I 

114TH CONGRESS 

2D SESSION H. R. 4442 

To amend titles XVIII and XI of the Social Security Act to promote cost 

savings and quality care under the Medicare program through the use 

of telehealth and remote patient monitoring services, and for other purposes. 

IN THE HOUSE OF REPRESENTATIVES 

FEBRUARY 3, 2016 

Mrs. BLACK (for herself, Mr. WELCH, Mr. HARPER, 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 amend titles XVIII and XI of the Social Security Act 

to promote cost savings and quality care under the Medicare program through the use of telehealth and remote 

patient monitoring services, and for other purposes. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE; TABLE OF CONTENTS. 

4 (a) SHORT TITLE.—This Act may be cited as the 

5 ‘‘Creating Opportunities Now for Necessary and Effective 


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1 Care Technologies (CONNECT) for Health Act’’ or the 

2 ‘‘CONNECT for Health Act’’. 

3 (b) TABLE OF CONTENTS.—The table of contents of 

4 this Act is as follows: 

Sec. 1. Short title; table of contents. 

TITLE I—TELEHEALTH AND REMOTE PATIENT MONITORING 

SERVICES ‘‘BRIDGE’’ DEMONSTRATION WAIVERS 

Sec. 101. Telehealth and remote patient monitoring services ‘‘bridge’’ demonstration waivers. 

TITLE II—TELEHEALTH AND REMOTE PATIENT MONITORING 

SERVICES FURNISHED BY QUALIFYING APM PARTICIPANTS 

Sec. 201. Telehealth and remote patient monitoring services furnished by qualifying APM participants. 

TITLE III—MEDICARE COVERAGE OF TELEHEALTH AND REMOTE 

PATIENT MONITORING SERVICES 

Sec. 301. Remote patient monitoring services for individuals with certain chronic health conditions. 

Sec. 302. Allowing telehealth to meet monthly clinician in-person visit requirement for certain home dialysis. 

Sec. 303. Allowing stroke evaluation sites and Native American health service 

facilities as sites eligible for telehealth payment. 

Sec. 304. Rural health clinics and Federally qualified health centers authorized 

to be distant sites. 

Sec. 305. Addressing gaps in quality measures for telehealth and remote patient monitoring services. 

TITLE IV—USE OF TELEHEALTH AND REMOTE PATIENT MONITORING SERVICES TO PROVIDE BASIC BENEFITS UNDER MEDICARE PART C 

Sec. 401. Use of telehealth and remote patient monitoring services to provide 

basic benefits under Medicare part C. 

TITLE V—CLARIFICATION REGARDING TELEHEALTH AND REMOTE PATIENT MONITORING TECHNOLOGIES PROVIDED TO 

BENEFICIARIES 

Sec. 501. Clarification regarding telehealth and remote patient monitoring technologies provided to beneficiaries. 


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1 TITLE I—TELEHEALTH AND RE2 MOTE PATIENT MONITORING 

3 SERVICES ‘‘BRIDGE’’ DEM4 ONSTRATION WAIVERS 

5 SEC. 101. TELEHEALTH AND REMOTE PATIENT MONI6 TORING SERVICES ‘‘BRIDGE’’ DEMONSTRA7 TION WAIVERS. 

8 Title XVIII of the Social Security Act (42 U.S.C. 

9 1395 et seq.) is amended by adding at the end the fol10 lowing new section: 

11 ‘‘SEC. 1899C. TELEHEALTH AND REMOTE PATIENT MONI12 TORING SERVICES ‘BRIDGE’ DEMONSTRA13 TION WAIVERS. 

14 ‘‘(a) IMPLEMENTATION.— 

15 ‘‘(1) IN GENERAL.—Subject to the succeeding 

16 provisions of this subsection, the Secretary shall so17 licit proposals from, and issue telehealth or remote 

18 patient monitoring services ‘bridge’ demonstration 

19 waivers under this title to, eligible applicants who, 

20 for the duration of time for which the demonstration 

21 waiver would apply, are furnishing telehealth or re22 mote patient monitoring services (as defined in sec23 tion 1861(iii)) to individuals under this title in a 

24 manner that is consistent with the goals of the 

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1 tion 1848(q), including the goals of quality, resource 

2 utilization, and clinical practice improvement (in3 cluding care coordination and patient engagement), 

4 or the incentive payments for participation in eligible 

5 alternative payment models under section 1833(z). 

