[Congressional Bills 106th Congress]
[From the U.S. Government Publishing Office]
[H.R. 4771 Introduced in House (IH)]
106th CONGRESS
2d Session
H. R. 4771
To amend title XVIII of the Social Security Act to provide increased
access to health care for Medicare beneficiaries through telemedicine.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
June 27, 2000
Mr. McHugh introduced the following bill; which was referred to the
Committee on 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 increased
access to health care for Medicare beneficiaries through telemedicine.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE; TABLE OF CONTENTS.
(a) Short Title.--This Act may be cited as the ``Telehealth
Improvement and Modernization Act of 2000''.
(b) Table of Contents.--The table of contents of this Act is as
follows:
Sec. 1. Short title; table of contents.
Sec. 2. Revision of telehealth payment methodology and elimination of
fee-sharing requirement.
Sec. 3. Elimination of requirement for telepresenter.
Sec. 4. Reimbursement for medicare beneficiaries who do not reside in a
HPSA.
Sec. 5. Telehealth coverage for direct patient care.
Sec. 6. All physicians and practitioners eligible for telehealth
reimbursement.
Sec. 7. Telehealth services provided using store-and-forward
technologies.
Sec. 8. Construction relating to home health services.
Sec. 9. Effective date.
SEC. 2. REVISION OF TELEHEALTH PAYMENT METHODOLOGY AND ELIMINATION OF
FEE-SHARING REQUIREMENT.
Section 4206(b) of the Balanced Budget Act of 1997 (42 U.S.C. 1395l
note) is amended to read as follows:
``(b) Methodology for Determining Amount of Payments.--
``(1) In general.--The Secretary shall pay to--
``(A) the physician or practitioner at a distant
site that provides an item or service under subsection
(a) an amount equal to the amount that such physician
or provider would have been paid had the item or
service been provided without the use of a
telecommunications system; and
``(B) the originating site a facility fee for
facility services furnished in connection with such
item or service.
``(2) Application of part b coinsurance and deductible.--
Any payment made under this section shall be subject to the
coinsurance and deductible requirements under subsections
(a)(1) and (b) of section 1833 of the Social Security Act (42
U.S.C. 1395l).
``(3) Definitions.--In this subsection:
``(A) Distant site.--The term `distant site' means
the site at which the physician or practitioner is
located at the time the item or service is provided via
a telecommunications system.
``(B) Facility fee.--The term `facility fee' means
an amount equal to--
``(i) for 2000 and 2001, $20; and
``(ii) for a subsequent year, the facility
fee under this subsection for the previous year
increased by the percentage increase in the MEI
(as defined in section 1842(i)(3)) for such
subsequent year.
``(C) Originating site.--
``(i) In general.--The term `originating
site' means the site described in clause (ii)
at which the eligible telehealth beneficiary
under the medicare program is located at the
time the item or service is provided via a
telecommunications system.
``(ii) Sites described.--The sites
described in this paragraph are as follows:
``(I) On or before January 1, 2002,
the office of a physician or a
practitioner, a critical access
hospital, a rural health clinic, and a
Federally qualified health center.
``(II) On or before January 1,
2003, a hospital, a skilled nursing
facility, a comprehensive outpatient
rehabilitation facility, a renal
dialysis facility, an ambulatory
surgical center, an Indian Health
Service facility, and a community
mental health center.''.
SEC. 3. ELIMINATION OF REQUIREMENT FOR TELEPRESENTER.
Section 4206 of the Balanced Budget Act of 1997 (42 U.S.C. 1395l
note) is amended--
(1) in subsection (a), by striking ``, notwithstanding that
the individual physician'' and all that follows before the
period at the end; and
(2) by adding at the end the following new subsection:
``(e) Telepresenter Not Required.--Nothing in this section shall be
construed as requiring an eligible telehealth beneficiary to be
presented by a physician or practitioner for the provision of an item
or service via a telecommunications system.''.
SEC. 4. REIMBURSEMENT FOR MEDICARE BENEFICIARIES WHO DO NOT RESIDE IN A
HPSA.
Section 4206(a) of the Balanced Budget Act of 1997 (42 U.S.C. 1395l
note), as amended by section 3, is amended--
(1) by striking ``In General.--Not later than'' and
inserting the following: ``Telehealth Services Reimbursed.--
``(1) In general.--Not later than'';
(2) by striking ``furnishing a service for which payment''
and all that follows before the period and inserting ``to an
eligible telehealth beneficiary''; and
(3) by adding at the end the following new paragraph:
``(2) Eligible telehealth beneficiary defined.--In this
section, the term `eligible telehealth beneficiary' means a
beneficiary under the medicare program under title XVIII of the
Social Security Act (42 U.S.C. 1395 et seq.) that resides in--
``(A) an area that is designated as a health
professional shortage area under section 332(a)(1)(A)
of the Public Health Service Act (42 U.S.C.
