Ensuring Telehealth Expansion Act of 2021

I 117TH CONGRESS 1ST SESSION H. R. 341 To make permanent certain telehealth flexibilities established in response to COVID–19. IN THE HOUSE OF REPRESENTATIVES JANUARY 15, 2021 Mr. WILLIAMS of Texas introduced the following bill; which was referred to the Committee on Ways and Means, and in addition to the Committee on Energy and Commerce, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall with- in the jurisdiction of the committee concerned A BILL To make permanent certain telehealth flexibilities established in response to COVID–19. Be it enacted by the Senate and House of Representa- 1 tives of the United States of America in Congress assembled, 2 SECTION 1. SHORT TITLE. 3 This Act may be cited as the ‘‘Ensuring Telehealth 4 Expansion Act of 2021’’. 5 SEC. 2. MAKING PERMANENT CERTAIN TELEHEALTH 6 FLEXIBILITIES ESTABLISHED IN RESPONSE 7 TO COVID–19. 8 (a) EXEMPTION FOR TELEHEALTH SERVICES.— 9 VerDate Sep 11 2014 18:57 Feb 08, 2021 Jkt 019200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\H341.IH H341 pamtmann on DSKBC07HB2PROD with BILLS 2 •HR 341 IH (1) IN GENERAL.—Subparagraph (E) of section 1 223(c)(2) of the Internal Revenue Code of 1986 is 2 amended by striking ‘‘In the case of plan years be- 3 ginning on or before December 31, 2021, a plan’’ 4 and inserting ‘‘A plan’’. 5 (2) CERTAIN COVERAGE DISREGARDED.— 6 Clause (ii) of section 223(c)(1)(B) of the Internal 7 Revenue Code of 1986 is amended by striking ‘‘(in 8 the case of plan years beginning on or before De- 9 cember 31, 2021)’’. 10 (b) INCREASING MEDICARE TELEHEALTH FLEXI- 11 BILITIES.—Section 1834(m) of the Social Security Act 12 (42 U.S.C. 1395m(m)) is amended by adding at the end 13 the following new paragraph: 14 ‘‘(9) WAIVER AUTHORITY.—The Secretary may 15 waive any requirement of this subsection if deter- 16 mined appropriate by the Secretary.’’. 17 (c) ENHANCING MEDICARE TELEHEALTH SERVICES 18 FOR FEDERALLY QUALIFIED HEALTH CENTERS AND 19 RURAL HEALTH CLINICS; ELIMINATING SPECIAL PAY- 20 MENT RULE FOR SUCH SERVICES.— 21 (1) IN GENERAL.—Paragraph (8) of section 22 1834(m) of the Social Security Act (42 U.S.C. 23 1395m(m)) is amended to read as follows: 24 VerDate Sep 11 2014 18:57 Feb 08, 2021 Jkt 019200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\H341.IH H341 pamtmann on DSKBC07HB2PROD with BILLS 3 •HR 341 IH ‘‘(8) ENHANCING TELEHEALTH SERVICES FOR 1 FEDERALLY QUALIFIED HEALTH CENTERS AND 2 RURAL HEALTH CLINICS.— 3 ‘‘(A) IN GENERAL.—With respect to serv- 4 ices furnished on or after the first day of the 5 emergency period described in section 6 1135(g)(1)(B), the Secretary shall pay for tele- 7 health services that are furnished via a tele- 8 communications system by a Federally qualified 9 health center or a rural health clinic to an eligi- 10 ble telehealth individual enrolled under this part 11 notwithstanding that the Federally qualified 12 health center or rural clinic providing the tele- 13 health service is not at the same location as the 14 beneficiary. 15 ‘‘(B) PAYMENT.— 16 ‘‘(i) IN GENERAL.—A telehealth serv- 17 ice furnished by a rural health clinic or a 18 Federally qualified health center serving as 19 a distant site to an individual shall be 20 deemed to be so furnished to such indi- 21 vidual as an outpatient of such clinic or 22 center (as applicable) for purposes of sec- 23 tion 1861(aa) and payable as a rural 24 health clinic service or Federally qualified 25 VerDate Sep 11 2014 18:57 Feb 08, 2021 Jkt 019200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\H341.IH H341 pamtmann on DSKBC07HB2PROD with BILLS 4 •HR 341 IH health center service (as applicable) under 1 section 1833(a)(3) or under the prospec- 2 tive payment system established under sec- 3 tion 1834(o) (as applicable). 4 ‘‘(ii) TREATMENT OF COSTS FOR 5 FQHC PPS CALCULATIONS AND RHC AIR 6 CALCULATIONS.—Costs associated with the 7 delivery of telehealth services by a Feder- 8 ally qualified health center or rural health 9 clinic serving as a distant site pursuant to 10 this paragraph shall be considered allow- 11 able costs for purposes of the prospective 12 payment system established under section 13 1834(o) and any payment methodologies 14 developed under section 1833(a)(3), as ap- 15 plicable. 16 ‘‘(C) DEFINITIONS.