KEEP Telehealth Options Act of 2021

II 117TH CONGRESS 1ST SESSION S. 620 To direct the Secretary of Health and Human Services, the Medicare Payment Advisory Commission, and the Medicaid and CHIP Payment and Access Commission to conduct studies and report to Congress on actions taken to expand access to telehealth services under the Medicare, Medicaid, and CHIP programs during the COVID–19 emergency. IN THE SENATE OF THE UNITED STATES MARCH 9, 2021 Mrs. FISCHER (for herself and Ms. ROSEN) introduced the following bill; which was read twice and referred to the Committee on Finance A BILL To direct the Secretary of Health and Human Services, the Medicare Payment Advisory Commission, and the Medicaid and CHIP Payment and Access Commission to conduct studies and report to Congress on actions taken to expand access to telehealth services under the Medicare, Medicaid, and CHIP programs during the COVID–19 emergency. Be it enacted by the Senate and House of Representa- 1 tives of the United States of America in Congress assembled, 2 VerDate Sep 11 2014 01:19 Apr 05, 2021 Jkt 019200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\S620.IS S620 kjohnson on DSK79L0C42PROD with BILLS 2 •S 620 IS SECTION 1. SHORT TITLE. 1 This Act may be cited as the ‘‘Knowing the Efficiency 2 and Efficacy of Permanent Telehealth Options Act of 3 2021’’ or the ‘‘KEEP Telehealth Options Act of 2021’’. 4 SEC. 2. FINDINGS. 5 Congress finds the following: 6 (1) On January 21, 2020, the United States 7 confirmed the Nation’s first case of the 2019 novel 8 coronavirus (which presents as the disease COVID– 9 19). 10 (2) On January 31, 2020, the Secretary of 11 Health and Human Services (in this Act referred to 12 as the ‘‘Secretary’’) declared a public health emer- 13 gency in response to COVID–19. 14 (3) By March, the disease reached the pan- 15 demic level according to the World Health Organiza- 16 tion, and the President proclaimed the COVID–19 17 outbreak in the United States to constitute a na- 18 tional emergency. 19 (4) This emergency declaration authorizes the 20 Secretary ‘‘to temporarily waive or modify certain 21 requirements of the Medicare, Medicaid, and State 22 Children’s Health Insurance programs and of the 23 Health Insurance Portability and Accountability Act 24 Privacy Rule throughout the duration of the public 25 VerDate Sep 11 2014 01:19 Apr 05, 2021 Jkt 019200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\S620.IS S620 kjohnson on DSK79L0C42PROD with BILLS 3 •S 620 IS health emergency declared in response to the 1 COVID–19 outbreak’’. 2 (5) Under this authority, the Secretary, and the 3 Administrator of the Centers for Medicare & Med- 4 icaid Services (in this Act referred to as the ‘‘Ad- 5 ministrator’’) acting under the Secretary’s authority, 6 issued numerous rules, regulations, and waivers ena- 7 bling the expansion of telehealth services during the 8 public health emergency. 9 (6) Telehealth services play a critical role in en- 10 hancing access to care for patients while simulta- 11 neously reducing the risk of exposure to the 12 coronavirus for both patients and providers. 13 (7) The Administrator expanded access to tele- 14 health services under the public health emergency to 15 all Medicare beneficiaries (including clinician-pro- 16 vided services to new and established patients). 17 (8) On April 23, 2020, the Administrator re- 18 leased a telehealth toolkit to assist States in expand- 19 ing the use of telehealth through Medicaid and 20 CHIP. 21 (9) Expanded telehealth options are valuable 22 for all Americans during this public health crisis, 23 but especially for high-risk patients and rural Ameri- 24 cans who already have difficulty accessing care. 25 VerDate Sep 11 2014 01:19 Apr 05, 2021 Jkt 019200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\S620.IS S620 kjohnson on DSK79L0C42PROD with BILLS 4 •S 620 IS SEC. 3. STUDIES AND REPORTS ON THE EXPANSION OF AC- 1 CESS TO TELEHEALTH SERVICES DURING 2 THE COVID–19 EMERGENCY. 3 (a) HHS.— 4 (1) IN GENERAL.