A bill to amend title XVIII of the Social Security Act to improve the provision of telehealth services under the Medicare program.

Summary: Medicare Telehealth Improvement Act of 2008 - Amends title XVIII (Medicare) of the Social Security Act with respect to telehealth services to provide for: (1) an increase in the number of types of originating sites; (2) no facility fee for certain such sites; (3) expansion of practitioners eligible to furnish telehealth services; and (4) changes in the process for updating the list of telehealth services.

Directs the Secretary of Health and Human Services to set up a Telehealth Advisory Committee to make recommendations on the appropriate addition or deletion of telehealth services and Healthcare Common Procedure Coding System (HCPCS) codes.

SECTION 1. SHORT TITLE; TABLE OF CONTENTS.

    (a) Short Title.--This Act may be cited as the ``Medicare 
Telehealth Improvement Act of 2008''.
    (b) Table of Contents.--The table of contents of this Act is as 
follows:

Sec. 1. Short title; table of contents.
Sec. 2. Increase in number of types of originating sites.
Sec. 3. Expansion of practitioners eligible to furnish telehealth 
                            services.
Sec. 4. Improvement of process for updating the list of telehealth 
                            services.

SEC. 2. INCREASE IN NUMBER OF TYPES OF ORIGINATING SITES.

    (a) Increase.--Section 1834(m)(4)(C)(ii) of the Social Security Act 
(42 U.S.C. 1395m(m)(4)(C)(ii)) 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 community mental health 
                                center (as defined in section 
                                1861(ff)(3)(B)), a qualified community 
                                program described in 1913(b)(1) of the 
                                Public Health Service Act, and a county 
                                mental health clinic.
                                    ``(IX) Any other site that has a 
                                telecommunications system.''.
    (b) No Facility Fee for Certain Originating Sites.--Section 
1834(m)(2) of the Social Security Act (42 U.S.C. 1395m(m)(2)) is 
amended--
            (1) in subparagraph (B), in the matter preceding clause 
        (i), by striking ``With respect'' and inserting ``Subject to 
        subparagraph (D), with respect''; and
            (2) by adding at the end the following new subparagraph:
                    ``(D) No facility fee for certain originating 
                sites.--
                            ``(i) In general.--No facility fee shall be 
                        paid to an originating site described in 
                        paragraph (4)(C)(ii)(IX).
                            ``(ii) No change in payment to distant 
                        site.--Clause (i) shall not be construed to 
                        affect the payment to a distant site under 
                        subparagraph (A).''.
    (c) Effective Date.--The amendments made by this section shall 
apply to services furnished on or after the date that is 90 days after 
the date of enactment of this Act.

SEC. 3. EXPANSION OF PRACTITIONERS ELIGIBLE TO FURNISH TELEHEALTH 
              SERVICES.

    (a) In General.--Section 1834(m) of the Social Security Act (42 
U.S.C. 1395m(m)) is amended--
            (1) in paragraph (1), by striking ``(as defined in section 
        1861(r)) or a practitioner (described in section 
        1842(b)(18)(C))'' and inserting ``or a practitioner''; and
            (2) in paragraph (4), by striking subparagraph (E) and 
        inserting the following new subparagraph:
                    ``(E) Practitioner.--The term `practitioner' 
                means--
                            ``(i) a practitioner described in section 
                        1842(b)(18)(C);
                            ``(ii) a physical therapist (as described 
                        in section 1861(p));
                            ``(iii) an occupational therapist (as so 
                        described);
                            ``(iv) a qualified speech-language 
                        pathologist (as defined in section 
                        1861(ll)(3)(A));
                            ``(v) a qualified audiologist (as defined 
                        in section 1861(ll)(3)(B));
                            ``(vi) a certified provider (as described 
                        in section 1861(qq)(2)(A)); and
                            ``(vii) any other individual or entity 
                        determined appropriate by the Secretary.''.
    (b) Effective Date.--The amendments made by subsection (a) shall 
apply to services furnished on or after the date that is 90 days after 
the date of enactment of this Act.

SEC. 4. IMPROVEMENT OF PROCESS FOR UPDATING THE LIST OF TELEHEALTH 
              SERVICES.

    (a) In General.--Section 1834(m)(4)(F)(ii) of the Social Security 
Act (42 U.S.C. 1395m(m)(4)(F)(ii)) is amended by adding at the end the 
following sentences: ``Such process shall require the Secretary to take 
into account the recommendations of the Telehealth Advisory Committee 
(as established under section 4(b) of the Medicare Telehealth 
Improvement Act of 2008) when adding or deleting services (and HCPCS 
codes). If the Secretary does not implement a recommendation of the 
Telehealth Advisory Committee, the Secretary shall publish in the 
Federal Register a statement regarding the reason such recommendation 
was not implemented.''.
    (b) Telehealth Advisory Committee.--
            (1) Establishment.--On and after the date that is 6 months 
        after the date of enactment of this Act, the Secretary of 
        Health and Human Services (in this subsection referred to as 
        the ``Secretary'') shall have in place a Telehealth Advisory 
        Committee (in this subsection referred to as the ``Advisory 
        Committee'') to make recommendations to the Secretary on the 
        appropriate addition or deletion of services (and HCPCS codes) 
        to those specified in paragraph (4)(F)(i) of section 1834(m) of 
        the Social Security Act (42 U.S.C. 1395m(m)) for authorized 
        payment under paragraph (1) of such section.
            (2) Membership; terms.--
                    (A) Membership.--
                            (i) In general.--The Advisory Committee 
                        shall be composed of 7 members, to be appointed 
                        by the Secretary, of whom--
                                    (I) five shall be practicing 
                                physicians; and
                                    (II) two shall be practicing non-
                                physician health care providers.
                            (ii) Requirements for appointing members.--
                        In appointing members of the Advisory 
                        Committee, the Secretary shall--
                                    (I) ensure that each member has 
                                prior experience with the practice of 
                                telemedicine or telehealth;
                                    (II) give preference to individuals 
                                who are currently providing 
                                telemedicine or telehealth services;
                                    (III) ensure that the membership of 
                                the Advisory Committee represents a 
                                balance of specialties and geographic 
                                regions; and
                                    (IV) take into account the 
                                recommendations of stakeholders.
                    (B) Terms.--The members of the Advisory Committee 
                shall serve for such term as the Secretary may specify.
            (3) Meetings.--The Advisory Committee shall meet twice per 
        year and at such other times as the Advisory Committee may 
        provide.
            (4) Permanent committee.--Section 14 of the Federal 
        Advisory Committee Act (5 U.S.C. App.) shall not apply to the 
        Advisory Committee.
            (5) Waiver of administrative limitation.--The Secretary 
        shall establish the Advisory Committee notwithstanding any 
        limitation that may apply to the number of advisory committees 
        that may be established (within the Department of Health and 
        Human Services or otherwise).