II 

116TH CONGRESS 

2D SESSION S. 4375 

To amend title XVIII of the Social Security Act to make permanent certain 

telehealth flexibilities under the Medicare program related to the COVID– 

19 public health emergency. 

IN THE SENATE OF THE UNITED STATES 

JULY 30, 2020 

Mr. ALEXANDER introduced the following bill; which was read twice and 

referred to the Committee on Finance 

A BILL 

To amend title XVIII of the Social Security Act to make 

permanent certain telehealth flexibilities under the Medicare program related to the COVID–19 public health 

emergency. 

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. 

4 This Act may be cited as the ‘‘Telehealth Moderniza5 tion Act’’. 


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1 SEC. 2. EXTENDING MEDICARE TELEHEALTH FLEXIBILI2 TIES. 

3 (a) EXPANDING ACCESS TO TELEHEALTH SERV4 ICES.— 

5 (1) IN GENERAL.—Section 1834(m)(4)(C) of 

6 the Social Security Act (42 U.S.C. 1395m(m)(4)(C)) 

7 is amended by adding at the end the following new 

8 clause: 

9 ‘‘(iii) EXPANDING ACCESS TO TELE10 HEALTH SERVICES.—With respect to tele11 health services furnished beginning on the 

12 first day after the end of the emergency 

13 period described in section 1135(g)(1)(B) 

14 of this clause, the term ‘originating site’ 

15 means any site at which the eligible tele16 health individual is located at the time the 

17 service is furnished via a telecommuni18 cations system, including the home of an 

19 individual.’’. 

20 (2) CONFORMING AMENDMENTS.—Such section 

21 is amended— 

22 (A) in paragraph (2)(B)— 

23 (i) in clause (i), in the matter pre24 ceding subclause (I), by striking ‘‘clause 

25 (ii)’’ and inserting ‘‘clauses (ii) and (iii)’’; 

26 and 


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1 (ii) by adding at the end the following 

2 new clause: 

3 ‘‘(iii) NO FACILITY FEE FOR NEW

4 SITES.—With respect to telehealth services 

5 furnished on or after the date of enact6 ment of this clause, a facility fee shall only 

7 be paid under this subparagraph to an 

8 originating site that is described in para9 graph (4)(C)(ii) (other than subclause (X) 

10 of such paragraph).’’. 

11 (B) in paragraph (4)(C)— 

12 (i) in clause (i), in the matter pre13 ceding subclause (I), by inserting ‘‘and 

14 clause (iii)’’ after ‘‘and (7)’’; and 

15 (ii) in clause (ii)(X), by inserting 

16 ‘‘prior to the first day after the end of the 

17 emergency period described in section 

18 1135(g)(1)(B)’’ before the period; 

19 (C) in paragraph (5), by inserting ‘‘and 

20 prior to the first day after the end of the emer21 gency period described in section 

22 1135(g)(1)(B)’’ after ‘‘January 1, 2019,’’; 

23 (D) in paragraph (6)(A), by inserting ‘‘and 

24 prior to the first day after the end of the emerVerDate Sep 11 2014 20:12 Aug 13, 2020 Jkt 099200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\S4375.IS S4375

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1 gency period described in section 

2 1135(g)(1)(B),’’ after ‘‘January 1, 2019,’’; and 

3 (E) in paragraph (7), by inserting ‘‘and 

4 prior to the first day after the end of the emer5 gency period described in section 

6 1135(g)(1)(B),’’ after ‘‘July 1, 2019,’’. 

