Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act of 2017 or the CONNECT for Health Act of 2017
This bill makes a series of changes to expand coverage of telehealth services under Medicare, including by exempting certain telehealth services (e.g., specified renal dialysis and stroke evaluation services) from originating site requirements.
[Congressional Bills 115th Congress]
[From the U.S. Government Publishing Office]
[H.R. 2556 Introduced in House (IH)]
<DOC>
115th CONGRESS
1st Session
H. R. 2556
To amend title XVIII of the Social Security Act to expand access to
telehealth services, and for other purposes.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
May 19, 2017
Mrs. Black (for herself, Mr. Welch, Mr. Harper, Mr. Thompson of
California, Mr. Johnson of Ohio, and Ms. Matsui) 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 amend title XVIII of the Social Security Act to expand access to
telehealth services, 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 ``Creating
Opportunities Now for Necessary and Effective Care Technologies for
Health Act of 2017'' or the ``CONNECT for Health Act of 2017''.
(b) Table of Contents.--The table of contents of this Act is as
follows:
Sec. 1. Short title; table of contents.
Sec. 2. Providing accountable care organizations the ability to expand
the use of telehealth.
Sec. 3. Expanding access to home dialysis therapy.
Sec. 4. Expanding the use of telehealth for individuals with stroke.
Sec. 5. Increasing access to digital tools for Medicare Advantage
enrollees through telehealth and remote
patient monitoring.
Sec. 6. Coverage of remote patient monitoring services furnished to
certain individuals.
Sec. 7. Rural health clinics and Federally qualified health centers.
Sec. 8. Allowing Native American health service facilities as sites
eligible for telehealth payment.
Sec. 9. Clarification regarding telehealth and remote patient
monitoring technologies provided to
beneficiaries.
Sec. 10. Allowing telehealth and remote patient monitoring services to
be included in bundled or global payments.
Sec. 11. Expanding the use of telehealth through the waiver of certain
requirements.
Sec. 12. Expanding the use of telehealth for mental health services.
Sec. 13. HHS evaluation and report on the use of telehealth and remote
patient monitoring under all demonstration
programs and pilots with a telehealth
waiver.
Sec. 14. Testing of models to examine the use of telehealth and remote
patient monitoring under the Medicare
program.
Sec. 15. Sense of Congress regarding the remote practice of medicine.
SEC. 2. PROVIDING ACCOUNTABLE CARE ORGANIZATIONS THE ABILITY TO EXPAND
THE USE OF TELEHEALTH.
(a) In General.--Section 1899 of the Social Security Act (42 U.S.C.
1395jjj) is amended by adding at the end the following new subsection:
``(l) Providing ACOs the Ability To Expand the Use of Telehealth
Services.--
``(1) In general.--
``(A) Expanding use of telehealth services.--In the
case of telehealth services for which payment would
otherwise be made under this title furnished on or
after January 1, 2018, for purposes of this subsection
only, the restrictions applicable to the coverage of
telehealth services under section 1834(m) described in
subparagraph (B) shall not apply with respect to such
services furnished to a Medicare fee-for-service
beneficiary assigned to an applicable ACO (as defined
in paragraph (2)).
``(B) Restrictions described.--For purposes of this
subsection, restrictions applicable to the coverage of
telehealth services under section 1834(m) shall include
requirements relating to qualifications for an
originating site under paragraph (4)(C)(ii) of such
section, any geographic limitations under paragraph
(4)(C)(i) of such section (other than applicable State
law requirements, including State licensure
requirements), any limitation on the use of store-and-
forward technologies described in paragraph (1) of such
section, any limitation on the type of health care
provider who may furnish such services (other than the
requirement that the provider is a Medicare-enrolled
provider), or any limitation on specific codes
designated as telehealth services that are covered
under this title pursuant to such section (provided
such codes are clinically appropriate to furnish
remotely).
``(2) Definition of applicable aco.--In this subsection,
the term `applicable ACO' means an ACO participating in a model
tested or expanded under section 1115A or under this section--
``(A) that operates under a two-sided model--
``(i) described in section 425.600(a) of
title 42, Code of Federal Regulations; or
``(ii) tested or expanded under section
1115A; and
``(B) for which Medicare fee-for-service
beneficiaries are assigned to the ACO using a
prospective assignment method, as determined
appropriate by the Secretary.
