Medicare Telehealth Enhancement Act of 2005 - Amends title XVIII (Medicare) of the Social Security Act regarding telehealth services (services furnished via a telecommunication system by a physician to an enrolled individual) to: (1) remove current geographic restrictions on the provision of such services; (2) add to the facilities authorized to participate in the telehealth program; and (3) direct the Secretary to encourage and facilitate multistate practitioner licensure across state lines to facilitate the program.
Directs the Secretary to make grants for expanding access to health care services for individuals in rural areas, frontier areas, and urban medically underserved areas through the use of telehealth.
Amends the Public Health Service Act to reauthorize telehealth network and telehealth resource centers grant programs.
[Congressional Bills 109th Congress]
[From the U.S. Government Publishing Office]
[H.R. 2807 Introduced in House (IH)]
109th CONGRESS
1st Session
H. R. 2807
To improve the provision of telehealth services under the Medicare
Program, to provide grants for the development of telehealth networks,
and for other purposes.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
June 8, 2005
Mr. Hulshof (for himself and Mr. Thompson of California) 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 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 improve the provision of telehealth services under the Medicare
Program, to provide grants for the development of telehealth networks,
and for other purposes.
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 ``Medicare
Telehealth Enhancement Act of 2005''.
(b) Table of Contents.--The table of contents of this Act is as
follows:
Sec. 1. Short title; table of contents.
TITLE I--MEDICARE PROGRAM
Sec. 101. Expansion and improvement of telehealth services.
Sec. 102. Increase in number of types of originating sites;
clarification.
Sec. 103. Facilitating the provision of telehealth services across
State lines.
Sec. 104. Definition of medicare program.
TITLE II--HRSA GRANT PROGRAM
Sec. 201. Grant program for the development of telehealth networks.
Sec. 202. Reauthorization of telehealth network and telehealth resource
centers grant programs.
TITLE I--MEDICARE PROGRAM
SEC. 101. EXPANSION AND IMPROVEMENT OF TELEHEALTH SERVICES.
(a) Expanding Access to Telehealth Services to All Areas.--Section
1834(m) of the Social Security Act (42 U.S.C. 1395m(m)) is amended in
paragraph (4)(C)(i) by striking ``and only if such site is located''
and all that follows and inserting ``without regard to the geographic
area where the site is located.''.
(b) Report to Congress on Store and Forward Technology.--
(1) Study.--The Secretary of Health and Human Services,
acting through the Director of the Office for the Advancement
of Telehealth, shall conduct a study on the use of store and
forward technologies (that provide for the asynchronous
transmission of health care information in single or multimedia
formats) in the provision of telehealth services for which
payment may be made under the medicare program in Alaska and
Hawaii and in other States. Such study shall include an
assessment of the feasibility, advisability, and the costs of
expanding the use of such technologies to other areas for use
in the diagnosis and treatment of certain conditions.
(2) Report.--Not later than 18 months after the date of the
enactment of this Act, the Secretary shall submit to Congress a
report on the study conducted under subparagraph (A) and shall
include in such report such recommendations for legislation or
administration action as the Secretary determines appropriate.
SEC. 102. INCREASE IN NUMBER OF TYPES OF ORIGINATING SITES;
CLARIFICATION.
(a) Increase.--Paragraph (4)(C)(ii) of section 1834(m) of the
Social Security Act (42 U.S.C. 1395m(m)) is amended by adding at the
end the following new subclauses:
``(VI) A skilled nursing facility
(as defined in section 1819(a)).
``(VII) A renal dialysis facility.
``(VIII) A county mental health
clinic or other publicly funded mental
health facility.''.
(b) Clarification of Intent of the Term Originating Site.--Such
section is further amended by adding at the end the following new
paragraph:
``(5) Construction.--In applying the term `originating
site' under this subsection, the Secretary shall apply the term
only for the purpose of determining whether a site is eligible
to receive a facility fee. Nothing in the application of that
term under this subsection shall be construed as affecting the
ability of an eligible practitioner to submit claims for
telehealth services that are provided to other sites that have
telehealth systems and capabilities.''.
SEC. 103. FACILITATING THE PROVISION OF TELEHEALTH SERVICES ACROSS
STATE LINES.
(a) In General.--For purposes of expediting the provision of
telehealth services, for which payment is made under the medicare
program, across State lines, the Secretary of Health and Human Services
shall, in consultation with representatives of States, physicians,
health care practitioners, and patient advocates, encourage and
facilitate the adoption of provisions allowing for multistate
practitioner licensure across State lines.