6 ‘‘(2) ELIGIBLE APPLICANT DEFINED.—In this 

7 section, the term ‘eligible applicant’ means the fol8 lowing: 

9 ‘‘(A) A professional described in section 

10 1848(q)(1)(C)(i)(I). 

11 ‘‘(B) A qualifying APM participant (as de12 fined in section 1833(z)(2)). 

13 ‘‘(C) Any other provider, including a pro14 fessional described in section 

15 1848(q)(1)(C)(i)(II), determined appropriate by 

16 the Secretary, and a group that includes such 

17 providers. 

18 ‘‘(b) DEMONSTRATION WAIVER APPLICATION RE19 QUIREMENTS.—An eligible applicant seeking a demonstra20 tion waiver under this section shall submit an application 

21 to the Secretary on an annual basis that includes the fol22 lowing: 

23 ‘‘(1) An attestation of the intent of the appli24 cant to use telehealth or remote patient monitoring 

25 services to meet the goals described in subsection 


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1 (a)(1), and details (as specified by the Secretary) on 

2 how the eligible applicant will use those services to 

3 meet such goals. 

4 ‘‘(2) An agreement by the applicant to— 

5 ‘‘(A) submit the information described in 

6 subsection (d) in accordance with such sub7 section; and 

8 ‘‘(B) cooperate in any audit conducted 

9 under subsection (e) with respect to claims for 

10 telehealth or remote patient monitoring services 

11 furnished by the applicant under the waiver. 

12 ‘‘(c) WAIVER OF LIMITATIONS FOR TELEHEALTH OR

13 REMOTE PATIENT MONITORING SERVICES.— 

14 ‘‘(1) IN GENERAL.—The Secretary shall waive 

15 certain applicable provisions of sections 1834(m) 

16 and 1861(iii) as a condition of payment for tele17 health or remote patient monitoring services for eli18 gible applicants whose application for a demonstra19 tion waiver was approved under this section. The 

20 provisions to be waived under the preceding sentence 

21 include any limitation on what qualifies as an origi22 nating site, any geographic limitation (subject to 

23 State licensing requirements), any limitation on the 

24 use of store-and-forward technologies, or any limita25 tion on the type of health care provider who may 


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1 furnish such services (provided the provider is a 

2 Medicare enrolled provider). 

3 ‘‘(2) GENERAL SUPERVISION.—The Secretary 

4 shall permit an eligible applicant whose application 

5 for a demonstration waiver was approved under this 

6 section to furnish telehealth or remote patient moni7 toring services under the general supervision of the 

8 applicant. 

9 ‘‘(d) ANNUAL SUBMISSION OF DATA.—An eligible ap10 plicant whose application for a demonstration waiver 

11 under this section was approved shall, on an annual basis, 

12 submit to the Secretary— 

13 ‘‘(1) information requested by the Secretary for 

14 evaluation of the demonstration, including informa15 tion on utilization and expenditures for telehealth or 

16 remote patient monitoring services under the dem17 onstration waiver during the preceding year; 

18 ‘‘(2) data on applicable quality measures during 

19 the preceding year, consistent with sections 1848 

20 and 1833(z); and 

21 ‘‘(3) such other information as the Secretary 

22 determines is necessary to complete the report under 

23 subsection (g). 

24 ‘‘(e) RANDOM AUDITS.—The Secretary shall conduct 

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1 tion waiver program under this section to ensure that 

2 waivers under the program are being used as intended to 

3 furnish telehealth or remote patient monitoring services. 

4 ‘‘(f) IMPLEMENTATION.— 

5 ‘‘(1) SUNSET.—Except as provided in para6 graph (2), the authority to carry out the demonstra7 tion waiver program under this section shall expire 

8 on December 31, 2019. 

