Telehealth Modernization Act

I 117TH CONGRESS 1ST SESSION H. R. 1332 To amend title XVIII of the Social Security Act to make permanent certain telehealth flexibilities under the Medicare program related to the COVID– 19 public health emergency. IN THE HOUSE OF REPRESENTATIVES FEBRUARY 25, 2021 Mr. CARTER of Georgia (for himself, Ms. BLUNT ROCHESTER, Mr. GRIFFITH, Mr. VAN DREW, Mr. MORELLE, Mr. KILMER, Mr. PENCE, and Mr. PA- NETTA) introduced the following bill; which was referred to the Com- mittee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned A BILL To amend title XVIII of the Social Security Act to make permanent certain telehealth flexibilities under the Medi- care program related to the COVID–19 public health emergency. 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 ‘‘Telehealth Moderniza- 4 tion Act’’. 5 VerDate Sep 11 2014 01:53 Mar 22, 2021 Jkt 019200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\H1332.IH H1332 pbinns on DSKJLVW7X2PROD with BILLS 2 •HR 1332 IH SEC. 2. EXTENDING MEDICARE TELEHEALTH FLEXIBILI- 1 TIES. 2 (a) EXPANDING ACCESS TO TELEHEALTH SERV- 3 ICES.— 4 (1) IN GENERAL.—Section 1834(m)(4)(C) of 5 the Social Security Act (42 U.S.C. 1395m(m)(4)(C)) 6 is amended by adding at the end the following new 7 clause: 8 ‘‘(iii) EXPANDING ACCESS TO TELE- 9 HEALTH SERVICES.—With respect to tele- 10 health services furnished beginning on the 11 first day after the end of the emergency 12 period described in section 1135(g)(1)(B) 13 of this clause, the term ‘originating site’ 14 means any site at which the eligible tele- 15 health individual is located at the time the 16 service is furnished via a telecommuni- 17 cations system, including the home of an 18 individual.’’. 19 (2) CONFORMING AMENDMENTS.—Such section 20 is amended— 21 (A) in paragraph (2)(B)— 22 (i) in clause (i), in the matter pre- 23 ceding subclause (I), by striking ‘‘clause 24 (ii)’’ and inserting ‘‘clauses (ii) and (iii)’’; 25 and 26 VerDate Sep 11 2014 01:53 Mar 22, 2021 Jkt 019200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\H1332.IH H1332 pbinns on DSKJLVW7X2PROD with BILLS 3 •HR 1332 IH (ii) by adding at the end the following 1 new clause: 2 ‘‘(iii) NO FACILITY FEE FOR NEW 3 SITES.—With respect to telehealth services 4 furnished on or after the date of enact- 5 ment of this clause, a facility fee shall only 6 be paid under this subparagraph to an 7 originating site that is described in para- 8 graph (4)(C)(ii) (other than subclause (X) 9 of such paragraph).’’; 10 (B) in paragraph (4)(C)— 11 (i) in clause (i), in the matter pre- 12 ceding subclause (I), by inserting ‘‘and 13 clause (iii)’’ after ‘‘and (7)’’; and 14 (ii) in clause (ii)(X), by inserting 15 ‘‘prior to the first day after the end of the 16 emergency period described in section 17 1135(g)(1)(B)’’ before the period; 18 (C) in paragraph (5), by inserting ‘‘and 19 prior to the first day after the end of the emer- 20 gency period described in section 21 1135(g)(1)(B)’’ after ‘‘January 1, 2019,’’; 22 (D) in paragraph (6)(A), by inserting ‘‘and 23 prior to the first day after the end of the emer- 24 VerDate Sep 11 2014 01:53 Mar 22, 2021 Jkt 019200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\H1332.IH H1332 pbinns on DSKJLVW7X2PROD with BILLS 4 •HR 1332 IH gency period described in section 1 1135(g)(1)(B),’’ after ‘‘January 1, 2019,’’; and 2 (E) in paragraph (7), by adding at the end 3 the following new subparagraph: 4 ‘‘(C) SUNSET.—The provisions of this 5 paragraph shall not apply with respect to serv- 6 ices furnished on or after the first day after the 7 end of the emergency period described in sec- 8 tion 1135(g)(1)(B).’’. 9 (b) EXPANDING PRACTITIONERS ELIGIBLE TO FUR- 10 NISH TELEHEALTH SERVICES.—Section 1834(m) of the 11 Social Security Act (42 U.S.C. 1395m(m)) is amended— 12 (1) in paragraph (1), by striking ‘‘(described in 13 section 1842(b)(18)(C))’’ and inserting ‘‘(defined in 14 paragraph (4)(E))’’; and 15 (2) in paragraph (4)(E)— 16 (A) by striking ‘‘PRACTITIONER.