``(3) No originating site facility fee for new sites.--The
Secretary shall not pay an originating site facility fee (as
described in paragraph (2)(B) of section 1834(m)) with respect
to telehealth services described in paragraph (1) if such
services would not have been covered under this title as of the
date of enactment of this subsection.
``(4) Annual submission of data.--An applicable ACO that
furnishes telehealth services described in paragraph (1) shall,
on an annual basis, submit to the Secretary information
requested by the Secretary for evaluation of the implementation
of this subsection, including information on utilization and
expenditures for telehealth under this subsection during the
preceding year and data on any applicable quality measures,
consistent with sections 1848 and 1833(z).''.
(b) Evaluation and Report.--
(1) Evaluation.--
(A) In general.--The Secretary of Health and Human
Services (in this subsection referred to as the
``Secretary'') shall conduct an evaluation on the
implementation of section 1899(l) of the Social
Security Act, as added by subsection (a). Such
evaluation shall include an analysis of the utilization
of, and expenditures for, telehealth services under
such section, including a comparison of the utilization
of, and expenditures for, the same services provided in
the office setting.
(B) Collection of data.--The Secretary may collect
such data as the Secretary determines necessary to
carry out the evaluation under this paragraph.
(2) Report.--Not later than January 1, 2025, the Secretary
shall submit to Congress a report containing the results of the
evaluation conducted under paragraph (1), together with
recommendations for such legislation and administrative action
as the Secretary determines appropriate.
SEC. 3. EXPANDING ACCESS TO HOME DIALYSIS THERAPY.
(a) In General.--Section 1881(b)(3) of the Social Security Act (42
U.S.C. 1395rr(b)(3)) is amended--
(1) by redesignating subparagraphs (A) and (B) as clauses
(i) and (ii), respectively;
(2) in clause (ii), as redesignated by subparagraph (A),
strike ``on a comprehensive'' and insert ``subject to
subparagraph (B), on a comprehensive'';
(3) by striking ``With respect to'' and inserting ``(A)
With respect to''; and
(4) by adding at the end the following new subparagraph:
``(B) For purposes of subparagraph (A)(ii), an individual
determined to have end stage renal disease receiving home dialysis may
choose to receive the monthly end stage renal disease-related visits
furnished on or after January 1, 2018, via telehealth, if the
individual receives a face-to-face visit, without the use of
telehealth, at least once every three consecutive months.''.
(b) Originating Site Requirements.--
(1) In general.--Section 1834(m) of the Social Security Act
(42 U.S.C. 1395m(m)) is amended--
(A) in paragraph (4)(C)(ii), by adding at the end
the following new subclauses:
``(IX) A renal dialysis facility,
but only for purposes of section
1881(b)(3)(B).
``(X) The home of an individual,
but only for purposes of section
1881(b)(3)(B).''; and
(B) by adding at the end the following new
paragraph:
``(5) Treatment of home dialysis monthly esrd-related
visit.--The geographic requirements described in paragraph
(4)(C)(i) shall not apply with respect to telehealth services
furnished on or after January 1, 2018, for purposes of section
1881(b)(3)(B), at an originating site described in subclause
(VI), (IX), or (X) of paragraph (4)(C)(ii)), subject to
applicable State law requirements, including State licensure
requirements.''.
(2) No facility fee if originating site for home dialysis
therapy is the home.--Section 1834(m)(2)(B) of the Social
Security (42 U.S.C. 1395m(m)(2)(B)) is amended--
(A) by redesignating clauses (i) and (ii) as
subclauses (I) and (II), and indenting appropriately;
(B) in subclause (II), as redesignated by
subparagraph (A), by striking ``clause (i) or this
clause'' and inserting ``subclause (I) or this
subclause'';
(C) by striking ``site.--With respect to'' and
inserting ``site.--
``(i) In general.--Subject to clause (ii),
with respect to''; and
(D) by adding at the end the following new clause:
``(ii) No facility fee if originating site
for home dialysis therapy is the home.--No
facility fee shall be paid under this
subparagraph to an originating site described
in paragraph (4)(C)(ii)(X).''.
(c) Conforming Amendment.--Section 1881(b)(1) of the Social
Security Act (42 U.S.C. 1395rr(b)(1)) is amended by striking
``paragraph (3)(A)'' and inserting ``paragraph (3)(A)(i)''.