9 ‘‘(2) EXPANSION.—Taking into account the re10 port under subsection (g), the Secretary may, 

11 through rulemaking, expand (including implementa12 tion on a nationwide basis) the duration and the 

13 scope of the demonstration waiver program under 

14 this section, to the extent determined appropriate by 

15 the Secretary, if— 

16 ‘‘(A) the Secretary determines that such 

17 expansion is expected to— 

18 ‘‘(i) reduce spending under this title 

19 without reducing the quality of care; or 

20 ‘‘(ii) improve the quality of patient 

21 care without increasing spending; 

22 ‘‘(B) the Chief Actuary of the Centers for 

23 Medicare & Medicaid Services certifies that 

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1 sult in any increase in) net program spending 

2 under this title; and 

3 ‘‘(C) the Secretary determines that such 

4 expansion would not deny or limit the coverage 

5 or provision of benefits under this title for indi6 viduals. 

7 ‘‘(g) REPORT TO CONGRESS.—Not later than Decem8 ber 31, 2020, the Chief Actuary of the Centers for Medi9 care & Medicaid Services shall submit to Congress a report 

10 containing an evaluation of the impact of telehealth and 

11 remote patient monitoring services under the demonstra12 tion waiver program on— 

13 ‘‘(1) spending under this title; and 

14 ‘‘(2) achieving the additional MIPS adjustment 

15 factors for exceptional performance described in sec16 tion 1848(q)(6)(C) and incentive payments for par17 ticipation in eligible alternative payment models de18 scribed in section 1833(z)(1).’’. 


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1 TITLE II—TELEHEALTH AND RE2 MOTE PATIENT MONITORING 

3 SERVICES FURNISHED BY 

4 QUALIFYING APM PARTICI5 PANTS 

6 SEC. 201. TELEHEALTH AND REMOTE PATIENT MONI7 TORING SERVICES FURNISHED BY QUALI8 FYING APM PARTICIPANTS. 

9 (a) IN GENERAL.—Title XVIII of the Social Security 

10 Act (42 U.S.C. 1395 et seq.), as amended by section 101, 

11 is amended by adding at the end the following new section: 

12 ‘‘SEC. 1899D. TELEHEALTH AND REMOTE PATIENT MONI13 TORING SERVICES FURNISHED BY QUALI14 FYING APM PARTICIPANTS. 

15 ‘‘(a) IN GENERAL.—The Secretary shall waive cer16 tain applicable provisions of section 1834(m) and section 

17 1861(iii) as a condition of payment for telehealth or re18 mote patient monitoring services for a qualifying APM 

19 participant (as defined in section 1833(z)(2)). The provi20 sions to be waived under the preceding sentence include 

21 any limitation on what qualifies as an originating site, any 

22 geographic limitation (subject to State licensing require23 ments), any limitation on the use of store-and-forward 

24 technologies, or any limitation on the type of health care 


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1 provider who may furnish such services (provided the pro2 vider is a Medicare enrolled provider). 

3 ‘‘(b) ANNUAL SUBMISSION OF DATA.—A qualifying 

4 APM participant (as so defined) who furnishes telehealth 

5 or remote patient monitoring services under this section 

6 shall, on an annual basis, submit to the Secretary informa7 tion requested by the Secretary for evaluation of the im8 plementation of this section, including information on uti9 lization and expenditures for telehealth or remote patient 

10 monitoring services under this section during the pre11 ceding year and data on any applicable quality measures, 

12 consistent with sections 1848 and 1833(z). 

13 ‘‘(c) NO INCREASE IN EXPENDITURES.—If the Sec14 retary determines payments for telehealth or remote pa15 tient monitoring services under this section will increase 

16 expenditures under this title, the Secretary shall make ad17 justments to such payments to eliminate such increased 

18 expenditures.’’. 

19 (b) EFFECTIVE DATE.—The amendment made by 

20 this section shall apply with respect to services furnished 

21 on or after January 1, 2017. 


