BREATHE Act

I 116TH CONGRESS 1ST SESSION H. R. 2508 To provide for a pilot program to include respiratory therapists as telehealth practitioners under the Medicare program. IN THE HOUSE OF REPRESENTATIVES MAY 2, 2019 Mr. THOMPSON of California (for himself, Mr. COX of California, Mr. CARTER of Georgia, and Mr. KELLY of Pennsylvania) introduced the following bill; which was referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subse- quently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned A BILL To provide for a pilot program to include respiratory thera- pists as telehealth practitioners under the Medicare pro- gram. 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 ‘‘Better Respiration 4 through Expanding Access to Tele-Health Act’’ or the 5 ‘‘BREATHE Act’’. 6 VerDate Sep 11 2014 03:46 May 09, 2019 Jkt 089200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\H2508.IH H2508 kjohnson on DSK79L0C42 with BILLS 2 •HR 2508 IH SEC. 2. PILOT PROGRAM FOR INCLUDING RESPIRATORY 1 THERAPISTS AS TELEHEALTH PRACTI- 2 TIONERS UNDER THE MEDICARE PROGRAM. 3 (a) IN GENERAL.—Beginning not later than 6 4 months after the date of the enactment of this Act, the 5 Secretary of Health and Human Services shall establish 6 a 3-year pilot program under title XVIII of the Social Se- 7 curity Act with respect to furnishing telehealth disease 8 management services to eligible telehealth individuals who 9 are diagnosed with chronic obstructive pulmonary disease 10 for purposes of determining the value of including quali- 11 fying respiratory therapists as telehealth practitioners 12 under the Medicare program to improve health outcomes 13 for, reduce unnecessary emergency department visits and 14 hospital admissions and readmissions of, and lower the 15 cost of care provided to such individuals. 16 (b) TELEHEALTH ACCESS.—Under the pilot pro- 17 gram, coverage shall be provided under title XVIII of the 18 Social Security Act for telehealth disease management 19 services furnished to eligible telehealth individuals who are 20 diagnosed with chronic obstructive pulmonary disease by 21 applying section 1834(m) of such Act (42 U.S.C. 22 1395m(m)), as if— 23 (1) the reference in paragraph (1) of such sec- 24 tion to ‘‘a practitioner (as described in section 25 VerDate Sep 11 2014 20:08 May 09, 2019 Jkt 089200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\H2508.IH H2508 kjohnson on DSK79L0C42 with BILLS 3 •HR 2508 IH 1842(b)(18)(C))’’ were a reference to ‘‘a practitioner 1 (as defined in paragraph (4)(E))’’; 2 (2) paragraph (2)(B) of such section does not 3 apply to any site that satisfies the definition of the 4 term ‘‘originating site’’ applied pursuant to para- 5 graph (3) and that would not otherwise be included 6 as an originating site without application of such 7 paragraph; 8 (3) the definition under paragraph (4)(C) of 9 such section for the term ‘‘originating site’’ included 10 as a site described in clause (ii) of such paragraph 11 the place of residence of such individual, regardless 12 of whether such place of residence satisfies the con- 13 ditions described in subclause (I), (II), or (III) of 14 clause (i) of such paragraph; 15 (4) the definition in paragraph (4)(E) of such 16 section for the term ‘‘practitioner’’ included quali- 17 fying respiratory therapists; and 18 (5) the definition in paragraph (4)(F) of such 19 section for ‘‘telehealth services’’ included the fol- 20 lowing HCPCS codes 98960, 94664, 99406, 99407, 21 and 99091. 22 (c) PAYMENT MODIFIER.—For purposes of the pilot 23 program, the Secretary shall establish a payment modifier 24 to ensure the collection of data relevant to telehealth dis- 25 VerDate Sep 11 2014 20:08 May 09, 2019 Jkt 089200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\H2508.IH H2508 kjohnson on DSK79L0C42 with BILLS 4 •HR 2508 IH ease management services furnished directly by a quali- 1 fying respiratory therapist to eligible telehealth individuals 2 who are diagnosed with chronic obstructive pulmonary dis- 3 ease. 4 (d) REPORT.—Not later than one year after the last 5 date of the pilot program, the Secretary of Health and 6 Human Services shall submit to Congress a report on the 7 findings of the program, including if acute care interven- 8 tions were reduced and the health status of eligible tele- 9 health individuals who are diagnosed with chronic obstruc- 10 tive pulmonary disease was improved based on the lower 11 utilization of services. 12 (e) DEFINITIONS.—For purposes of this section: 13 (1) The term ‘‘eligible telehealth individual’’ has 14 the meaning given such term in section 1834(m)(4) 15 of the Social Security Act (42 U.S.C. 1395m(m)(4)). 16 (2) The term ‘‘qualifying respiratory therapist’’ 17 means a respiratory therapist who— 18 (A) is credentialed by a national 19 credentialing board recognized by the Secretary 20 of Health and Human Services; 21 (B) if applicable, is licensed in the State in 22 which the therapist furnishes the services in- 23 volved; 24 VerDate Sep 11 2014 03:46 May 09, 2019 Jkt 089200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\H2508.IH H2508 kjohnson on DSK79L0C42 with BILLS 5 •HR 2508 IH (C) holds the credential of Registered Res- 1 piratory Therapist; and 2 (D) has a minimum of a bachelor’s degree 3 or other advanced degree in biological or health 4 science. 5 (3) The term ‘‘telehealth disease management 6 services’’ means any of the following disease man- 7 agement services furnished via a telecommunications 8 system by a qualifying respiratory therapist: 9 (A) Self-management education and train- 10 ing. 11 (B) Demonstration and evaluation of in- 12 haler techniques. 13 (C) Smoking cessation counseling. 14 (D) Remote patient monitoring. 15 Æ VerDate Sep 11 2014 03:46 May 09, 2019 Jkt 089200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6301 E:\BILLS\H2508.IH H2508 kjohnson on DSK79L0C42 with BILLS