Helping Ensure Access to Local TeleHealth Act of 2025 or the HEALTH Act of 2025
This bill modifies requirements relating to Medicare coverage of telehealth services, including services that are furnished by federally qualified health centers (FQHCs) and rural health clinics (RHCs).
Specifically, the bill expands coverage to include audio-only telehealth services. It also permanently allows FQHCs and RHCs to serve as the distant site (i.e., the location of the health care practitioner) for telehealth services and excludes such services from certain geographic restrictions. Payment must be made in the same manner as for non-telehealth services, rather than in accordance with a separate methodology determined by the Centers for Medicare & Medicaid Services.
[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[H.R. 5496 Introduced in House (IH)]
<DOC>
119th CONGRESS
1st Session
H. R. 5496
To amend title XVIII of the Social Security Act to provide for
permanent payments for telehealth services furnished by federally
qualified health centers and rural health clinics under the Medicare
program.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
September 18, 2025
Mr. Thompson of Pennsylvania (for himself and Ms. Tokuda) 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 provide for
permanent payments for telehealth services furnished by federally
qualified health centers and rural health clinics under the Medicare
program.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Helping Ensure Access to Local
TeleHealth Act of 2025'' or the ``HEALTH Act of 2025''.
SEC. 2. PROVIDING FOR PERMANENT COST-RELATED PAYMENTS FOR TELEHEALTH
SERVICES FURNISHED BY FEDERALLY QUALIFIED HEALTH CENTERS
AND RURAL HEALTH CLINICS UNDER THE MEDICARE PROGRAM AND
PERMANENTLY REMOVING ORIGINATING SITE FACILITY AND
LOCATION REQUIREMENTS FOR DISTANT SITE TELEHEALTH
SERVICES FURNISHED BY SUCH CENTERS AND SUCH CLINICS.
(a) Coverage of Audio-Only Telehealth Services.--
(1) In general.--Section 1834(m)(4) of the Social Security
Act (42 U.S.C. 1395m(m)(4)) is amended by adding at the end the
following new subparagraph:
``(G) Telecommunications system.--Except as
provided in paragraph (1), the term `telecommunications
system' means a two-way, real-time interactive
communications system, whether by audiovisual or audio-
only communications.''.
(2) Required implementation steps.--Not later than 60 days
after the date of the enactment of this Act, the Secretary of
Health and Human Services shall--
(A) revise section 410.78(a)(3) of title 42, Code
of Federal Regulations (or a successor regulation) to
define the term ``interactive telecommunications
system'' in accordance with the amendment made by
paragraph (1); and
(B) revise section 405.2463 of such title (or a
successor regulation) to provide that, for purposes of
distant site telehealth services furnished by federally
qualified health centers and rural health clinics under
section 1834(m)(8) of the Social Security Act (42
U.S.C. 1395m(m)(8)), a visit includes any two-way,
real-time interactive communication between an
individual and the distant site Federally qualified
health center provider or rural health clinic, whether
by audiovisual or audio-only communication.
(b) Permanent Telehealth Payments.--Section 1834(m)(8) of the
Social Security Act (42 U.S.C. 1395m(m)(8)) is amended--
(1) in subparagraph (A), in the matter preceding clause
(i), by striking ``During the emergency period'' and all that
follows through ``2025--'' and inserting ``With respect to
telehealth services furnished on or after the date of the
beginning of the emergency period described in section
1135(g)(1)(B)--''; and
(2) by striking subparagraph (B) and inserting the
following new subparagraph:
``(B) Payment.--
``(i) In general.--A telehealth service
furnished by a rural health clinic or a
federally qualified health center serving as a
distant site to an individual shall be deemed
to be so furnished to such individual as an
outpatient of such clinic or facility (as
applicable) for purposes of paragraph (1) or
(3), respectively, of section 1861(aa) and
payable as a rural health clinic service or
federally qualified health center service (as
applicable) under section 1833(a)(3) or under
the prospective payment system established
under section 1834(o), respectively.
``(ii) Treatment of costs for fqhc pps
calculations and rhc air calculations.--Costs
associated with the delivery of telehealth
services by a federally qualified health center
or rural health clinic serving as a distant
site pursuant to this paragraph shall be
considered allowable costs for purposes of the
prospective payment system established under
section 1834(o) and any payment methodologies
developed under section 1833(a)(3), as
applicable.''.
(c) Elimination of Originating Site Requirements for Telehealth
Services Furnished by FQHCs or RHCs.--
(1) In general.--Section 1834(m) of the Social Security Act
(42 U.S.C. 1395m(m)), as amended by subsection (b), is further
amended--
(A) in paragraph (4)(C)(i), by striking ``and (7)''
and inserting ``(7), and (8)''; and
(B) in paragraph (8), by adding at the end the
following new subparagraph:
``(C) Nonapplication of originating site
requirements.--The geographic and site requirements
described in paragraph (4)(C) shall not apply with
respect to telehealth services furnished by a federally
qualified health center or a rural health clinic
serving as a distant site.''.
(2) Special payment rule for originating sites with respect
to telehealth services furnished by an fqhc or rhc.--Section
1834(m)(2)(B) of the Social Security Act (42 U.S.C.
1395m(m)(2)(B)) is amended--
(A) in clause (i), by striking ``clause (ii)'' and
inserting ``clauses (ii) and (iii)''; and
(B) by adding at the end the following new clause:
``(iii) Special rule for telehealth
services furnished by fqhcs and rhcs.--No
facility fee shall be paid under this
subparagraph to an originating site with
respect to telehealth services furnished by a
federally qualified health center or rural
health clinic serving as a distant site unless
such originating site is a site described in
any of subclauses (I) through (IX) or (XI) of
paragraph (4)(C)(ii).''.
<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.
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