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1 TITLE III—MEDICARE COV2 ERAGE OF TELEHEALTH AND 

3 REMOTE PATIENT MONI4 TORING SERVICES 

5 SEC. 301. REMOTE PATIENT MONITORING SERVICES FOR 

6 INDIVIDUALS WITH CERTAIN CHRONIC 

7 HEALTH CONDITIONS. 

8 (a) COVERAGE.— 

9 (1) IN GENERAL.—Section 1861(s)(2) of the 

10 Social Security Act (42 U.S.C. 1395x(s)(2)) is 

11 amended— 

12 (A) in subparagraph (EE), by striking 

13 ‘‘and’’ at the end; 

14 (B) in subparagraph (FF), by inserting 

15 ‘‘and’’ at the end; and 

16 (C) by inserting after subparagraph (FF) 

17 the following new subparagraph: 

18 ‘‘(GG) applicable remote patient monitoring 

19 services for individuals with certain chronic health 

20 conditions (as defined in subsection (iii));’’. 

21 (2) COVERAGE AS RURAL HEALTH CLINIC SERV22 ICES AND FEDERALLY QUALIFIED HEALTH CENTER

23 SERVICES.—Section 1861(aa) of the Social Security 

24 Act (42 U.S.C. 1395x(aa)) is amended— 

25 (A) in paragraph (1)— 


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1 (i) in subparagraph (B), by striking ‘‘, 

2 and’’ and inserting a comma; 

3 (ii) in subparagraph (C), by inserting 

4 ‘‘and’’ after the comma at the end; and 

5 (iii) by inserting after subparagraph 

6 (C) the following new subparagraph: 

7 ‘‘(D) applicable remote patient monitoring serv8 ices for individuals with certain chronic health condi9 tions (as defined in subsection (iii)),’’; and 

10 (B) in paragraph (3)— 

11 (i) in subparagraph (A), by striking ‘‘; 

12 and’’ and inserting a semicolon; 

13 (ii) in subparagraph (B), by striking 

14 the comma and inserting ‘‘; and’’; and 

15 (iii) by inserting after subparagraph 

16 (B) the following new subparagraph: 

17 ‘‘(C) applicable remote patient monitoring 

18 services for individuals with certain chronic 

19 health conditions (as defined in subsection 

20 (iii)),’’. 

21 (b) SERVICES DESCRIBED.—Section 1861 of the So22 cial Security Act (42 U.S.C. 1395x) is amended by adding 

23 at the end the following new subsection: 

24 ‘‘(iii) REMOTE PATIENT MONITORING SERVICES FOR

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1 TIONS.—(1)(A) The term ‘applicable remote patient moni2 toring services for individuals with certain chronic health 

3 conditions’ means remote patient monitoring services (as 

4 defined in subparagraph (B)) furnished to an applicable 

5 individual (as defined in subparagraph (C)) under general 

6 supervision of the provider, with the exception of those 

7 services covered under subsection (s)(1). 

8 ‘‘(B) The term ‘remote patient monitoring services’ 

9 means personal medical data transmitted from an applica10 ble individual in one location via electronic communica11 tions technologies to an eligible provider (as defined in 

12 subparagraph (D)) in a different location and used by the 

13 eligible provider in furnishing remote patient monitoring 

14 services to such individual that complies with the Federal 

15 regulations (concerning the privacy and security of indi16 vidually identifiable health information) promulgated 

17 under section 264(c) of the Health Insurance Portability 

18 and Accountability Act of 1996, as part of an established 

19 plan of care for that individual that includes the review 

20 and interpretation of that data by an eligible provider. 

21 Such term includes those services furnished in a Federally 

22 qualified health center or a rural health clinic. 

23 ‘‘(C) The term ‘applicable individual’ means an indi24 vidual— 


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1 ‘‘(i) with 2 or more covered chronic conditions 

2 (as defined in paragraph (2)); and 

3 ‘‘(ii) who has a history of 2 or more hospitaliza4 tions or emergency room visits related to such cov5 ered chronic conditions of the individual in the pre6 ceding 12 months. 

