]r$ to z ,,rpm7       
supports highly coord9at$ c>e1 improves 
pati5t outcomes1 & c l[] co/s to !      
,m$ic>e program4  7#b7 ,?ree out ( five 
f$]ally designat$ heal? pr(essional     

%ortage areas are 9 rural regions1 &    
rural resid5ts g5]ally mu/ travel f>!r  
?an urban c\nt]p>ts to access heal? c>e 
s]vices4  7#c7 ,m$ic>e reimbursem5t =   
,,rpm is l[e/ 9 ,/ates :]e ! preval5ce (
 he>t failure1 hyp]t5sion1 & diabetes   
are well above ! national av]age4  7#d7 
,! practice exp5ses & malpractice       
exp5ses incurr$ 9 ! deliv]y ( ,,rpm are 
n l[] 9 rural areas & d n widely v>y by 
,/ate4  #c4 ,floor = practice exp5se &  
malpractice geographic indices = remote 
pati5t monitor+ ,section #ahdh7;e77#a7 (
 ! ,social ,security ,act 7#db ,u4,s4,c4
 #aciew-#d7;e77#a77 is am5d$ by add+ at 
! end ! foll[+ new subp>agraph3  7,j7   
,floor = practice exp5se & malpractice  
geographic indices = remote pati5t      
monitor+ ,= purposes ( paym5t = remote  
pati5t monitor+ furni%$ on or aft]      
,janu>y #a1 #bjbf1 aft] calculat+ !     
practice exp5se & malpractice geographic
 indices 9 clauses 7i7 & 7ii7 (         
subp>agraph 7,a7 & 9 subp>agraph 7,b71 !
 ,secret>y %all increase any su* index  

to #a4jj if su* index w\ld o!rwise be   
less ?an #a4jj4 ,! prec$+ s5t5ce %all n 
be appli$ 9 a budget neutral mann]4  4  
#d4 ,ensur+ high-quality remote pati5t  
monitor+ "u ,m$ic>e  7a7 ,9 g5]al       
,section #ahcd ( ! ,social ,security    
,act 7#db ,u4,s4,c4 #aciem7 is am5d$ by 
add+ at ! end ! foll[+ new subsection3  
7aa7 ,paym5t = remote pati5t monitor+ ,9
 ! case ( remote pati5t monitor+ furni%$
 on or aft] ,janu>y #a1 #bjbf1 no paym5t
 may be made "u ?is "p = su* monitor+   
furni%$ by a provid] ( s]vices or       
suppli] unless-- 7#a7 a physician1 nurse
 practition]1 cl9ical nurse speciali/1  
or physician assi/ant is available 9    
real "t to respond to any physiologic   
anomaly detect$ ?r\gh su* monitor+2     
7#b7 su* monitor+ is furni%$ ?r\gh a    
sy/em t c transmit physiologic data     
obta9$ ?r\gh su* monitor+ 9 a =mat t is 
compatible ) electronic heal? records1 z
 ne$$2 &  7#c7 ! provid] or suppli]     
collects & reports su* data z !         
,secret>y may require 9 ord] to         

facilitate ! evaluation ( co/ sav+s to !
 program "u ?is title t are g5]at$ by ! 
use ( remote pati5t monitor+1 except t !
 ,secret>y may exempt a provid] or      
suppli] "u ?is p>agraph if ! ,secret>y  
det]m9es t su* collection & report+ (   
data w\ld result 9 unreasonable h>d%ip  
^u su* provid] or suppli]4  4  7b7      
,report  7#a7 ,9 g5]al ,n lat] ?an #e   
ye>s aft] ! date ( ! enactm5t ( ?is     
section1 ! ,secret>y ( ,heal? & ,human  
,s]vices %all submit to ,congress a     
report t includes ! foll[+ in=mation1 ) 
respect to ! #d-ye> p]iod beg9n+ ,janu>y
 #a1 #bjbf3 7,a7 ,an analysis ( !       
e/imat$ sav+s to ! ,m$ic>e program      
result+ f e>li] int]v5tions & few] days 
( hospitalization among ,m$ic>e         
b5efici>ies furni%$ remote pati5t       
monitor+ 7z su* t]m is us$ = purposes ( 
title ,,xviii ( ! ,social ,security ,act
 7#db ,u4,s4,c4 #acie et seq477 dur+ su*
 p]iod4  7,b7 ,an analysis ( ! e/imat$  
sav+s to ! ,m$ic>e program result+ f    
increas$ adh]5ce to prescription        

m$ications among ,m$ic>e b5efici>ies    
furni%$ remote pati5t monitor+ dur+ su* 
p]iod4  7,c7 ,an analysis ( practice    
exp5ses z def9$ 9 section #ahdh7;j7 ( ! 
,social ,security ,act 7#db ,u4,s4,c4   
#aciew-#d7;j77 relat$ to ! furni%+ (    
remote pati5t monitor+ dur+ su* p]iod1  
includ+ exp5ses relat$ to cellul>       
connectivity & o!r te*nology plat=m     
ma9t5ance4  7#b7 ,def9itions ,9 ?is     
subsection3 7,a7 ,m$ic>e b5efici>y ,!   
t]m ,m$ic>e b5efici>y means an          
individual entitl$ to b5efits "u "p ,a (
 title ,,xviii ( ! ,social ,security    
,act 7#db ,u4,s4,c4 #acie;c et seq47 or 
enroll$ "u "p ,b ( su* title 7#db       
,u4,s4,c4 #acie;j et seq47  7,b7 ,m$ic>e
 program ,! t]m ,m$ic>e program means ! 
,m$ic>e program "u title ,,xviii ( !    
,social ,security ,act 7#db ,u4,s4,c4   
#acie et seq474