The Rural Patient Monitoring Access Act (RPM Access Act) aims to reshape how Medicare pays for remote patient monitoring (RPM) and to boost RPM use in rural areas. It adds a floor to geographic payment indices so RPM-related costs are not paid at artificially low rates in rural regions, and it imposes new requirements to ensure RPM is high quality. Starting January 1, 2026, RPM payments would require: (1) real-time clinician availability to respond to any abnormal readings, (2) data transmission in a format compatible with electronic health records (as needed), and (3) mandatory data collection and reporting to help measure cost savings and program impact (with possible exemptions for hardship). The bill also directs a future Congress-returned report analyzing potential Medicare savings and expenses from RPM, including connectivity and platform costs. The overall goal is to improve access to RPM for rural beneficiaries while ensuring clinical quality and accountability.
Key Points
- 1Purpose and scope: The act amends Medicare (title XVIII) to improve payment for remote patient monitoring and expand access in rural areas, addressing gaps in current reimbursement and care access.
- 2Floor on geographic payment indices: For RPM, the secretary must raise any practice expense and malpractice geographic indices to at least 1.00 if they would otherwise be lower. This floor is not applied in a budget-neutral way, meaning it cannot be offset by cuts elsewhere.
- 3New quality and data requirements for RPM: Beginning January 1, 2026, RPM may be paid only if:
- 4- A physician, nurse practitioner, clinical nurse specialist, or physician assistant is available in real time to respond to physiologic anomalies detected by monitoring.
- 5- The RPM system can transmit data in a format compatible with electronic health records if needed.
- 6- The provider/supplier collects and reports data as required by the Secretary to evaluate Medicare cost savings from RPM (with an exemption for undue hardship).
- 7Reporting and evaluation: The Secretary must, within 5 years of enactment, report to Congress on:
- 8- Estimated savings from earlier interventions and fewer hospital days due to RPM (for 4 years starting in 2026).
- 9- Estimated savings from improved medication adherence due to RPM.
- 10- RPM-related practice expenses, including cellular connectivity and platform maintenance costs.
- 11Definitions and scope: Clarifies terms such as Medicare beneficiary and Medicare program for purposes of the report and ensures alignment with existing Medicare structures.
- 12Effective date: Payments for RPM furnished on or after January 1, 2026 are subject to these changes.