Increasing Rural Health Access During the COVID–19 Public Health Emergency Act of 2020

II 116TH CONGRESS 2D SESSION S. 3951 To amend the Public Health Service Act to provide for the establishment of a virtual health pilot program to facilitate utilization of remote patient monitoring technology to maintain or expand access to health care serv- ices for individuals in rural areas during the COVID–19 emergency period, and for other purposes. IN THE SENATE OF THE UNITED STATES JUNE 11, 2020 Ms. MCSALLY (for herself and Mr. JONES) introduced the following bill; which was read twice and referred to the Committee on Health, Education, Labor, and Pensions A BILL To amend the Public Health Service Act to provide for the establishment of a virtual health pilot program to facilitate utilization of remote patient monitoring tech- nology to maintain or expand access to health care serv- ices for individuals in rural areas during the COVID– 19 emergency period, and for other purposes. 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 05:16 Jun 26, 2020 Jkt 099200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\S3951.IS S3951 pbinns on DSKJLVW7X2PROD with BILLS 2 •S 3951 IS SECTION 1. SHORT TITLE. 1 This Act may be cited as the ‘‘Increasing Rural 2 Health Access During the COVID–19 Public Health 3 Emergency Act of 2020’’. 4 SEC. 2. INCREASING RURAL HEALTH ACCESS DURING THE 5 COVID–19 PUBLIC HEALTH EMERGENCY. 6 (a) DEFINITIONS.—Subsection (a) of section 330I of 7 the Public Health Service Act (42 U.S.C. 254c–14) is 8 amended— 9 (1) by redesignating paragraphs (1) through 10 (7) as paragraphs (2), (3), (4), (5), (6), (8), and 11 (9), respectively; 12 (2) by inserting before paragraph (2), as redes- 13 ignated, the following new paragraph: 14 ‘‘(1) COVID–19 EMERGENCY PERIOD.—The 15 term ‘COVID–19 emergency period’ means the pe- 16 riod beginning on the date of enactment of the In- 17 creasing Rural Health Access During the COVID– 18 19 Public Health Emergency Act of 2020 and end- 19 ing on the date on which the national emergency de- 20 clared by the President under the National Emer- 21 gencies Act with respect to the COVID–19 outbreak 22 in the United States expires.’’; and 23 (3) by inserting before paragraph (8), as redes- 24 ignated, the following: 25 VerDate Sep 11 2014 05:16 Jun 26, 2020 Jkt 099200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\S3951.IS S3951 pbinns on DSKJLVW7X2PROD with BILLS 3 •S 3951 IS ‘‘(7) REMOTE PATIENT MONITORING TECH- 1 NOLOGY.—The term ‘remote patient monitoring 2 technology’ means digital technologies used to collect 3 medical and other forms of health data from individ- 4 uals in one location and electronically transmit such 5 data securely to health care providers in a different 6 location for assessment, recommendations, and inter- 7 ventions.’’. 8 (b) PROGRAMS.—Subsection (b) of section 330I of 9 the Public Health Service Act (42 U.S.C. 254c–14) is 10 amended— 11 (1) by striking ‘‘The Secretary shall establish, 12 under section 301’’ and inserting the following: 13 ‘‘(1) IN GENERAL.—The Secretary shall estab- 14 lish, under section 301’’; and 15 (2) by adding at the end the following new 16 paragraph: 17 ‘‘(2) VIRTUAL HEALTH PILOT PROGRAM.—The 18 Secretary shall establish a virtual health pilot pro- 19 gram to facilitate utilization of remote patient moni- 20 toring technology to maintain or expand access to 21 health care services for individuals in rural areas 22 during the COVID–19 emergency period.’’. 23 VerDate Sep 11 2014 05:16 Jun 26, 2020 Jkt 099200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\S3951.IS S3951 pbinns on DSKJLVW7X2PROD with BILLS 4 •S 3951 IS (c) GRANTS.—Subsection (d) of section 330I of the 1 Public Health Service Act (42 U.S.C. 254c–14) is amend- 2 ed by adding at the end the following new paragraph: 3 ‘‘(3) VIRTUAL HEALTH NETWORK PILOT PRO- 4 GRAM GRANTS.—The Director shall, in carrying out 5 the virtual health pilot program referred to in sub- 6 section (b)(2), award grants to eligible entities to fa- 7 cilitate utilization of remote patient monitoring tech- 8 nology in rural areas to— 9 ‘‘(A) maintain or expand access to, and co- 10 ordinate health care services for, individuals 11 with chronic conditions; 12 ‘‘(B) improve and expand the training of 13 health care providers using remote patient mon- 14 itoring technology; and 15 ‘‘(C) minimize challenges facing health 16 care providers and health care facilities, includ- 17 ing rural health clinics, community health cen- 18 ters, community behavioral health centers, long- 19 term care facilities, and rural hospitals, as such 20 providers and facilities serve their communities 21 especially during the COVID–19 emergency pe- 22 riod.’’