SEC. 4. EXPANDING THE USE OF TELEHEALTH FOR INDIVIDUALS WITH STROKE.
Section 1834(m) of the Social Security Act (42 U.S.C. 1395m(m)), as
amended by section 3(b), is amended by adding at the end the following
new paragraph:
``(6) Treatment of stroke telehealth services.--
``(A) Nonapplication of originating site
requirements.--The requirements described in paragraph
(4)(C) shall not apply with respect to telehealth
services furnished on or after January 1, 2018, for
purposes of evaluation of an acute stroke, as
determined by the Secretary, subject to applicable
State law requirements, including State licensure
requirements.
``(B) No originating site facility fee for new
sites.--The Secretary shall not pay an originating site
facility fee (as described in paragraph (2)(B)) with
respect to telehealth services described in
subparagraph (A) if the services would not have been
covered under this title as of the date of enactment of
this paragraph.''.
SEC. 5. INCREASING ACCESS TO DIGITAL TOOLS FOR MEDICARE ADVANTAGE
ENROLLEES THROUGH TELEHEALTH AND REMOTE PATIENT
MONITORING.
(a) In General.--Section 1852 of the Social Security Act (42 U.S.C.
1395w-22) is amended--
(1) in subsection (a)(1)(B)(i), by inserting ``, subject to
subsection (m),'' after ``means''; and
(2) by adding at the end the following new subsection:
``(m) Provision of Additional Telehealth Benefits and Treatment of
Remote Patient Monitoring.--
``(1) MA plan option.--For plan year 2018 and subsequent
plan years, subject to the requirements of paragraph (3), an MA
plan may provide additional telehealth benefits (as defined in
paragraph (2)) to individuals enrolled under this part.
``(2) Additional telehealth benefits defined.--
``(A) In general.--For purposes of this subsection
and section 1854:
``(i) Definition.--The term `additional
telehealth benefits' means services for which
benefits are available under part B,
notwithstanding the restrictions applicable to
the coverage of telehealth services under
section 1834(m) described in subparagraph (B).
``(ii) Exclusion of capital and
infrastructure costs and investments.--The term
`additional telehealth benefits' does not
include capital and infrastructure costs and
investments relating to such benefits.
``(B) Restrictions described.--For purposes of this
subsection, restrictions applicable to the coverage of
telehealth services under section 1834(m) shall include
requirements relating to qualifications for an
originating site under paragraph (4)(C)(ii) of such
section, any geographic limitations under paragraph
(4)(C)(i) of such section (other than applicable State
law requirements, including State licensure
requirements), any limitation on the use of store-and-
forward technologies described in paragraph (1) of such
section, any limitation on the type of health care
provider who may furnish such services (other than the
requirement that the provider is a Medicare-enrolled
provider), or any limitation on specific codes
designated as telehealth services that are covered
under this title pursuant to such section (provided
such codes are clinically appropriate to furnish
remotely).
``(C) Public comment.--Not later than November 30,
2017, the Secretary shall solicit comments on what
types of telehealth services should be considered to
meet the definition of additional telehealth benefits
under this paragraph.
``(3) Requirements for additional telehealth benefits.--The
Secretary shall specify requirements for the provision or
furnishing of additional telehealth benefits, including with
respect to the following:
``(A) Physician, practitioner, or other health care
provider licensure consistent with State law and other
requirements such as specific training.
``(B) Factors necessary to ensure the coordination
of such benefits with items and services furnished in
person.
``(C) Such other areas as determined by the
Secretary.
``(4) Enrollee choice.--If an MA plan provides a service as
an additional telehealth benefit (as defined in paragraph (2)),
an individual enrollee shall have discretion as to whether to
receive such service as an additional telehealth benefit.
``(5) Construction regarding network access adequacy.--The
provision of additional telehealth benefits under this
subsection shall not be construed as making such benefits
available and accessible for purposes of compliance with
subsection (d).
``(6) Treatment under ma.--For purposes of this subsection
and section 1854, additional telehealth benefits shall be
treated as if they were benefits under the original Medicare
fee-for-service program option.
``(7) Construction.--Nothing in this subsection shall be
construed as affecting the requirement under subsection (a)(1)
that MA plans provide enrollees with items and services (other
than hospice care) for which benefits are available under parts
A and B, including benefits available under section 1834(m).