7 ‘‘(D) The term ‘eligible provider’ means a physician 

8 (as defined in section 1861(r)) or a practitioner described 

9 in section 1842(b)(18)(C). 

10 ‘‘(E) The Secretary shall establish procedures under 

11 which eligible providers who furnish remote patient moni12 toring services are required to annually submit data on 

13 applicable quality measures under sections 1848 and 

14 1833(z). 

15 ‘‘(2)(A) For purposes of paragraph (1)(C), subject to 

16 subparagraph (B), the term ‘covered chronic condition’ 

17 means— 

18 ‘‘(i) a condition that qualifies an individual for 

19 chronic care management services under section 

20 1848(b)(8); and 

21 ‘‘(ii) any other condition the Secretary may 

22 specify. 

23 ‘‘(B) If the Chief Actuary of the Centers for Medicare 

24 & Medicaid Services determines that the inclusion of a 

25 condition described in subparagraph (A) in the definition 


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1 of the term ‘covered chronic condition’ under such sub2 paragraph will result in increased expenditures under this 

3 title, the Secretary shall make adjustments to such defini4 tion to eliminate such increased expenditures. 

5 ‘‘(3)(A) Payment may be made under this part for 

6 applicable remote patient monitoring services for individ7 uals with certain chronic health conditions furnished to 

8 an applicable individual during a period of up to 90 days 

9 (beginning with the commencement of such services) and 

10 such additional period as provided for under subparagraph 

11 (B). 

12 ‘‘(B) The 90-day period described in subparagraph 

13 (A), with respect to an applicable individual, may be re14 newed by the eligible provider who provides chronic care 

15 management services to such individual if the individual 

16 has had one or more hospitalizations, not including emer17 gency room visits, related to the covered chronic conditions 

18 of the individual described in paragraph (1)(C) since the 

19 beginning of such period.’’. 

20 (c) PAYMENT.— 

21 (1) IN GENERAL.—Section 1848(j)(3) of the 

22 Social Security Act (42 U.S.C. 1395w–4(j)(3)) is 

23 amended by inserting ‘‘(2)(GG),’’ after ‘‘health risk 

24 assessment),’’. 


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1 (2) RURAL HEALTH CLINIC SERVICES AND FED2 ERALLY QUALIFIED HEALTH CENTER SERVICES.— 

3 Section 1833 of the Social Security Act (42 U.S.C. 

4 1395l) is amended by adding at the end the fol5 lowing new subsection: 

6 ‘‘(aa) PAYMENT FOR APPLICABLE REMOTE PATIENT

7 MONITORING SERVICES FOR INDIVIDUALS WITH CERTAIN

8 CHRONIC HEALTH CONDITIONS FURNISHED BY A RURAL

9 HEALTH CLINIC OR A FEDERALLY QUALIFIED HEALTH

10 CENTER.—Notwithstanding any other provision of law, in 

11 the case of applicable remote patient monitoring services 

12 for individuals with certain chronic health conditions (as 

13 defined in section 1861(iii)) furnished by a rural health 

14 clinic or a Federally qualified health center under para15 graphs (1) and (3), respectively, of section 1861(aa), pay16 ment shall be made in an amount equal to the national 

17 average payment amount for such service, as determined 

18 by the Secretary, in accordance with section 1848 (without 

19 regard to any adjustment under subsections (a)(5), (a)(7), 

20 (a)(8), (p), or (q) of such section).’’. 

21 (d) EFFECTIVE DATE.—The amendments made by 

22 this section shall apply to services furnished on or after 

23 January 1, 2017. 


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1 SEC. 302. ALLOWING TELEHEALTH TO MEET MONTHLY CLI2 NICIAN IN-PERSON VISIT REQUIREMENT FOR 

3 CERTAIN HOME DIALYSIS. 

4 (a) IN GENERAL.—Section 1881(b)(3) of the Social 

5 Security Act (42 U.S.C. 1395rr(b)(3)) is amended— 

6 (1) by redesignating subparagraphs (A) and 

7 (B) as clauses (i) and (ii), respectively; 