. 23 VerDate Sep 11 2014 05:16 Jun 26, 2020 Jkt 099200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\S3951.IS S3951 pbinns on DSKJLVW7X2PROD with BILLS 5 •S 3951 IS (d) GRANT PERIODS.—Subsection (e) of section 330I 1 of the Public Health Service Act (42 U.S.C. 254c–14) is 2 amended— 3 (1) by striking ‘‘The Director may award 4 grants under this section’’ and inserting the fol- 5 lowing: 6 ‘‘(1) TELEHEALTH NETWORK AND TELE- 7 HEALTH RESEARCH CENTER GRANTS.—The Director 8 may award grants under paragraphs (1) and (2) of 9 subsection (d)’’; and 10 (2) by adding at the end the following new 11 paragraph: 12 ‘‘(2) VIRTUAL HEALTH NETWORK PILOT PRO- 13 GRAM GRANTS.—The Director shall— 14 ‘‘(A) not later than 30 days after the date 15 of enactment of Increasing Rural Health Access 16 During the COVID–19 Public Health Emer- 17 gency Act of 2020, issue a notice of the avail- 18 ability of funding through grants under sub- 19 section (d)(3); and 20 ‘‘(B) not later than 90 days after the date 21 of issuance of the notice required by subpara- 22 graph (A), award all grants under subsection 23 (d)(3).’’. 24 VerDate Sep 11 2014 05:16 Jun 26, 2020 Jkt 099200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\S3951.IS S3951 pbinns on DSKJLVW7X2PROD with BILLS 6 •S 3951 IS (e) ELIGIBLE ENTITIES.—Subsection (f) of section 1 330I of the Public Health Service Act (42 U.S.C. 254c– 2 14) is amended by adding at the end the following: 3 ‘‘(4) VIRTUAL HEALTH NETWORK PILOT PRO- 4 GRAM GRANTS.—To be eligible to receive a grant 5 under subsection (d)(3), an entity shall— 6 ‘‘(A) meet the requirements of paragraphs 7 (1), (2), and (3) of this subsection that apply 8 to an entity seeking a grant under subsection 9 (d)(1); 10 ‘‘(B) be located in a rural area; and 11 ‘‘(C) demonstrate that the entity will pro- 12 vide services using remote patient monitoring 13 technology that is— 14 ‘‘(i) cellular enabled; 15 ‘‘(ii) approved, cleared, or authorized 16 by the Food and Drug Administration; and 17 ‘‘(iii) operable using cellular stand- 18 ards, including 2G and 3G, that offer 19 broad network coverage in rural areas 20 without broadband access, as determined 21 by the Secretary.’’. 22 (f) APPLICATIONS.—Subsection (g) of section 330I of 23 the Public Health Service Act (42 U.S.C. 254c–14) is 24 amended— 25 VerDate Sep 11 2014 05:16 Jun 26, 2020 Jkt 099200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\S3951.IS S3951 pbinns on DSKJLVW7X2PROD with BILLS 7 •S 3951 IS (1) by redesignating paragraphs (1) through 1 (8) as subparagraphs (A) through (H), respectively, 2 and moving the margin of each such redesignated 3 subparagraph 2 ems to the right; 4 (2) by striking ‘‘To be eligible to receive a grant 5 under subsection (d)’’ and inserting the following: 6 ‘‘(1) TELEHEALTH NETWORK AND TELE- 7 HEALTH RESEARCH CENTER GRANTS.—To be eligi- 8 ble to receive a grant under paragraph (1) or (2) of 9 subsection (d)’’; and 10 (3) by adding at the end the following new 11 paragraph: 12 ‘‘(2) VIRTUAL HEALTH NETWORK PILOT PRO- 13 GRAM GRANTS.—To be eligible to receive a grant 14 under subsection (d)(3), an eligible entity shall pre- 15 pare and submit to the Secretary an application at 16 such time, in such manner, and containing such in- 17 formation as the Secretary may require and include 18 in such application— 19 ‘‘(A) a description of the project that the 20 eligible entity will carry out using the funds 21 provided under the grant; 22 ‘‘(B) a description of the manner in which 23 the project funded under the grant will meet 24 the health care needs of rural or other popu- 25 VerDate Sep 11 2014 05:16 Jun 26, 2020 Jkt 099200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\S3951.IS S3951 pbinns on DSKJLVW7X2PROD with BILLS 8 •S 3951 IS lations to be served through the project, or 1 maintain or improve access to services of, and 2 the quality of the services received by, those 3 populations; 4 ‘‘(C) information on the source and 5 amount of non-Federal funds that the entity 6 will provide for the project; and 7 ‘‘(D) evidence of intent to provide services 8 using remote patient monitoring technology as 9 described in subsection (f)(4)(C).’’. 