II 

116TH CONGRESS 

2D SESSION S. 4854 

To provide payments for home health services furnished via visual or audio 

telecommunication systems during an emergency period. 

IN THE SENATE OF THE UNITED STATES 

OCTOBER 23 (legislative day, OCTOBER 19), 2020 

Ms. COLLINS (for herself and Mr. CARDIN) introduced the following bill; which 

was read twice and referred to the Committee on Finance 

A BILL 

To provide payments for home health services furnished via 

visual or audio telecommunication systems during an 

emergency period. 

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 ‘‘Home Health Emer5 gency Access to Telehealth Act’’ or the ‘‘HEAT Act’’. 

6 SEC. 2. AUTHORIZATION OF PAYMENTS FOR HOME HEALTH 

7 SERVICES FURNISHED VIA VISUAL OR AUDIO 

8 TELECOMMUNICATION SYSTEMS DURING AN 

9 EMERGENCY PERIOD. 

10 (a) WAIVER AUTHORITY.— 


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1 (1) IN GENERAL.—The first sentence of section 

2 1135(b) of the Social Security Act (42 U.S.C. 

3 1320b–5(b)) is amended— 

4 (A) in paragraph (7), by striking ‘‘and’’ at 

5 the end; 

6 (B) in paragraph (8), by striking the pe7 riod at the end and inserting ‘‘; and’’; and 

8 (C) by adding the following new para9 graph: 

10 ‘‘(9) in the case of home health services fur11 nished in an emergency area (or portion of such an 

12 area) during any portion of any emergency period 

13 (as those terms are defined in subsection (g)(1)(C)), 

14 the provisions of subparagraphs (A) and (B) of sec15 tion 1895(e)(1), as determined appropriate by the 

16 Secretary.’’. 

17 (2) DEFINITIONS OF EMERGENCY AREA; EMER18 GENCY PERIOD.—Section 1135(g)(1) of the Social 

19 Security Act (42 U.S.C. 1320b–5(g)(1)) is amend20 ed— 

21 (A) in subparagraph (A), by striking ‘‘sub22 paragraph (B)’’ and inserting ‘‘subparagraphs 

23 (B) and (C)’’; and 

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

25 subparagraph: 


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1 ‘‘(C) ADDITIONAL EXCEPTION.—For pur2 poses of subsection (b)(9), an ‘emergency area’ 

3 is a geographical area in which, and an ‘emer4 gency period’ is the period during which, there 

5 exists a public health emergency declared by the 

6 Secretary pursuant to section 319 of the Public 

7 Health Service Act.’’. 

8 (b) AUTHORIZATION.—Section 1895(e) of the Social 

9 Security Act (42 U.S.C. 1395fff(e)) is amended— 

10 (1) in paragraph (1), by striking ‘‘Nothing’’ 

11 and inserting ‘‘Subject to paragraph (2), nothing’’; 

12 (2) by redesignating paragraph (2) as para13 graph (3); and 

14 (3) by inserting after paragraph (1) the fol15 lowing new paragraph: 

16 ‘‘(2) EXCEPTION FOR PUBLIC HEALTH EMER17 GENCIES.—Nothing in this section shall be con18 strued as preventing a home health agency fur19 nishing a home health unit of service for which pay20 ment is made under the prospective payment system 

21 established by this section for such units of service 

22 from furnishing services via a video or audio tele23 communication system if such services— 

24 ‘‘(A) are furnished pursuant to a waiver 

25 under section 1135(b)(9); 


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•S 4854 IS

1 ‘‘(B) constitute no more than 50 percent of 

2 the number of billable visits, consistent with the 

3 in-person visit equivalency determination, billed 

4 under the 30-day period of care established 

5 under section 484.215(f) of title 42, Code of 

6 Federal Regulations; 

7 ‘‘(C) are furnished to a beneficiary under 

8 a plan of care established by a physician or 

9 practitioner with whom the beneficiary has an 

10 existing care relationship prior to the receipt of 

11 home health services that includes home health 

12 services to be furnished via a video or audio 

13 telecommunication system; and 

14 ‘‘(D) such beneficiary consents to receiving 

15 home health services via a video or audio tele16 communication system.’’. 

17 (c) IMPLEMENTATION.— 

18 (1) IN GENERAL.—The Secretary shall pre19 scribe regulations to apply to home health services 

20 furnished pursuant to the amendments made by this 

21 Act, which shall become effective no later than 60 

22 days after the date of enactment of this Act. The 

23 Secretary shall issue an interim final rule, if nec24 essary, to comply with the required effective date. 


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1 (2) CONSIDERATIONS.—In prescribing such reg2 ulations, the Secretary may consider including— 

3 (A) standards for the content of orders 

4 and patient consent for such services; 

5 (B) documentation of such services pro6 vided and billing units of such services; 

7 (C) the nature and level of resources uti8 lized for such services provided via video or 

9 audio telecommunication systems for purposes 

10 of determining equivalency with in-person visits 

11 in establishing the payment for such services; 

12 and 

13 (D) standards to ensure program integrity 

14 and prevent the incidence of fraud, waste, and 

15 abuse with respect to such services. 

Æ 


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