``(8) Clarification regarding remote patient monitoring
services.--For purposes of this subsection and section 1854,
remote patient monitoring services shall be treated as if they
were benefits under the original Medicare fee-for-service
program option so long as such treatment does not increase the
bid amount attributable to such benefits from the amount it
would otherwise be, as determined by the Secretary.
``(9) Provision of data.--An MA plan that provides
additional telehealth benefits or remote patient monitoring
services with respect to a plan year shall provide to the
Secretary (at such time and in such manner as the Secretary may
specify) data on expenditures and utilization for telehealth or
remote patient monitoring services under the plan for enrollees
during that plan year.''.
(b) Clarification Regarding Inclusion in Bid Amount.--Section
1854(a)(6)(A)(ii)(I) of the Social Security Act (42 U.S.C. 1395w-
24(a)(6)(A)(ii)(I)) is amended by inserting ``, including, for plan
year 2019 and subsequent plan years, the provision of additional
telehealth benefits and remote patient monitoring as described in
section 1852(m)'' before the semicolon at the end.
SEC. 6. COVERAGE OF REMOTE PATIENT MONITORING SERVICES FURNISHED TO
CERTAIN INDIVIDUALS.
(a) In General.--Section 1848(b) of the Social Security Act (42
U.S.C. 1395w-4(b)) is amended by adding at the end the following new
paragraph:
``(12) Coverage of remote patient monitoring services
furnished to certain individuals.--
``(A) In general.--The Secretary shall, subject to
subparagraph (B), make payment (as the Secretary
determines to be appropriate) under this section for
remote patient monitoring services (as defined in
subparagraph (C)(iii)) furnished on or after January 1,
2018, to an applicable individual (as defined in
subparagraph (C)(i)) by an eligible provider (as
defined in subparagraph (C)(ii)).
``(B) Requirements.--The following shall apply with
respect to remote patient monitoring services under
this paragraph:
``(i) Coverage of such remote patient
monitoring services shall be in addition to
coverage for chronic care management services
or transitional care management services
furnished to an applicable individual under
this section.
``(ii) The Secretary shall consult with
public and private stakeholders in determining
the amount of payment for remote patient
monitoring services under this section.
``(iii) Payment, pricing, and coverage for
such remote patient monitoring services may
occur through the unbundling, modification, or
establishment of certain codes.
``(iv) Such remote patient monitoring
services (other than those services that are
physicians' services) shall be furnished under
the general supervision of an eligible
provider.
``(C) Definitions.--In this paragraph:
``(i) Applicable individual.--The term
`applicable individual' means an individual--
``(I) receiving chronic care
management services or transitional
care management services under this
section;
``(II) who is in the top five
percent of Medicare cost utilization
and has two or more chronic diseases,
as determined on a yearly basis by the
Secretary; or
``(III) who has any other condition
or with respect to an episode of care
that the Secretary may specify, so long
as the Chief Actuary of the Centers for
Medicare & Medicaid Services certifies
that providing coverage for remote
patient monitoring services with
respect to such individuals would--
``(aa) reduce spending
under this title without
reducing the quality of care;
or
``(bb) improve the quality
of patient care without
increasing spending.
``(ii) Eligible provider.--The term
`eligible provider' means a physician (as
defined in section 1861(r)) or a practitioner
described in section 1842(b)(18)(C).
``(iii) Remote patient monitoring
services.--The term `remote patient monitoring
services' means clinical data transmitted from
an applicable individual in one location via
electronic communications technologies that are
devices as defined in section 201(h) of the
Federal Food, Drug, and Cosmetic Act to an
eligible provider in a different location and
used by the eligible provider in furnishing
such services to such individual that complies
with the Federal regulations (concerning the
privacy and security of individually
identifiable health information) promulgated
under section 264(c) of the Health Insurance
Portability and Accountability Act of 1996, as
part of an established plan of care for the
applicable individual that includes the review
and interpretation of that data by an eligible
provider. Such term includes those services
furnished in a Federally qualified health
center or a rural health clinic. Such term
shall not include a communication that consists
solely of a telephone audio conversation,
facsimile, or electronic text message between
an eligible provider and the applicable
individual.''.