10 (g) PREFERENCES.—Subsection (h) of section 330I 11 of the Public Health Service Act (42 U.S.C. 254c–14) is 12 amended by adding at the end the following new para- 13 graph: 14 ‘‘(3) VIRTUAL HEALTH NETWORK PILOT PRO- 15 GRAM GRANTS.—In awarding grants under sub- 16 section (d)(3), the Secretary shall give preference to 17 any eligible entity that— 18 ‘‘(A) is able to establish a virtual health 19 program using remote patient monitoring tech- 20 nology within 60 days of receipt of the award; 21 and 22 ‘‘(B) proposes to use Federal funds made 23 available through such a grant to establish and 24 furnish services using remote patient moni- 25 VerDate Sep 11 2014 05:16 Jun 26, 2020 Jkt 099200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6201 E:\BILLS\S3951.IS S3951 pbinns on DSKJLVW7X2PROD with BILLS 9 •S 3951 IS toring technology that provides real time, con- 1 tinuous coaching services.’’. 2 (h) USE OF FUNDS.—Subsection (j) of section 330I 3 of the Public Health Service Act (42 U.S.C. 254c–14) is 4 amended by adding at the end the following new para- 5 graph: 6 ‘‘(3) VIRTUAL HEALTH NETWORK PILOT PRO- 7 GRAM GRANTS.—The recipient of a grant under sub- 8 section (d)(3) may use funds received through such 9 grant for salaries, equipment, and operating or other 10 costs for— 11 ‘‘(A) developing and delivering services 12 using remote patient monitoring technology 13 that enhance access to community-based health 14 care services in rural areas; 15 ‘‘(B) developing and acquiring, through 16 lease or purchase, computer hardware and soft- 17 ware, audio and video equipment, computer net- 18 work equipment, interactive equipment, data 19 terminal equipment, and other equipment that 20 furthers the objectives of the virtual health pilot 21 program; 22 ‘‘(C)(i) providing for transmission of med- 23 ical data, and maintenance of equipment; and 24 VerDate Sep 11 2014 05:16 Jun 26, 2020 Jkt 099200 PO 00000 Frm 00009 Fmt 6652 Sfmt 6201 E:\BILLS\S3951.IS S3951 pbinns on DSKJLVW7X2PROD with BILLS 10 •S 3951 IS ‘‘(ii) providing for compensation (including 1 travel expenses) of specialists, and referring 2 health care providers, who are providing virtual 3 health services through remote patient moni- 4 toring technology if no third-party payment is 5 available; and 6 ‘‘(D) collecting and analyzing usage statis- 7 tics and data to document the cost-effectiveness 8 of services using remote patient monitoring 9 technology; and 10 ‘‘(E) carrying out such other activities as 11 are consistent with achieving the objectives of 12 the virtual health pilot program, as determined 13 by the Secretary.’’. 14 (i) FUNDING.—Subsection (q) of section 330I of the 15 Public Health Service Act (42 U.S.C. 254c–14) is amend- 16 ed— 17 (1) in the subsection heading, by striking ‘‘AU- 18 THORIZATION OF APPROPRIATIONS’’ and inserting 19 ‘‘FUNDING’’; 20 (2) by striking ‘‘There are authorized to be ap- 21 propriated to carry out this section’’ and inserting 22 the following: 23 ‘‘(1) TELEHEALTH NETWORK AND TELE- 24 HEALTH RESEARCH CENTER GRANTS.—To carry out 25 VerDate Sep 11 2014 05:16 Jun 26, 2020 Jkt 099200 PO 00000 Frm 00010 Fmt 6652 Sfmt 6201 E:\BILLS\S3951.IS S3951 pbinns on DSKJLVW7X2PROD with BILLS 11 •S 3951 IS this section with respect to grants under paragraphs 1 (1) and (2) of subsection (d), there is authorized to 2 be appropriated’’; and 3 (3) by adding at the end the following new 4 paragraph: 5 ‘‘(2) VIRTUAL HEALTH NETWORK PILOT PRO- 6 GRAM GRANTS.—To carry out this section with re- 7 spect to the virtual health pilot program under sub- 8 section (b)(2), including grants under subsection 9 (d)(3), there is authorized to be appropriated 10 $50,000,000, to remain available through the end of 11 the COVID–19 emergency period.’’. 12 (j) REPORT.—Not later than two years after award- 13 ing all grants under subsection (d)(3) of section 330I of 14 the Public Health Service Act, as added by this section, 15 the Secretary of Health and Human Services shall prepare 16 and submit to the Committee on Energy and Commerce 17 of the House of Representatives and the Committee on 18 Health, Education, Labor, and Pensions of the Senate a 19 report on the activities and outcomes of the pilot program 20 under subsection (b)(2) of section 330I of such Act, as 21 added by this section. 22 Æ VerDate Sep 11 2014 05:16 Jun 26, 2020 Jkt 099200 PO 00000 Frm 00011 Fmt 6652 Sfmt 6301 E:\BILLS\S3951.IS S3951 pbinns on DSKJLVW7X2PROD with BILLS