ITAM Act

Increasing Telehealth Access in Medicare Act or the ITAM Act

This bill allows Medicare Advantage organizations to include additional telehealth services as basic benefits in their annual bids beginning in plan year 2020.

The bill also permits payment under Medicare for chronic care management services that use specified telecommunication technologies.

The bill increases funding available to the Medicare Improvement Fund.

[Congressional Bills 115th Congress]
[From the U.S. Government Publishing Office]
[H.R. 3727 Introduced in House (IH)]

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115th CONGRESS
  1st Session
                                H. R. 3727

 To amend title XVIII of the Social Security Act to include additional 
telehealth services for purposes of MA organization bids, and for other 
                               purposes.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                           September 11, 2017

  Mrs. Black (for herself, Mr. Thompson of California, Mrs. Brooks of 
   Indiana, and Ms. Matsui) introduced the following bill; which was 
  referred to the Committee on Ways and Means, and in addition to the 
   Committee on Energy and Commerce, 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 include additional 
telehealth services for purposes of MA organization bids, 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. INCLUSION OF ADDITIONAL TELEHEALTH SERVICES IN MEDICARE 
              ADVANTAGE ORGANIZATION BIDS.

    (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 adding at the end the 
        following new sentence: ``For plan year 2020 and each 
        subsequent plan year, for purposes of subsection (m) and 
        section 1854, in the case that an MA plan makes an election 
        described in subsection (m)(1) with respect to such plan year, 
        additional telehealth services shall be treated as a service 
        included as a benefit under the original medicare fee-for-
        service program option with respect to such plan and plan 
        year.''; and
            (2) by adding at the end the following new subsection:
    ``(m) Provision of Additional Telehealth Services.--
            ``(1) MA plan option.--For purposes of subsection 
        (a)(1)(B)(i), an election described in this paragraph, with 
        respect to an MA plan and plan year, is an election by the 
        sponsor of such plan to provide under the plan for such plan 
        year, in accordance with the subsequent provisions of this 
        subsection, additional telehealth services (as defined in 
        paragraph (2)) as a benefit under the original medicare fee-
        for-service program option. Such additional telehealth 
        services, with respect to a plan year, shall be in addition to 
        benefits included under the original medicare fee-for-service 
        program option for such year.
            ``(2) Additional telehealth services defined.--
                    ``(A) In general.--For purposes of this subsection 
                and section 1854, the term `additional telehealth 
                services' means, subject to subparagraph (C), 
                services--
                            ``(i) for which payment may be made under 
                        part B (without regard to application of 
                        section 1834(m));
                            ``(ii) that, if furnished via a 
                        telecommunications system, would not be payable 
                        under section 1834(m);
                            ``(iii) furnished using electronic 
                        information and telecommunications technology;
                            ``(iv) furnished in accordance with such 
                        requirements as the Secretary specifies 
                        pursuant to paragraph (3); and
                            ``(v) which are identified annually by the 
                        Secretary as appropriate to furnish using 
                        electronic information and telecommunications 
                        technology where a physician (as defined in 
                        section 1861(r)) or practitioner (described in 
                        section 1842(b)(18)(C)) furnishing the service 
                        is not at the same location as the plan 
                        enrollee.
                    ``(B) Flexibility for phasing in identifications.--
                In making identifications under subparagraph (A)(iv), 
                the Secretary may make such identifications in a manner 
                that results in additional telehealth services being 
                phased in, as determined appropriate by the Secretary.
                    ``(C) Exclusion of capital and infrastructure costs 
                and investments.--For purposes of this subsection and 
                section 1854, the term `additional telehealth services' 
                does not include capital and infrastructure costs and 
                investments relating to such benefits provided pursuant 
                to this subsection.
            ``(3) Requirements for additional telehealth services.--The 
        Secretary shall specify requirements for the provision of 
        additional telehealth services with respect to--
                    ``(A) qualifications (other than licensure) of 
                physicians and practitioners who furnish such services;
                    ``(B) the technology used in furnishing such 
                services;
                    ``(C) factors necessary for coordination of 
                additional telehealth services with other services; and
                    ``(D) such other criteria (such as clinical 
                criteria) as determined by the Secretary.
            ``(4) Enrollee choice.--An MA plan that provides a service 
        as an additional telehealth service may not, when furnished 
        without use of electronic information and telecommunications 
        technology, restrict access to the equivalent in-person 
        service, including by encouraging or discouraging an individual 
        from being furnished such service as an additional telehealth 
        service.
            ``(5) Construction.--
                    ``(A) In general.--In determining if an MA 
                organization or MA plan, as applicable, is in 
                compliance with each requirement specified in 
                subparagraph (B), such determination shall be made 
                without regard to any additional telehealth services 
                covered by the plan offered by such organization or 
                plan pursuant to this subsection.
                    ``(B) Requirements specified.--The requirements 
                specified in this subparagraph are the following:
                            ``(i) The requirements under subsection 
                        (d).
                            ``(ii) The requirement under subsection 
                        (a)(1) with respect to covering benefits under 
                        the original medicare fee-for-service program 
                        option, as defined in the first sentence of 
                        paragraph (B)(i) of such subsection.''.
    (b) Inclusion of Additional Telehealth Services in MA Organization 
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 such benefits through the use of additional telehealth services 
under section 1852(m)'' before the semicolon at the end.

SEC. 2. USE OF TELECOMMUNICATIONS SYSTEMS IN FURNISHING CHRONIC CARE 
              MANAGEMENT SERVICES.

    Section 1848(b)(8) of the Social Security Act (42 U.S.C. 
1395(b)(8)) is amended by adding at the end the following new 
subparagraph:
                    ``(C) Clarification.--In carrying out this 
                paragraph, with respect to chronic care management 
                services, the Secretary may, subject to subparagraph 
                (B), make payment for such services furnished through 
                the use of secure messaging, Internet, store and 
                forward technologies, or other non-face-to-face 
                communication methods determined appropriate by the 
                Secretary.''.

SEC. 3. SENSE OF CONGRESS REGARDING PARITY OF TELEHEALTH SERVICES.

    It is the sense of Congress that there should be--
            (1) parity, with respect to access to telehealth, between 
        the original medicare fee-for-service program under parts A and 
        B of title XVIII of the Social Security Act and the Medicare 
        Advantage program under part C of such title; and
            (2) access to medically appropriate, quality telehealth for 
        all Medicare beneficiaries.
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