8 (2) in clause (ii), as redesignated by subpara9 graph (A), strike ‘‘on a comprehensive’’ and insert 

10 ‘‘subject to subparagraph (B), on a comprehensive’’; 

11 (3) by striking ‘‘With respect to’’ and inserting 

12 ‘‘(A) With respect to’’; and 

13 (4) by adding at the end the following new sub14 paragraph: 

15 ‘‘(B) For purposes of subparagraph (A)(ii), an 

16 individual determined to have end stage renal dis17 ease receiving home dialysis may elect to receive the 

18 monthly end stage renal disease-related visits via 

19 telehealth if the individual receives an in-person ex20 amination at least once every three consecutive 

21 months. For purposes of the preceding sentence, a 

22 dialysis facility shall be the originating site at which 

23 the individual is located at the time the service is 

24 furnished via telehealth.’’. 

25 (b) CONFORMING AMENDMENT.—Section 1881(b)(1) 

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1 ing ‘‘paragraph (3)(A)’’ and inserting ‘‘paragraph 

2 (3)(A)(i)’’. 

3 (c) EFFECTIVE DATE.—The amendments made by 

4 this subsection shall apply with respect to the monthly fee 

5 or other basis of payment for home dialysis services fur6 nished on or after January 1, 2017. 

7 SEC. 303. ALLOWING STROKE EVALUATION SITES AND NA8 TIVE AMERICAN HEALTH SERVICE FACILI9 TIES AS SITES ELIGIBLE FOR TELEHEALTH 

10 PAYMENT. 

11 (a) STROKE EVALUATION SITES.—Section 

12 1834(m)(4)(C) of the Social Security Act (42 U.S.C. 

13 1395m(m)(4)(C)) is amended— 

14 (1) in clause (i), by striking ‘‘The term’’ and 

15 inserting ‘‘Subject to clause (iii), the term’’; and 

16 (2) by adding at the end the following new 

17 clause: 

18 ‘‘(iii) STROKE TELEHEALTH SERV19 ICES.—The originating site requirements 

20 described in clauses (i) and (ii) shall not 

21 apply with respect to services related to the 

22 evaluation or management of an acute 

23 stroke for the purpose of determining opti24 mal acute stroke therapy.’’. 


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1 (b) NATIVE AMERICAN HEALTH SERVICE FACILI2 TIES.—Section 1834(m)(4)(C) of the Social Security Act 

3 (42 U.S.C. 1395m(m)(4)(C)), as amended by subsection 

4 (a), is amended— 

5 (1) in clause (i), by striking ‘‘clause (iii)’’ and 

6 inserting ‘‘clauses (iii) and (iv)’’; and 

7 (2) by adding at the end the following new 

8 clause: 

9 ‘‘(iv) NATIVE AMERICAN HEALTH

10 SERVICE FACILITIES.—The originating site 

11 requirements described in clauses (i) and 

12 (ii) shall not apply with respect to a facil13 ity of the Indian Health Service, whether 

14 operated by such Service, or by an Indian 

15 tribe (as that term is defined in section 4 

16 of the Indian Health Care Improvement 

17 Act (25 U.S.C. 1603)) or a tribal organiza18 tion (as that term is defined in section 4 

19 of the Indian Self-Determination and Edu20 cation Assistance Act (25 U.S.C. 450b)), 

21 or a facility of the Native Hawaiian health 

22 care systems authorized under the Native 

23 Hawaiian Health Care Improvement Act 

24 (42 U.S.C. 11701 et seq.).’’. 


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1 (c) NO ORIGINATING SITE FACILITY FEE FOR NEW

2 SITES.—Section 1834(m)(2)(B) of the Social Security Act 

3 (42 U.S.C. 1395m(m)(2)(B)) is amended, in the matter 

4 preceding clause (i), by inserting ‘‘(other than an origi5 nating site that is only described in clause (iii) or (iv) of 

6 paragraph (4)(C), and does not meet the requirement for 

7 an originating site under clause (i) of such paragraph)’’ 

8 after ‘‘the originating site’’. 