(b) Expanding the Use of Remote Patient Monitoring Services Under
Alternative Payment Models.--Section 1848(b)(12) of the Social Security
Act (42 U.S.C. 1395w-4(b)(12)), as added by subsection (a), is amended
by adding at the end the following new subparagraph:
``(D) Application to alternative payment models.--
For purposes of applying this paragraph with respect to
remote patient monitoring services furnished by an
eligible provider participating in an alternative
payment model (as defined in section 1833(z)(3)(C)),
the term `applicable individual' shall mean any
beneficiary assigned to the alternative payment
model.''.
SEC. 7. RURAL HEALTH CLINICS AND FEDERALLY QUALIFIED HEALTH CENTERS.
(a) Expansion of Originating Sites.--Section 1834(m)(4)(C) of the
Social Security Act (42 U.S.C. 1395m(m)(4)(C)) is amended--
(1) in clause (i), by striking ``The term'' and inserting
``Subject to clause (iii), the term''; and
(2) by adding at the end the following new clause:
``(iii) Rural health clinics and federally
qualified health centers.--In the case of a
service furnished on or after the date that is
6 months after the date of the enactment of the
CONNECT for Health Act of 2017, the term
`originating site' shall also include any
Federally qualified health center and any rural
health clinic (as such terms are defined in
section 1861(aa)) at which the eligible
telehealth individual is located at the time
the service is furnished via a
telecommunications system, whether or not they
are located in an area described in clause (i),
insofar as such sites are not otherwise
included in the definition of originating site
under such clause, subject to applicable State
law requirements, including State licensure
requirements.''.
(b) Expansion of Distant Sites.--Section 1834(m) of the Social
Security Act (42 U.S.C. 1395m(m)) is amended--
(1) in the first sentence of paragraph (1)--
(A) by striking ``or a practitioner (described in
section 1842(b)(18)(C))'' and inserting ``, a
practitioner (described in section 1842(b)(18)(C)), a
Federally qualified health center, or a rural health
clinic''; and
(B) by striking ``or practitioner'' and inserting
``, practitioner, Federally qualified health center, or
rural health clinic'';
(2) in paragraph (2)(A)--
(A) by inserting after ``eligible telehealth
individual'' the following: ``or to a Federally
qualified health center or rural health clinic that
serves as a distant site and furnishes a telehealth
service to an eligible telehealth individual''; and
(B) by striking ``such physician or practitioner''
and inserting ``such physician, practitioner, Federally
qualified health center, or rural health clinic''; and
(3) in paragraph (4)(A), by inserting the following before
the period at the end: ``and includes a Federally qualified
health center or rural health clinic that furnishes a
telehealth service to an eligible individual''.
(c) Effective Date.--The amendments made by this section shall
apply to services furnished on or after January 1, 2018.
SEC. 8. ALLOWING NATIVE AMERICAN HEALTH SERVICE FACILITIES AS SITES
ELIGIBLE FOR TELEHEALTH PAYMENT.
(a) In General.--Section 1834(m)(4)(C) of the Social Security Act
(42 U.S.C. 1395m(m)(4)(C)), as amended by section 7, is amended--
(1) in clause (i), by striking ``clause (iii)'' and
inserting ``clauses (iii) and (iv)''; and
(2) by adding at the end the following new clause:
``(iv) Native american health service
facilities.--The originating site requirements
described in clauses (i) and (ii) shall not
apply with respect to a facility of the Indian
Health Service, whether operated by such
Service, or by an Indian tribe (as that term is
defined in section 4 of the Indian Health Care
Improvement Act (25 U.S.C. 1603)) or a tribal
organization (as that term is defined in
section 4 of the Indian Self-Determination and
Education Assistance Act (25 U.S.C. 450b)), or
a facility of the Native Hawaiian health care
systems authorized under the Native Hawaiian
Health Care Improvement Act (42 U.S.C. 11701 et
seq.).''.
(b) No Originating Site Facility Fee for New Sites.--Section
1834(m)(2)(B) of the Social Security Act (42 U.S.C. 1395m(m)(2)(B)) is
amended, in the matter preceding clause (i), by inserting ``(other than
an originating site that is only described in clause (iv) of paragraph
(4)(C), and does not meet the requirement for an originating site under
clause (i) of such paragraph)'' after ``the originating site''.
(c) Effective Date.--The amendments made by this section shall
apply to services furnished on or after January 1, 2018.