—Not later than 180 days 5 after the date of the enactment of this Act, the Sec- 6 retary, in consultation with the Administrator, shall 7 conduct a study and submit to Congress a report on 8 actions taken by the Secretary during the emergency 9 period described in section 1135(g)(1)(B) of the So- 10 cial Security Act (42 U.S.C. 1320b–5(g)(1)(B)) to 11 expand access to telehealth services under the Medi- 12 care program, the Medicaid program, and the Chil- 13 dren’s Health Insurance Program. Such report shall 14 include the following: 15 (A) A comprehensive list of telehealth serv- 16 ices available under such programs and an ex- 17 planation of all actions undertaken by the Sec- 18 retary during the emergency period described in 19 such paragraph to expand access to such serv- 20 ices. 21 (B) A comprehensive list of types of pro- 22 viders that may be reimbursed for such services 23 furnished under such programs during such pe- 24 riod, including a list of services which may only 25 be reimbursed under such programs during 26 VerDate Sep 11 2014 01:19 Apr 05, 2021 Jkt 019200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\S620.IS S620 kjohnson on DSK79L0C42PROD with BILLS 5 •S 620 IS such period if furnished by such providers in- 1 person. 2 (C) A quantitative analysis of the use of 3 such telehealth services under such programs 4 during such period, including data points on 5 use by rural, minority, low-income, and elderly 6 populations. 7 (D) A quantitative analysis of the use of 8 such services under such programs during such 9 period for mental and behavioral health treat- 10 ments. 11 (E) An analysis of the public health im- 12 pacts of the actions described in subparagraph 13 (A). 14 (2) PUBLICATION OF REPORT.—Not later than 15 180 days after the date of the enactment of this Act, 16 the Secretary shall publish on the public website of 17 the Department of Health and Human Services the 18 report described in paragraph (1). 19 (b) MEDPAC REPORT.— 20 (1) IN GENERAL.—Not later than 210 days 21 after the date of enactment of this Act, the Medicare 22 Payment Advisory Commission shall, in consultation 23 with the Office of the Inspector General of the De- 24 VerDate Sep 11 2014 01:19 Apr 05, 2021 Jkt 019200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\S620.IS S620 kjohnson on DSK79L0C42PROD with BILLS 6 •S 620 IS partment of Health and Human Services, conduct a 1 study and submit to Congress a report on— 2 (A) the efficiency, management, and suc- 3 cess and failures of the expansion of access to 4 telehealth services under the Medicare program 5 during the emergency period described in sub- 6 section (a)(1); and 7 (B) any risk in increased fraudulent activ- 8 ity, and types of fraudulent activity, associated 9 with such expansion. 10 (2) RECOMMENDATIONS.—The report sub- 11 mitted under paragraph (1) shall include rec- 12 ommendations on— 13 (A) potential improvements to telehealth 14 services, and expansions of such services, under 15 the Medicare program; and 16 (B) ways to address any fraudulent activ- 17 ity described in paragraph (1)(B). 18 (c) MACPAC REPORT.— 19 (1) IN GENERAL.—Not later than 210 days 20 after the date of enactment of this Act, the Medicaid 21 and CHIP Payment and Access Commission shall, 22 in consultation with the Office of the Inspector Gen- 23 eral of the Department of Health and Human Serv- 24 VerDate Sep 11 2014 01:19 Apr 05, 2021 Jkt 019200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\S620.IS S620 kjohnson on DSK79L0C42PROD with BILLS 7 •S 620 IS ices, conduct a study and submit to Congress a re- 1 port on— 2 (A) the efficiency, management, and suc- 3 cess and failures of the expansion of access to 4 telehealth services under the Medicaid program 5 and the Children’s Health Insurance Program 6 during the emergency period described in sub- 7 section (a)(1); and 8 (B) any risk in increased fraudulent activ- 9 ity, and types of fraudulent activity, associated 10 with such expansion. 11 (2) RECOMMENDATIONS.—The report sub- 12 mitted under paragraph (1) shall include rec- 13 ommendations on— 14 (A) potential improvements to telehealth 15 services, and expansions of such services, under 16 the programs described in paragraph (1)(A); 17 and 18 (B) ways to address any fraudulent activ- 19 ity described in paragraph (1)(B). 20 (d) DATA.—In conducting the studies and creating 21 the reports required under this section, the Secretary, the 22 Medicare Payment Advisory Commission, and the Med- 23 icaid and CHIP Payment and Access Commission shall 24 review the most recent claims data from the Medicare pro- 25 VerDate Sep 11 2014 01:19 Apr 05, 2021 Jkt 019200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\S620.IS S620 kjohnson on DSK79L0C42PROD with BILLS 8 •S 620 IS gram, the Medicaid program, and the Children’s Health 1 Insurance Program (as applicable) that is available as of 2 the date of enactment of this Act. 3 Æ VerDate Sep 11 2014 01:19 Apr 05, 2021 Jkt 019200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6301 E:\BILLS\S620.IS S620 kjohnson on DSK79L0C42PROD with BILLS