(b) Definitions.--In paragraph (1):
(1) Telehealth service.--The term ``telehealth service''
has the meaning given that term in subparagraph (F) of section
1834(m)(4) of the Social Security Act (42 U.S.C. 1395m(m)(4)).
(2) Physician, practitioner.--The terms ``physician'' and
``practitioner'' has the meaning given those terms in
subparagraphs (D) and (E), respectively, of such section.
SEC. 104. DEFINITION OF MEDICARE PROGRAM.
In this title, the term ``medicare program'' means the program of
health insurance administered by the Secretary of Health and Human
Services under title XVIII of the Social Security Act (42 U.S.C. 1395
et seq.).
TITLE II--HRSA GRANT PROGRAM
SEC. 201. GRANT PROGRAM FOR THE DEVELOPMENT OF TELEHEALTH NETWORKS.
(a) In General.--The Secretary of Health and Human Services (in
this section referred to as the ``Secretary''), acting through the
Director of the Office for the Advancement of Telehealth (of the Health
Resources and Services Administration), shall make grants to eligible
entities (as described in subsection (b)(2)) for the purpose of
expanding access to health care services for individuals in rural
areas, frontier areas, and urban medically underserved areas through
the use of telehealth.
(b) Eligible Entities.--
(1) Application.--To be eligible to receive a grant under
this section, an eligible entity described in paragraph (2)
shall, in consultation with the State office of rural health or
other appropriate State entity, prepare and submit to the
Secretary an application, at such time, in such manner, and
containing such information as the Secretary may require,
including the following:
(A) A description of the anticipated need for the
grant.
(B) A description of the activities which the
entity intends to carry out using amounts provided
under the grant.
(C) A plan for continuing the project after Federal
support under this section is ended.
(D) A description of the manner in which the
activities funded under the grant will meet health care
needs of underserved rural populations within the
State.
(E) A description of how the local community or
region to be served by the network or proposed network
will be involved in the development and ongoing
operations of the network.
(F) The source and amount of non-Federal funds the
entity would pledge for the project.
(G) A showing of the long-term viability of the
project and evidence of health care provider commitment
to the network.
The application should demonstrate the manner in which the
project will promote the integration of telehealth in the
community so as to avoid redundancy of technology and achieve
economies of scale.
(2) Eligible entities.--An eligible entity described in
this paragraph is a hospital or other health care provider in a
health care network of community-based health care providers
that includes at least two of the organizations described in
subparagraph (A) and one of the institutions and entities
described in subparagraph (B) if the institution or entity is
able to demonstrate use of the network for purposes of
education or economic development (as required by the
Secretary).
(A) The organizations described in this
subparagraph are the following:
(i) Community or migrant health centers.
(ii) Local health departments.
(iii) Nonprofit hospitals.
(iv) Private practice health professionals,
including community and rural health clinics.
(v) Other publicly funded health or social
services agencies.
(vi) Skilled nursing facilities.
(vii) County mental health and other
publicly funded mental health facilities.
(viii) Providers of home health services.
(ix) Renal dialysis facilities.
(B) The institutions and entities described in this
subparagraph are the following:
(i) A public school.
(ii) A public library.
(iii) A university or college.
(iv) A local government entity.
(v) A local health entity.
(vi) A health-related nonprofit foundation.
(vii) An academic health center.
An eligible entity may include for-profit entities so long as
the recipient of the grant is a not-for-profit entity.
(c) Preference.--The Secretary shall establish procedures to
prioritize financial assistance under this section based upon the
following considerations:
(1) The applicant is a health care provider in a health
care network or a health care provider that proposes to form
such a network that furnishes or proposes to furnish services
in a medically underserved area, health professional shortage
area, or mental health professional shortage area.
(2) The applicant is able to demonstrate broad geographic
coverage in the rural or medically underserved areas of the
State, or States in which the applicant is located.
(3) The applicant proposes to use Federal funds to develop
plans for, or to establish, telehealth systems that will link
rural hospitals and rural health care providers to other
hospitals, health care providers, and patients.
(4) The applicant will use the amounts provided for a range
of health care applications and to promote greater efficiency
in the use of health care resources.
(5) The applicant is able to demonstrate the long-term
viability of projects through cost participation (cash or in-
kind).