9 (d) EFFECTIVE DATE.—The amendments made by 

10 this section shall apply to services furnished on or after 

11 January 1, 2017. 

12 SEC. 304. RURAL HEALTH CLINICS AND FEDERALLY QUALI13 FIED HEALTH CENTERS AUTHORIZED TO BE 

14 DISTANT SITES. 

15 (a) IN GENERAL.—Section 1834(m) of the Social Se16 curity Act (42 U.S.C. 1395m(m)) is amended— 

17 (1) in the first sentence of paragraph (1)— 

18 (A) by striking ‘‘or a practitioner (de19 scribed in section 1842(b)(18)(C))’’ and insert20 ing ‘‘, a practitioner (described in section 

21 1842(b)(18)(C)), a Federally qualified health 

22 center, or a rural health clinic’’; and 

23 (B) by striking ‘‘or practitioner’’ and in24 serting ‘‘, practitioner, Federally qualified 

25 health center, or rural health clinic’’; 


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1 (2) in paragraph (2)(A)— 

2 (A) by inserting the following after ‘‘eligi3 ble telehealth individual’’: ‘‘or to a Federally 

4 qualified health center or rural health clinic 

5 that serves as a distant site and whose clinician 

6 furnishes a telehealth service to an eligible tele7 health individual’’; and 

8 (B) by striking ‘‘such physician or practi9 tioner’’ and inserting ‘‘such physician, practi10 tioner, Federally qualified health center, or 

11 rural health clinic’’; and 

12 (3) in paragraph (4)(A), by inserting the fol13 lowing before the period at the end: ‘‘and includes 

14 a Federally qualified health center or rural health 

15 clinic whose clinician furnishes a telehealth service to 

16 an eligible individual’’. 

17 (b) EFFECTIVE DATE.—The amendments made by 

18 this section shall apply to services furnished on or after 

19 January 1, 2017. 

20 SEC. 305. ADDRESSING GAPS IN QUALITY MEASURES FOR 

21 TELEHEALTH AND REMOTE PATIENT MONI22 TORING SERVICES. 

23 Section 1848(s)(1)(C) of the Social Security Act (42 

24 U.S.C. 1395w–4(s)(1)(C)) is amended— 


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1 (1) by redesignating clauses (i) through (iv) as 

2 subclauses (I) through (IV), respectively, and in3 denting appropriately; 

4 (2) by striking ‘‘CONSIDERATION.—In devel5 oping’’ and inserting ‘‘CONSIDERATION.— 

6 ‘‘(i) IN GENERAL.—Subject to clause 

7 (ii), in developing’’; and 

8 (3) by adding at the end the following new 

9 clause: 

10 ‘‘(ii) ADDRESSING GAPS IN MEASURES

11 FOR TELEHEALTH AND REMOTE PATIENT

12 MONITORING SERVICES.—Consistent with 

13 this subsection, the Secretary shall ensure 

14 that the plan identifying measure develop15 ment priorities and timelines developed 

16 under this subsection addresses relevant 

17 gaps in measures with respect to telehealth 

18 services, remote patient monitoring serv19 ices, and the use of such services to ad20 dress health disparities (as described in 

21 section 1890(b)(1)(B)(ii)) that are not oth22 erwise addressed through existing quality 

23 measures.’’. 


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1 TITLE IV—USE OF TELEHEALTH 

2 AND REMOTE PATIENT MONI3 TORING SERVICES TO PRO4 VIDE BASIC BENEFITS UNDER 

5 MEDICARE PART C 

6 SEC. 401. USE OF TELEHEALTH AND REMOTE PATIENT 

7 MONITORING SERVICES TO PROVIDE BASIC 

8 BENEFITS UNDER MEDICARE PART C. 

9 (a) IN GENERAL.—Section 1852 of the Social Secu10 rity Act (42 U.S.C. 1395w–22) is amended— 

11 (1) in subsection (a)(1)(B)(i), by striking ‘‘part, 

12 the term’’ and inserting ‘‘part, subject to subsection 

13 (m), the term’’; and 

14 (2) by adding at the end the following new sub15 section: 

