Congress Eyes Reimbursement Boost for Rural RPM Programs
By Eric Wicklund
While adoption rates are growing for remote patient monitoring (RPM), rural and remote providers are holding back, due in large part to low Medicare reimbursement. A new bill before Congress aims to change that.
The Rural Patient Monitoring Access Act, introduced this week by U.S. Senators Marsha Blackburn (R-Tennessee) and Mark Warner (D-Virginia) in the Senate and by U.S. Reps. David Kustoff (R-Tennessee), Mark Pocan (D-Wisconsin), Troy Balderson (R-Ohio) and Don Davis (D-North Carolina) in the House, would set a geographic payment floor for RPM reimbursement, enabling rural providers to recoup expenses from Medicare at the same rate as their urban and suburban counterparts.
Supporters say the bill would also ensure that providers are capable of responding to health concerns detected by RPM and that the RPM technology can promptly transmit biometric data at the EHR. It would also give the Centers for Medical & Medicaid Services (CMS) a pathway for reporting data to the Health and Human Services Department (HHS) to evaluate costs savings generated by RPM.
The proposed legislation has a number of supporters, including Marshfield Clinic, Lifepoint Health, SSM Health, Ascension, the University of Virginia Center for Telehealth, the American Telemedicine Association (ATA), the National Rusal Health Association, HIMSS, and the Alliance for Connected Care.
“Patients in rural and underserved communities deserve the same opportunity to manage their health as those in more resourced areas,” Christ Frost, Lifepoint Health’s CMO and Chief Quality Officer, said in a press release. At Lifepoint, we’ve seen firsthand how high-quality remote patient monitoring can help bridge long-standing access gaps and drive meaningful clinical improvement, especially for chronic conditions like hypertension and diabetes.
The bill comes just two weeks after the Peterson Center on Healthcare released a study that called for improvements to RPM reimbursement, including coverage that aligns with specific services that have shown the most value, improved access to high-impact RPM services and improved data collection from RPM devices.
The study also found that hypertension, diabetes and heart failure are the most common conditions being monitored through RPM.
“As we adopt exciting, new technologies that extend care beyond the walls of the doctor’s office, we need to design payment models that align with clinical benefits for patients,” Caroline Pearson, executive director of the Peterson Center on Healthcare, said in a press release. “That means ending ‘forever codes’ that incentivize long-term billing of ineffective care and instead designing payments that reimburse providers for the periods of time they should be actively monitoring and managing their patients’ diseases.”