SEC. 9. CLARIFICATION REGARDING TELEHEALTH AND REMOTE PATIENT
MONITORING TECHNOLOGIES PROVIDED TO BENEFICIARIES.
Section 1128A(i)(6) of the Social Security Act (42 U.S.C. 1320a-
7a(i)(6)) is amended--
(1) in subparagraph (H), by striking ``; or'' and inserting
a semicolon;
(2) in subparagraph (I), by striking the period at the end
and inserting ``; or''; and
(3) by adding at the end the following new subparagraph:
``(J) the provision of telehealth or remote patient
monitoring technologies to individuals under title
XVIII by a health care provider for the purpose of
furnishing telehealth or remote patient monitoring
services.''.
SEC. 10. ALLOWING TELEHEALTH AND REMOTE PATIENT MONITORING SERVICES TO
BE INCLUDED IN BUNDLED OR GLOBAL PAYMENTS.
Title XVIII of the Social Security Act (42 U.S.C. 1395 et seq.) is
amended by adding at the end the following new section:
``SEC. 1899C. ALLOWING TELEHEALTH AND REMOTE PATIENT MONITORING
SERVICES TO BE INCLUDED IN BUNDLED OR GLOBAL PAYMENTS.
``Notwithstanding any other provision of this title, the Secretary
may include under any bundled or global payment under this title the
following:
``(1) Telehealth services.--Notwithstanding requirements
otherwise applicable under section 1834(m), including any
requirements relating to qualifications for an originating site
under paragraph (4)(C)(ii) of such section, any geographic
limitations under paragraph (4)(C)(i) of such section (other
than applicable State law requirements, including State
licensure requirements), any limitation on the use of store-
and-forward technologies described in paragraph (1) of such
section, any limitation on the type of health care provider who
may furnish such services (other than the requirement that the
provider is a Medicare-enrolled provider), any items and
services for which payment would otherwise be made under this
title that are furnished using telehealth, or any limitation on
specific codes designated as telehealth services that are
covered under this title pursuant to section 1834(m) (provided
such codes are clinically appropriate to furnish remotely).
``(2) Remote patient monitoring services.--Notwithstanding
section 1848(b)(12), remote patient monitoring services (as
defined in such section) furnished to any individual under this
title.''.
SEC. 11. EXPANDING THE USE OF TELEHEALTH THROUGH THE WAIVER OF CERTAIN
REQUIREMENTS.
Section 1834(m) of the Social Security Act (42 U.S.C. 1395m(m)), as
amended by sections 3(b) and 4, is amended by adding at the end the
following new paragraph:
``(7) Authority to waive requirements and limitations if
certain conditions met.--
``(A) In general.--In the case of telehealth
services furnished on or after January 1, 2018, the
Secretary may waive any restriction applicable to the
coverage of telehealth services under this subsection
described in subparagraph (B) with respect to certain
providers of services, suppliers, provider groups,
sites of care, services, conditions, individuals
receiving the services, or States, as determined by the
Secretary, if each of the requirements described in
subparagraph (C) is met with respect to the waiver.
``(B) Restrictions described.--For purposes of this
paragraph, restrictions applicable to the coverage of
telehealth services under this subsection shall include
requirements relating to qualifications for an
originating site under paragraph (4)(C)(ii), any
geographic limitations under paragraph (4)(C)(i) (other
than applicable State law requirements, including State
licensure requirements), any limitation on the use of
store-and-forward technologies described in paragraph
(1), any limitation on the type of health care provider
who may furnish such services (other than the
requirement that the provider is a Medicare-enrolled
provider), or any limitation on specific codes
designated as telehealth services that are covered
under this title pursuant to this subsection (provided
such codes are clinically appropriate to furnish
remotely).
``(C) Requirements for waiver.--The requirements
described in this subparagraph are, with respect to the
waiver of a restriction described in subparagraph (B),
the following:
``(i) The Secretary determines that the
waiver is expected to--
``(I) reduce spending under this
title without reducing the quality of
care; or
``(II) improve the quality of
patient care without increasing
spending.
``(ii) The Chief Actuary of the Centers for
Medicare & Medicaid Services certifies that
such waiver would reduce (or would not result
in any increase in) net program spending under
this title.
``(iii) The Secretary determines that such
waiver would not deny or limit the coverage or
provision of benefits under this title for
individuals.
