H.R. 3108 — RPM Access Act

This section states congressional findings that remote patient monitoring (RPM) supports coordinated care, improves patient outcomes, and lowers Medicare costs; three-fifths of federally designated health professional shortage areas are rural, where residents travel farther for care; Medicare RPM reimbursement is lowest in states with above-average heart failure, hypertension, and diabetes prevalence; and RPM practice and malpractice expenses are not lower in rural areas or widely variable by state.

This section establishes a floor of 1.00 for the practice expense geographic practice cost index (GPCI) under clause (i) of subparagraph (A), the malpractice GPCI under clause (ii) of subparagraph (A), and the malpractice GPCI under subparagraph (B) used in Medicare physician fee schedule payments for remote patient monitoring (RPM) services—i.e., monitoring of patient physiologic data outside healthcare settings—furnished on or after January 1, 2026 (previously, such indices could be below 1.00 in low-cost areas). The adjustment is not required to be budget neutral.

This section establishes conditions for Medicare payment under part B for remote patient monitoring (RPM)—which enables remote collection and analysis of physiologic data from patients, typically those with chronic conditions, to facilitate timely interventions—furnished by providers or suppliers on or after January 1, 2026. Payment requires (1) real-time availability of a physician, nurse practitioner, clinical nurse specialist, or physician assistant to respond to detected physiologic anomalies; (2) transmission capability of physiologic data in a format compatible with electronic health records, as needed; and (3) collection and reporting of data, as specified by the Secretary of Health and Human Services, to evaluate Medicare cost savings from RPM (with exemptions possible for unreasonable hardship). Additionally, the section requires the Secretary, not later than five years after enactment, to submit to Congress a report analyzing, for the four-year period beginning January 1, 2026, estimated Medicare savings from RPM due to earlier interventions and fewer hospitalizations, increased prescription medication adherence, and related practice expenses (e.g., cellular connectivity and technology maintenance).