254e(a)(1)(A));
``(B) a county that is not included in a
Metropolitan Statistical Area;
``(C) an inner-city area that is medically
underserved (as defined in section 330(b)(3) of the
Public Health Service Act (42 U.S.C. 254b(b)(3))); or
``(D) an area in which there is a Federal
telemedicine demonstration program.''.
SEC. 5. TELEHEALTH COVERAGE FOR DIRECT PATIENT CARE.
(a) In General.--Section 4206 of the Balanced Budget Act of 1997
(42 U.S.C. 1395l note), as amended by section 4, is amended--
(1) in subsection (a)(1), by striking ``professional
consultation via telecommunications systems with a physician''
and inserting ``items and services for which payment may be
made under such part that are furnished via a
telecommunications system by a physician''; and
(2) by adding at the end the following new subsection:
``(f) Coverage of Items and Services.--Payment for items and
services provided pursuant to subsection (a) shall include payment for
professional consultations, office visits, office psychiatry services,
including any service identified as of July 1, 2000, by HCPCS codes
99241-99275, 99201-99215, 90804-90815, and 90862, and any additional
item or service specified by the Secretary.''.
(b) Study and Report Regarding Additional Items and Services.--
(1) Study.--The Secretary of Health and Human Services
shall conduct a study to identify items and services in
addition to those described in section 4206(f) of the Balanced
Budget Act of 1997 (as added by subsection (a)) that would be
appropriate to provide payment under title XVIII of the Social
Security Act (42 U.S.C. 1395 et seq.).
(2) Report.--Not later than 2 years after the date of
enactment of this Act, the Secretary shall submit a report to
Congress on the study conducted under paragraph (1) together
with such recommendations for legislation that the Secretary
determines are appropriate.
SEC. 6. ALL PHYSICIANS AND PRACTITIONERS ELIGIBLE FOR TELEHEALTH
REIMBURSEMENT.
Section 4206(a) of the Balanced Budget Act of 1997 (42 U.S.C. 1395l
note), as amended by section 5, is amended--
(1) in paragraph (1), by striking ``(described in section
1842(b)(18)(C) of such Act (42 U.S.C. 1395u(b)(18)(C))''; and
(2) by adding at the end the following new paragraph:
``(3) Practitioner defined.--For purposes of paragraph (1),
the term `practitioner' includes--
``(A) a practitioner described in section
1842(b)(18)(C) of the Social Security Act (42 U.S.C.
1395u(b)(18)(C)); and
``(B) a physical, occupational, or speech
therapist.''.
SEC. 7. TELEHEALTH SERVICES PROVIDED USING STORE-AND-FORWARD
TECHNOLOGIES.
Section 4206(a)(1) of the Balanced Budget Act of 1997 (42 U.S.C.
1395l note), as amended by section 6, is amended by adding at the end
the following new paragraph:
``(4) Use of store-and-forward technologies.--For purposes
of paragraph (1), in the case of any Federal telemedicine
demonstration program in Alaska or Hawaii, the term
`telecommunications system' includes store-and-forward
technologies that provide for the asynchronous transmission of
health care information in single or multimedia formats.''.
SEC. 8. CONSTRUCTION RELATING TO HOME HEALTH SERVICES.
Section 4206(a) of the Balanced Budget Act of 1997 (42 U.S.C. 1395l
note), as amended by section 7, is amended by adding at the end the
following new paragraph:
``(5) Construction relating to home health services.--
``(A) In general.--Nothing in this section or in
section 1895 of the Social Security Act (42 U.S.C.
1395fff) shall be construed as preventing a home health
agency that is receiving payment under the prospective
payment system described in such section from
furnishing a home health service via a
telecommunications system.
``(B) Limitation.--The Secretary shall not consider
a home health service provided in the manner described
in subparagraph (A) to be a home health visit for
purposes of--
``(i) determining the amount of payment to
be made under the prospective payment system
established under section 1895 of the Social
Security Act (42 U.S.C. 1395fff); or
``(ii) any requirement relating to the
certification of a physician required under
section 1814(a)(2)(C) of such Act (42 U.S.C.
1395f(a)(2)(C)).''.
SEC. 9. EFFECTIVE DATE.
The amendments made by this Act shall apply to items and services
provided on or after the date of enactment of this Act.
<all>
Introduced in House
Introduced in House
Referred to the Committee on 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.
Referred to the Committee on 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.
Referred to the Committee on 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.
Referred to the Subcommittee on Health and Environment.
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