16 ‘‘(m) USE OF TELEHEALTH AND REMOTE PATIENT

17 MONITORING SERVICES TO PROVIDE BASIC BENEFITS.— 

18 For plan year 2017 and subsequent plan years, the fol19 lowing shall apply: 

20 ‘‘(1) IN GENERAL.—An MA plan may elect to 

21 use telehealth or remote patient monitoring services 

22 to provide benefits under the original medicare fee23 for-service program option, including items or serv24 ices furnished to treat medical or behavioral health 

25 conditions. 


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1 ‘‘(2) WAIVER OF LIMITATIONS.—Notwith2 standing any other provision of law, in the case 

3 where an MA plan elects to use telehealth or remote 

4 patient monitoring services to provide such benefits, 

5 with respect to enrollees, such services may be fur6 nished without application of any provision under 

7 section 1834(m) or any other provision of this Act 

8 that applies a limitation on what qualifies as an 

9 originating site, any geographic limitation (subject 

10 to State licensing requirements), any limitation on 

11 the use of store-and-forward technologies, or any 

12 limitation on the type of health care provider who 

13 may furnish such services (provided the provider is 

14 a Medicare enrolled provider). 

15 ‘‘(3) TREATMENT AS BASIC BENEFITS.—In the 

16 case where an MA plan makes such election under 

17 paragraph (1), the use of such telehealth or remote 

18 patient monitoring services shall be considered part 

19 of the provision of benefits under the original medi20 care fee-for-service program option for purpose of 

21 this part. 

22 ‘‘(4) AVAILABILITY OF BENEFITS IN PERSON.— 

23 In the case where an MA plan makes such election 

24 under paragraph (1), any benefits provided using 


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1 such telehealth services shall continue to be made 

2 available in person to enrollees under the plan. 

3 ‘‘(5) PROVISION OF DATA.—An MA plan that 

4 makes such an election under paragraph (1) with re5 spect to a plan year shall provide to the Secretary 

6 (at such time and in such manner as the Secretary 

7 may specify) data on expenditures and utilization for 

8 telehealth or remote patient monitoring services 

9 under the plan for enrollees during that plan year.’’. 

10 (b) CLARIFICATION REGARDING INCLUSION IN BID

11 AMOUNT.—Section 1854(a)(6)(A)(ii)(I) of the Social Se12 curity Act (42 U.S.C. 1395w–24(a)(6)(A)(ii)(I)) is 

13 amended by inserting ‘‘, including, for plan year 2017 and 

14 subsequent plan years, the use of telehealth or remote pa15 tient monitoring services to provide such benefits as de16 scribed in section 1852(m)’’ before the semicolon at the 

17 end. 

18 (c) RULE OF CONSTRUCTION.—Nothing in this sec19 tion shall be construed as affecting the furnishing of items 

20 or services under the original Medicare fee-for-service pro21 gram. 


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1 TITLE V—CLARIFICATION RE2 GARDING TELEHEALTH AND 

3 REMOTE PATIENT MONI4 TORING TECHNOLOGIES PRO5 VIDED TO BENEFICIARIES 

6 SEC. 501. CLARIFICATION REGARDING TELEHEALTH AND 

7 REMOTE PATIENT MONITORING TECH8 NOLOGIES PROVIDED TO BENEFICIARIES. 

9 Section 1128A(i)(6) of the Social Security Act (42 

10 U.S.C. 1320a–7a(i)(6)) is amended— 

11 (1) in subparagraph (H), by striking ‘‘; or’’ and 

12 inserting a semicolon; 

13 (2) in subparagraph (I), by striking the period 

14 at the end and inserting ‘‘; or’’; and 

15 (3) by adding at the end the following new sub16 paragraph: 

17 ‘‘(J) the provision of telehealth or remote 

18 patient monitoring technologies to individuals 

19 under title XVIII by a health care provider for 

20 the purpose of furnishing telehealth or remote 

21 patient monitoring services.’’. 

Æ 


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