H.R. 8840
Fair Care Act of 2026
Sponsor: Bruce Westerman · 0 cosponsors
Official summary
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Text of the bill
I Modernization of health savings accounts
A Modernization of health savings accounts and contributions
B Assistance to health savings accounts
II Improving Private Health Insurance
A Maintaining Protections for Patients with Preexisting Conditions
B Expanding Coverage Options
C Improving Commercial Health Insurance
III Competition, Transparency and Accountability
A Provider and Insurer Competition
B Price Transparency
C Prescription Drug Competition and Innovation
D Prescription Drug and Pharmacy Benefit Manager Transparency
E Medicare and Medicaid Prescription Drug Reforms
F Medical Malpractice Reform
IV Medicare and Medicaid Reforms
A Medicaid Reforms
B Medicare Reforms
C Medicare Choice and Competition
D Telehealth Improvements and Expansion
(a) Covered services. Section 1834(m)(4)(F)(i) of the Social Security Act (42 U.S.C. 1395m(m)(4)(F)(i)) is amended—
(1) by striking and office and inserting office; and
(2) by inserting: respiratory services, audiology services (as defined in section 1861(ll)), outpatient therapy services (including physical therapy, occupational therapy, and speech-language pathology services) after the Secretary)),.
(b) Providers. Subsection (m) of section 1834 of such Act (42 U.S.C. 1395m) is amended—
(1) in paragraph (1), by striking or a practitioner (described in section 1842(b)(18)(C)) and inserting , a practitioner (described in section 1842(b)(18)(C)), or an applicable professional (as defined in paragraph (4)(G));
(2) by striking physician or practitioner each time it appears in such subsection and inserting physician, practitioner, or applicable professional;
(3) in paragraph (3)(A)—
(A) in the heading, by striking Physician and practitioner and inserting Physician, practitioner, and applicable professional; and
(B) by striking physicians or practitioners and inserting physicians, practitioners, or applicable professionals; and
(4) in paragraph (4), by adding at the end the following new subparagraph:
(G) Applicable professional. The term applicable professional means, with respect to services furnished on or after the date that is 6 months after the date of the enactment of this subparagraph, a certified diabetes educator or licensed—
(i) respiratory therapist;
(ii) audiologist;
(iii) occupational therapist;
(iv) physical therapist; or
(v) speech language pathologist.
(c) Home-Based monitoring services for congestive heart failure and chronic obstructive pulmonary disease
(1) Coverage of remote patient monitoring services for certain chronic health conditions. Section 1861(s)(2) of the Social Security Act (42 U.S.C. 1395x(s)(2)) is amended—
(A) in subparagraph (GG), by striking and at the end;
(B) in subparagraph (HH), by inserting and at the end; and
(C) by inserting after subparagraph (HH) the following new subparagraph:
(II) applicable remote patient monitoring services (as defined in paragraph (1)(A) of subsection (iii));
(2) Services described. Section 1861 of the Social Security Act (42 U.S.C. 1395x) is amended by adding at the end the following new subsection:
(kkk) Remote Patient Monitoring Services for Chronic Health Conditions
(1)
(A) The term applicable remote patient monitoring services means remote patient monitoring services (as defined in subparagraph (B)) furnished to provide for the monitoring, evaluation, and management of an individual with a covered chronic condition (as defined in paragraph (2)), insofar as such services are for the management of such chronic condition.
(B) The term remote patient monitoring services means services furnished through remote patient monitoring technology (as defined in subparagraph (C)).
(C) The term remote patient monitoring technology means a coordinated system that uses one or more home-based or mobile monitoring devices that automatically transmit vital sign data or information on activities of daily living and may include responses to assessment questions collected on the devices wirelessly or through a telecommunications connection to a server that complies with the Federal regulations (concerning the privacy of individually identifiable health information) promulgated under section 264(c) of the Health Insurance Portability and Accountability Act of 1996, as part of an established plan of care for that patient that includes the review and interpretation of that data by a health care professional.
(2) For purposes of paragraph (1), the term covered chronic health condition means applicable conditions (as defined in and applied under section 1886(q)(5)) when under chronic care management (identified as of July 1, 2015, by HCPCS code 99490 (and as subsequently modified by the Secretary)).
(3)
(A) Payment may be made under this part for applicable remote patient monitoring services provided to an individual during a period of up to 90 days and such additional period as provided for under subparagraph (B).
(B) The 90-day period described in subparagraph (A), with respect to an individual, may be renewed by the physician who provides chronic care management to such individual if the individual continues to qualify for such management.
(3) Payment under the physician fee schedule. Section 1848 of the Social Security Act (42 U.S.C. 1395w–4) is amended—
(A) in subsection (c)—
(i) in paragraph (2)(B)—
(I) in clause (ii)(II), by striking and (v) and inserting (v), and (vii); and
(II) by adding at the end the following new clause:
(vii) Budgetary treatment of certain services. The additional expenditures attributable to services described in section 1861(s)(2)(II) shall not be taken into account in applying clause (ii)(II).
; and
(ii) by adding at the end the following new paragraph:
(7) Treatment of applicable remote patient monitoring services
(A) In determining relative value units for applicable remote patient monitoring services (as defined in section 1861(iii)(1)(A)), the Secretary, in consultation with appropriate physician groups, practitioner groups, and supplier groups, shall take into consideration—
(i) physician or practitioner resources, including physician or practitioner time and the level of intensity of services provided, based on—
(I) the frequency of evaluation necessary to manage the individual being furnished the services;
(II) the complexity of the evaluation, including the information that must be obtained, reviewed, and analyzed; and
(III) the number of possible diagnoses and the number of management options that must be considered;
(ii) practice expense costs associated with such services, including the direct costs associated with installation and information transmission, costs of remote patient monitoring technology (including equipment and software), device delivery costs, and resource costs necessary for patient monitoring and followup (but not including costs of any related item or non-physician service otherwise reimbursed under this title); and
(iii) malpractice expense resources.
(B) Using the relative value units determined in subparagraph (A), the Secretary shall provide for separate payment for such services and shall not adjust the relative value units assigned to other services that might otherwise have been determined to include such separately paid remote patient monitoring services.
; and
(B) in subsection (j)(3), by inserting (2)(II), after health risk assessment),.