—For purposes of this 17 subsection— 18 ‘‘(i) the term ‘distant site’ includes a 19 Federally qualified health center or rural 20 health clinic that furnishes a telehealth 21 service to an eligible telehealth individual; 22 and 23 ‘‘(ii) the term ‘telehealth services’ in- 24 cludes a rural health clinic service or Fed- 25 VerDate Sep 11 2014 18:57 Feb 08, 2021 Jkt 019200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\H341.IH H341 pamtmann on DSKBC07HB2PROD with BILLS 5 •HR 341 IH erally qualified health center service that is 1 furnished using telehealth to the extent 2 that payment codes corresponding to serv- 3 ices identified by the Secretary under 4 clause (i) or (ii) of paragraph (4)(F) are 5 listed on the corresponding claim for such 6 rural health clinic service or Federally 7 qualified health center service.’’. 8 (2) CONFORMING AMENDMENT.—Section 9 1834(m)(2)(A) of the Social Security Act (42 U.S.C. 10 1395m(m)(2)(A)) is amended by striking ‘‘Subject 11 to paragraph (8), the’’ and inserting ‘‘The’’. 12 (3) EFFECTIVE DATE.—The amendments made 13 by this subsection shall take effect as if included in 14 the enactment of the CARES Act (Public Law 116– 15 136). 16 (d) WAIVER OF REQUIREMENTS FOR FACE-TO-FACE 17 VISITS BETWEEN HOME DIALYSIS PATIENTS AND PHYSI- 18 CIANS.—Section 1881(b)(3)(B)(iii) of the Social Security 19 Act (42 U.S.C. 1395rr(b)(3)(B)(iii)) is amended by strik- 20 ing ‘‘during the emergency period described in section 21 1135(g)(1)(B)’’ and inserting ‘‘during any period begin- 22 ning on or after the first day of the emergency period de- 23 scribed in section 1135(g)(1)(B)’’. 24 VerDate Sep 11 2014 18:57 Feb 08, 2021 Jkt 019200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\H341.IH H341 pamtmann on DSKBC07HB2PROD with BILLS 6 •HR 341 IH (e) USE OF TELEHEALTH TO CONDUCT FACE-TO- 1 FACE ENCOUNTER PRIOR TO RECERTIFICATION OF ELI- 2 GIBILITY FOR HOSPICE CARE.—Section 3 1814(a)(7)(D)(i)(II) of the Social Security Act (42 U.S.C. 4 1395f(a)(7(D)(i)(II)) is amended by striking ‘‘during the 5 emergency period described in section 1135(g)(1)(B)’’ and 6 inserting ‘‘during any period beginning on or after the 7 first day of the emergency period described in section 8 1135(g)(1)(B)’’. 9 (f) ENCOURAGING USE OF TELECOMMUNICATIONS 10 SYSTEMS FOR HOME HEALTH SERVICES.—Section 3707 11 of the CARES Act (Public Law 116–136) is amended by 12 striking ‘‘during the emergency period described in section 13 1135(g)(1)(B) of such Act (42 U.S.C. 1320b– 14 5(g)(1)(B))’’ and inserting ‘‘on or after the first day of 15 the emergency period described in section 1135(g)(1)(B) 16 of such Act (42 U.S.C. 1320b–5(g)(1)(B))’’. 17 SEC. 3. NONAPPLICATION OF ORIGINATING SITE REQUIRE- 18 MENTS WITH RESPECT TO TELEHEALTH 19 SERVICES UNDER MEDICARE PROGRAM. 20 Section 1834(m)(4)(C) of the Social Security Act (42 21 U.S.C. 1395m(m)(4)(C)) is amended— 22 (1) in clause (i), by inserting before ‘‘para- 23 graphs (5), (6), and (7)’’ the following: ‘‘clause (iii) 24 and’’; and 25 VerDate Sep 11 2014 18:57 Feb 08, 2021 Jkt 019200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\H341.IH H341 pamtmann on DSKBC07HB2PROD with BILLS 7 •HR 341 IH (2) by adding at the end the following new 1 clause: 2 ‘‘(iii) NONAPPLICATION OF ORIGI- 3 NATING SITE REQUIREMENTS.—Beginning 4 on the first day of the emergency period 5 described in section 1135(g)(1)(B), the 6 term ‘originating site’ means any site at 7 which the eligible telehealth individual is 8 located at the time the service is furnished 9 via a telecommunications system.’’. 10 SEC. 4. REPORT BY COMPTROLLER GENERAL. 11 Not later than 5 years after the date of the enact- 12 ment of this Act, the Comptroller General of the United 13 States shall submit to Congress a report on the successes 14 and limitations of implementing the statutory provisions 15 amended by sections 2 and 3, including— 16 (1) details of any savings or costs to the Fed- 17 eral Government that are attributable to the imple- 18 mentation of such provisions; and 19 (2) an analysis of how the implementation of 20 such provisions have impacted rural hospitals. 21 Æ VerDate Sep 11 2014 18:57 Feb 08, 2021 Jkt 019200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6301 E:\BILLS\H341.IH H341 pamtmann on DSKBC07HB2PROD with BILLS