7 (b) EXPANDING PRACTITIONERS ELIGIBLE TO FUR8 NISH TELEHEALTH SERVICES.—Section 1834(m) of the 

9 Social Security Act (42 U.S.C. 1395m(m)) is amended— 

10 (1) in paragraph (1), by striking ‘‘(described in 

11 section 1842(b)(18)(C))’’ and inserting ‘‘(defined in 

12 paragraph (4)(E))’’; and 

13 (2) in paragraph (4)(E)— 

14 (A) by striking ‘‘PRACTITIONER.—The 

15 term’’ and inserting ‘‘PRACTITIONER.— 

16 ‘‘(A) IN GENERAL.—Subject to subpara17 graph (B), the term’’; and 

18 (B) by adding at the end the following new 

19 subparagraph: 

20 ‘‘(B) EXPANSION.—The Secretary, after 

21 consulting with stakeholders regarding services 

22 that are clinically appropriate, may expand the 

23 types of practitioners who may furnish tele24 health services to include any health care proVerDate Sep 11 2014 20:12 Aug 13, 2020 Jkt 099200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\S4375.IS S4375

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1 fessional that is eligible to bill the program 

2 under this title for their professional services.’’. 

3 (c) RETENTION OF ADDITIONAL SERVICES AND SUB4 REGULATORY PROCESS FOR MODIFICATIONS FOLLOWING

5 EMERGENCY PERIOD.—Section 1834(m)(4)(F) of the So6 cial Security Act (42 U.S.C. 1395m(m)(4)(F)) is amend7 ed— 

8 (1) in clause (i), by inserting ‘‘and clause (iii)’’ 

9 after ‘‘paragraph (8)’’; 

10 (2) in clause (ii), by striking ‘‘The Secretary’’ 

11 and inserting ‘‘Subject to clause (iii), the Sec12 retary’’; and 

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

14 clause: 

15 ‘‘(iii) RETENTION OF ADDITIONAL

16 SERVICES AND SUBREGULATORY PROCESS

17 FOR MODIFICATIONS FOLLOWING EMER18 GENCY PERIOD.—With respect to tele19 health services furnished after the last day 

20 of the emergency period described in sec21 tion 1135(g)(1)(B), the Secretary may— 

22 ‘‘(I) retain as appropriate the ex23 panded list of telehealth services spec24 ified in clause (i) pursuant to the 

25 waiver authority under section 


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1 1135(b)(8) during such emergency pe2 riod; and 

3 ‘‘(II) retain the subregulatory 

4 process used to modify the services in5 cluded on the list of such telehealth 

6 services pursuant to clause (ii) during 

7 such emergency period.’’. 

8 (d) ENHANCING TELEHEALTH SERVICES FOR FED9 ERALLY QUALIFIED HEALTH CENTERS AND RURAL

10 HEALTH CLINICS.—Section 1834(m)(8) of the Social Se11 curity Act (42 U.S.C. 1395m(m)(8)) is amended— 

12 (1) in the paragraph heading by inserting ‘‘AND

13 AFTER’’ after ‘‘DURING’’; 

14 (2) in subparagraph (A), in the matter pre15 ceding clause (i), by inserting ‘‘and after’’ after 

16 ‘‘During’’; and 

17 (3) in the first sentence of subparagraph (B)(i), 

18 by inserting ‘‘and after’’ after ‘‘during’’. 

19 (e) USE OF TELEHEALTH, AS CLINICALLY APPRO20 PRIATE, TO CONDUCT FACE-TO-FACE ENCOUNTER FOR

21 HOSPICE CARE.—Section 1814(a)(7)(D)(i)(II) of the So22 cial Security Act (42 U.S.C. 1395f(a)(7)(D)(i)(II)) is 

23 amended by inserting ‘‘and after such emergency period 

24 as clinically appropriate’’ after ‘‘1135(g)(1)(B)’’. 


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1 (f) USE OF TELEHEALTH, AS CLINICALLY APPRO2 PRIATE, TO CONDUCT FACE-TO-FACE CLINICAL ASSESS3 MENTS FOR HOME DIALYSIS.—Clause (iii) of section 

4 1881(b)(3)(B) of the Social Security Act (42 U.S.C. 

5 1395rr(b)(3)(B)) is amended— 

6 (1) by moving such clause 4 ems to the left; 

7 and 

8 (2) by inserting ‘‘and after such emergency pe9 riod as clinically appropriate’’ before the period. 

10 (g) IMPLEMENTATION.—Notwithstanding any provi11 sion of law, the Secretary may implement the provisions 

12 of, and amendments made by, this section by interim final 

13 rule, program instruction, or otherwise. 

Æ 


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