—The 17 term’’ and inserting ‘‘PRACTITIONER.— 18 ‘‘(A) IN GENERAL.—Subject to subpara- 19 graph (B), the term’’; and 20 (B) by adding at the end the following new 21 subparagraph: 22 ‘‘(B) EXPANSION.—The Secretary, after 23 consulting with stakeholders regarding services 24 that are clinically appropriate, may expand the 25 VerDate Sep 11 2014 01:53 Mar 22, 2021 Jkt 019200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\H1332.IH H1332 pbinns on DSKJLVW7X2PROD with BILLS 5 •HR 1332 IH types of practitioners who may furnish tele- 1 health services to include any health care pro- 2 fessional that is eligible to bill the program 3 under this title for their professional services.’’. 4 (c) RETENTION OF ADDITIONAL SERVICES AND SUB- 5 REGULATORY PROCESS FOR MODIFICATIONS FOLLOWING 6 EMERGENCY PERIOD.—Section 1834(m)(4)(F) of the So- 7 cial Security Act (42 U.S.C. 1395m(m)(4)(F)) is amend- 8 ed— 9 (1) in clause (i), by inserting ‘‘and clause (iii)’’ 10 after ‘‘paragraph (8)’’; 11 (2) in clause (ii), by striking ‘‘The Secretary’’ 12 and inserting ‘‘Subject to clause (iii), the Sec- 13 retary’’; and 14 (3) by adding at the end the following new 15 clause: 16 ‘‘(iii) RETENTION OF ADDITIONAL 17 SERVICES AND SUBREGULATORY PROCESS 18 FOR MODIFICATIONS FOLLOWING EMER- 19 GENCY PERIOD.—With respect to tele- 20 health services furnished after the last day 21 of the emergency period described in sec- 22 tion 1135(g)(1)(B), the Secretary may— 23 ‘‘(I) retain as appropriate the ex- 24 panded list of telehealth services spec- 25 VerDate Sep 11 2014 01:53 Mar 22, 2021 Jkt 019200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\H1332.IH H1332 pbinns on DSKJLVW7X2PROD with BILLS 6 •HR 1332 IH ified in clause (i) pursuant to the 1 waiver authority under section 2 1135(b)(8) during such emergency pe- 3 riod; and 4 ‘‘(II) retain the subregulatory 5 process used to modify the services in- 6 cluded on the list of such telehealth 7 services pursuant to clause (ii) during 8 such emergency period.’’. 9 (d) ENHANCING TELEHEALTH SERVICES FOR FED- 10 ERALLY QUALIFIED HEALTH CENTERS AND RURAL 11 HEALTH CLINICS.—Section 1834(m)(8) of the Social Se- 12 curity Act (42 U.S.C. 1395m(m)(8)) is amended— 13 (1) in the paragraph heading by inserting ‘‘AND 14 AFTER’’ after ‘‘DURING’’; 15 (2) in subparagraph (A), in the matter pre- 16 ceding clause (i), by inserting ‘‘and after’’ after 17 ‘‘During’’; and 18 (3) in the first sentence of subparagraph (B)(i), 19 by inserting ‘‘and after’’ after ‘‘during’’. 20 (e) USE OF TELEHEALTH, AS CLINICALLY APPRO- 21 PRIATE, TO CONDUCT FACE-TO-FACE ENCOUNTER FOR 22 HOSPICE CARE.—Section 1814(a)(7)(D)(i)(II) of the So- 23 cial Security Act (42 U.S.C. 1395f(a)(7)(D)(i)(II)) is 24 VerDate Sep 11 2014 01:53 Mar 22, 2021 Jkt 019200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\H1332.IH H1332 pbinns on DSKJLVW7X2PROD with BILLS 7 •HR 1332 IH amended by inserting ‘‘and after such emergency period 1 as clinically appropriate’’ after ‘‘1135(g)(1)(B)’’. 2 (f) USE OF TELEHEALTH, AS CLINICALLY APPRO- 3 PRIATE, TO CONDUCT FACE-TO-FACE CLINICAL ASSESS- 4 MENTS FOR HOME DIALYSIS.—Clause (iii) of section 5 1881(b)(3)(B) of the Social Security Act (42 U.S.C. 6 1395rr(b)(3)(B)) is amended— 7 (1) by moving such clause 4 ems to the left; 8 and 9 (2) by inserting ‘‘and after such emergency pe- 10 riod as clinically appropriate’’ before the period. 11 (g) IMPLEMENTATION.—Notwithstanding any provi- 12 sion of law, the Secretary may implement the provisions 13 of, and amendments made by, this section by interim final 14 rule, program instruction, or otherwise. 15 Æ VerDate Sep 11 2014 01:53 Mar 22, 2021 Jkt 019200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6301 E:\BILLS\H1332.IH H1332 pbinns on DSKJLVW7X2PROD with BILLS