``(D) Public comment.--The Secretary shall
establish a process by which stakeholders may (on at
least an annual basis) submit requests for a waiver
under this paragraph.''.
SEC. 12. EXPANDING THE USE OF TELEHEALTH FOR MENTAL HEALTH SERVICES.
Section 1834(m) of the Social Security Act (42 U.S.C. 1395m(m)), as
amended by sections 3(b), 4, and 11, is amended by adding at the end
the following new paragraph:
``(8) Treatment of mental health services delivered via
telehealth.--
``(A) In general.--Restrictions applicable to the
coverage of telehealth services under this subsection
described in subparagraph (B) shall not apply with
respect to telehealth services that are mental health
services (as determined by the Secretary) and are
furnished on or after January 1, 2018.
``(B) Restrictions described.--For purposes of this
paragraph, restrictions applicable to the coverage of
telehealth services under this subsection shall include
requirements relating to qualifications for an
originating site under paragraph (4)(C)(ii), any
geographic limitations under paragraph (4)(C)(i) (other
than applicable State law requirements, including State
licensure requirements), any limitation on the use of
store-and-forward technologies described in paragraph
(1), any limitation on the type of health care provider
who may furnish such services (other than the
requirement that the provider is a Medicare-enrolled
provider), or any limitation on specific codes
designated as telehealth services that are covered
under this title pursuant to this subsection (provided
such codes are clinically appropriate to furnish
remotely).''.
SEC. 13. HHS EVALUATION AND REPORT ON THE USE OF TELEHEALTH AND REMOTE
PATIENT MONITORING UNDER ALL DEMONSTRATION PROGRAMS AND
PILOTS WITH A TELEHEALTH WAIVER.
(a) Study.--The Secretary of Health and Human Services (in this
subsection referred to as the ``Secretary'') shall conduct an
evaluation on the use of telehealth and remote patient monitoring under
all programs and pilots under the Medicare program under title XVIII of
the Social Security Act and the Medicaid program under title XIX of
such Act with a waiver of telehealth restrictions otherwise applicable
under such titles of the Social Security Act (42 U.S.C. 1395m(m)). Such
evaluation shall include an analysis of the following:
(1) The number of providers and payers using telehealth and
remote patient monitoring under such programs and pilots.
(2) The cost impact among the beneficiaries receiving
telehealth and remote patient monitoring under such programs
and pilots, including with respect to preventable
hospitalizations, hospital readmissions, and emergency room
visits, and the total cost of items and services under the
Medicare and Medicaid programs.
(3) Beneficiary and family caregiver satisfaction with the
use of telehealth and remote patient monitoring under such
programs and pilots.
(4) A comparison of the utilization of, and expenditures
for, the same services furnished under the Medicare and
Medicaid programs in the office setting.
(b) Report.--Not later than 2 years after the date of the enactment
of this Act, the Secretary shall submit to Congress a report containing
the results of the evaluation conducted under subsection (a), together
with recommendations for such legislation and administrative action as
the Secretary determines appropriate.
SEC. 14. TESTING OF MODELS TO EXAMINE THE USE OF TELEHEALTH AND REMOTE
PATIENT MONITORING UNDER THE MEDICARE PROGRAM.
Section 1115A(b)(2) of the Social Security Act (42 U.S.C.
1315a(b)(2)) is amended by adding at the end the following new
subparagraph:
``(D) Testing models to examine use of telehealth
and remote patient monitoring under medicare.--The
Secretary shall consider testing under this subsection
models to examine the use of telehealth and remote
patient monitoring under title XVIII.''.
SEC. 15. SENSE OF CONGRESS REGARDING THE REMOTE PRACTICE OF MEDICINE.
(a) Findings.--Congress finds that the laws of all 50 States and
the District of Columbia--
(1) consider the practice of medicine to include remote
visits; and
(2) recognize that any remote practice of medicine is
governed by the same medical practice statutes as in-person
care.
(b) Sense of Congress.--It is the sense of Congress that--
(1) telemedicine is the delivery of safe, effective,
quality health care services, by a health care provider, using
technology-based modalities to deliver medical care;
(2) States have recognized this by treating telemedicine as
the practice of medicine; and
(3) the Medicare program under title XVIII of the Social
Security Act should cover the delivery of remote patient
services.
<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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