HEALTH Act of 2020

I 116TH CONGRESS 2D SESSION H. R. 7187 To amend title XVIII of the Social Security Act to provide for permanent payments for telehealth services furnished by Federally qualified health centers and rural health clinics under the Medicare program. IN THE HOUSE OF REPRESENTATIVES JUNE 11, 2020 Mr. THOMPSON of Pennsylvania (for himself and Mr. BUTTERFIELD) intro- duced 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 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 provide for permanent payments for telehealth services furnished by Federally qualified health centers and rural health clinics under the Medicare program. 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 ‘‘Helping Ensure Access 4 to Local TeleHealth Act of 2020’’ or the ‘‘HEALTH Act 5 of 2020’’. 6 VerDate Sep 11 2014 22:27 Jun 30, 2020 Jkt 099200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\H7187.IH H7187 pamtmann on DSKBC07HB2PROD with BILLS 2 •HR 7187 IH SEC. 2. PROVIDING FOR PERMANENT COST-RELATED PAY- 1 MENTS FOR TELEHEALTH SERVICES FUR- 2 NISHED BY FEDERALLY QUALIFIED HEALTH 3 CENTERS AND RURAL HEALTH CLINICS 4 UNDER THE MEDICARE PROGRAM AND PER- 5 MANENTLY REMOVING ORIGINATING SITE 6 FACILITY AND LOCATION REQUIREMENTS 7 FOR DISTANT SITE TELEHEALTH SERVICES 8 FURNISHED BY SUCH CENTERS AND SUCH 9 CLINICS. 10 (a) PERMANENT TELEHEALTH PAYMENTS.—Section 11 1834(m)(8) of the Social Security Act (42 U.S.C. 12 1395m(m)(8)) is amended— 13 (1) in the header, by striking ‘‘DURING EMER- 14 GENCY PERIOD’’; 15 (2) in subparagraph (A), in the matter pre- 16 ceding clause (i), by striking ‘‘During the emergency 17 period described in section 1135(g)(1)(B)’’ and in- 18 serting ‘‘With respect to telehealth services furnished 19 on or after the date of the beginning of the emer- 20 gency period described in section 1135(g)(1)(B)’’; 21 and 22 (3) by striking subparagraph (B) and inserting 23 the following new subparagraph: 24 ‘‘(B) PAYMENT.— 25 VerDate Sep 11 2014 22:27 Jun 30, 2020 Jkt 099200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\H7187.IH H7187 pamtmann on DSKBC07HB2PROD with BILLS 3 •HR 7187 IH ‘‘(i) IN GENERAL.—A telehealth serv- 1 ice furnished by a rural health clinic or a 2 Federally qualified health center serving as 3 a distant site to an individual shall be 4 deemed to be so furnished to such indi- 5 vidual as an outpatient of such clinic or fa- 6 cility (as applicable) for purposes of para- 7 graph (1) or (3), respectively, of section 8 1861(aa) and payable as a rural health 9 clinic service or Federally qualified health 10 center service (as applicable) under section 11 1833(a)(3) or under the prospective pay- 12 ment system established under section 13 1834(o), respectively. 14 ‘‘(ii) TREATMENT OF COSTS FOR 15 FQHC PPS CALCULATIONS AND RHC AIR 16 CALCULATIONS.—Costs associated with the 17 delivery of telehealth services by a Feder- 18 ally qualified health center or rural health 19 clinic serving as a distant site pursuant to 20 this paragraph shall be considered allow- 21 able costs for purposes of the prospective 22 payment system established under section 23 1834(o) and any payment methodologies 24 VerDate Sep 11 2014 22:56 Jul 01, 2020 Jkt 099200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\H7187.IH H7187 pamtmann on DSKBC07HB2PROD with BILLS 4 •HR 7187 IH developed under section 1833(a)(3), as ap- 1 plicable.’’. 2 (b) ELIMINATION OF ORIGINATING SITE REQUIRE- 3 MENTS FOR TELEHEALTH SERVICES FURNISHED BY 4 FQHCS OR RHCS.— 5 (1) IN GENERAL.—Section 1834(m) of the So- 6 cial Security Act (42 U.S.C. 1395m(m)), as amend- 7 ed by subsection (a), is further amended— 8 (A) in paragraph (4)(C)(i), by striking 9 ‘‘and (7)’’ and inserting ‘‘(7), and (8)’’; and 10 (B) by adding at the end the following new 11 subparagraph: 12 ‘‘(C) NONAPPLICATION OF ORIGINATING 13 SITE REQUIREMENTS.—The geographic and site 14 requirements described in paragraph (4)(C) 15 shall not apply with respect to telehealth serv- 16 ices furnished by a Federally qualified health 17 center or a rural health clinic serving as a dis- 18 tant site.’’. 19 (2) SPECIAL PAYMENT RULE FOR ORIGINATING 20 SITES WITH RESPECT TO TELEHEALTH SERVICES 21 FURNISHED BY AN FQHC OR RHC.—Section 22 1834(m)(2)(B) of the Social Security Act (42 U.S.C. 23 1395m(m)(2)(B)) is amended— 24 VerDate Sep 11 2014 22:27 Jun 30, 2020 Jkt 099200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\H7187.IH H7187 pamtmann on DSKBC07HB2PROD with BILLS 5 •HR 7187 IH (A) in clause (i), by striking ‘‘clause (ii)’’ 1 and inserting ‘‘clauses (ii) and (iii)’’; and 2 (B) by adding at the end the following new 3 clause: 4 ‘‘(iii) SPECIAL RULE FOR TELE- 5 HEALTH SERVICES FURNISHED BY FQHCS 6 AND RHCS.—No facility fee shall be paid 7 under this subparagraph to an originating 8 site with respect to telehealth services fur- 9 nished by a Federally qualified health cen- 10 ter or rural health clinic serving as a dis- 11 tant site unless such originating site is a 12 site described in any of subclauses (I) 13 through (IX) of paragraph (4)(C)(ii).’’. 14 (c) TREATMENT OF FQHC AND RHC TELEHEALTH 15 SERVICES AS A VISIT.—The Secretary of Health and 16 Human Services shall revise section 405.2463 of title 42, 17 Code of Federal Regulations (or a successor regulation) 18 to provide that, in the case of a Federally qualified health 19 center or a rural health clinic serving as a distant site 20 furnishing telehealth services to an individual in accord- 21 ance with section 1834(m) of the Social Security Act (42 22 U.S.C. 1395m(m)), such services so furnished are consid- 23 VerDate Sep 11 2014 22:27 Jun 30, 2020 Jkt 099200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\H7187.IH H7187 pamtmann on DSKBC07HB2PROD with BILLS 6 •HR 7187 IH ered to constitute a visit to such center or such clinic (as 1 applicable) by such individual. 2 Æ VerDate Sep 11 2014 22:27 Jun 30, 2020 Jkt 099200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6301 E:\BILLS\H7187.IH H7187 pamtmann on DSKBC07HB2PROD with BILLS