(6) The applicant is able to demonstrate financial,
institutional, and community support for the long-term
viability of the network.
(7) The applicant is able to provide a detailed plan for
coordinating system use by eligible entities so that health
care services are given a priority over non-clinical uses.
(d) Maximum Amount of Assistance to Individual Recipients.--The
Secretary shall establish, by regulation, the terms and conditions of
the grant and the maximum amount of a grant award to be made available
to an individual recipient for each fiscal year under this section. The
Secretary shall cause to have published in the Federal Register or the
``HRSA Preview'' notice of the terms and conditions of a grant under
this section and the maximum amount of such a grant for a fiscal year.
(e) Use of Amounts.--The recipient of a grant under this section
may use sums received under such grant for the acquisition of
telehealth equipment and modifications or improvements of
telecommunications facilities including the following:
(1) The development and acquisition through lease or
purchase of computer hardware and software, audio and video
equipment, computer network equipment, interactive equipment,
data terminal equipment, and other facilities and equipment
that would further the purposes of this section.
(2) The provision of technical assistance and instruction
for the development and use of such programming equipment or
facilities.
(3) The development and acquisition of instructional
programming.
(4) Demonstration projects for teaching or training medical
students, residents, and other health profession students in
rural or medically underserved training sites about the
application of telehealth.
(5) The provision of telenursing services designed to
enhance care coordination and promote patient self-management
skills.
(6) The provision of services designed to promote patient
understanding and adherence to national guidelines for common
chronic diseases, such as congestive heart failure or diabetes.
(7) Transmission costs, maintenance of equipment, and
compensation of specialists and referring health care
providers, when no other form of reimbursement is available.
(8) Development of projects to use telehealth to facilitate
collaboration between health care providers.
(9) Electronic archival of patient records.
(10) Collection and analysis of usage statistics and data
that can be used to document the cost-effectiveness of the
telehealth services.
(11) Such other uses that are consistent with achieving the
purposes of this section as approved by the Secretary.
(f) Prohibited Uses.--Sums received under a grant under this
section may not be used for any of the following:
(1) To acquire real property.
(2) Expenditures to purchase or lease equipment to the
extent the expenditures would exceed more than 40 percent of
the total grant funds.
(3) To purchase or install transmission equipment off the
premises of the telehealth site and any transmission costs not
directly related to the grant.
(4) For construction, except that such funds may be
expended for minor renovations relating to the installation of
equipment.
(5) Expenditures for indirect costs (as determined by the
Secretary) to the extent the expenditures would exceed more
than 15 percent of the total grant.
(g) Administration.--
(1) Nonduplication.--The Secretary shall ensure that
facilities constructed using grants provided under this section
do not duplicate adequately established telehealth networks.
(2) Coordination with other agencies.--The Secretary shall
coordinate, to the extent practicable, with other Federal and
State agencies and not-for-profit organizations, operating
similar grant programs to pool resources for funding
meritorious proposals.
(3) Informational efforts.--The Secretary shall establish
and implement procedures to carry out outreach activities to
advise potential end users located in rural and medically
underserved areas of each State about the program authorized by
this section.
(h) Prompt Implementation.--The Secretary shall take such actions
as are necessary to carry out the grant program as expeditiously as
possible.
(i) Authorization of Appropriations.--There are authorized to be
appropriated to carry out this section $10,000,000 for fiscal year
2006, and such sums as may be necessary for each of the fiscal years
2007 through 2012.
SEC. 202. REAUTHORIZATION OF TELEHEALTH NETWORK AND TELEHEALTH RESOURCE
CENTERS GRANT PROGRAMS.
Subsection (s) of section 330I of the Public Health Service Act (42
U.S.C. 254c-14) is amended--
(1) in paragraph (1)--
(A) by striking ``and'' before ``such sums''; and
(B) by inserting ``$10,000,000 for fiscal year
2007, and such sums as may be necessary for each of
fiscal years 2008 through 2012'' before the semicolon;
and
(2) in paragraph (2)--
(A) by striking ``and'' before ``such sums''; and
(B) by inserting ``$10,000,000 for fiscal year
2007, and such sums as may be necessary for each of
fiscal years 2008 through 2012'' before the semicolon.
<all>
Introduced in House
Introduced in House
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.
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.
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.
Referred to the Subcommittee on Health.
Referred to the Subcommittee on Health.
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