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[Congressional Bills 116th Congress]
[From the U.S. Government Publishing Office]
[H.R. 7992 Introduced in House (IH)]

<DOC>

116th CONGRESS
  2d Session
                                H. R. 7992

    To expand access to telehealth services, and for other purposes.

_______________________________________________________________________

                    IN THE HOUSE OF REPRESENTATIVES

                             August 7, 2020

 Mrs. Wagner introduced the following bill; which was referred to the 
Committee on Energy and Commerce, and in addition to the Committees on 
 Ways and Means, the Judiciary, and Veterans' Affairs, 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 expand access to telehealth services, and for other purposes.

    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 ``Telehealth Act''.

              TITLE I--VA MISSION TELEHEALTH CLARIFICATION

SEC. 101. LICENSURE OF HEALTH CARE PROFESSIONALS PROVIDING TREATMENT 
              VIA TELEMEDICINE.

    Section 1730C(b) of title 38, United States Code, is amended to 
read as follows:
    ``(b) Covered Health Care Professionals.--For purposes of this 
section, a covered health care professional is any of the following 
individuals:
            ``(1) A health care professional who--
                    ``(A) is an employee of the Department appointed 
                under the authority under section 7306, 7401, 7405, 
                7406, or 7408 of this title or title 5;
                    ``(B) is authorized by the Secretary to provide 
                health care under this chapter;
                    ``(C) is required to adhere to all standards for 
                quality relating to the provision of medicine in 
                accordance with applicable policies of the Department; 
                and
                    ``(D) has an active, current, full, and 
                unrestricted license, registration, or certification in 
                a State to practice the health care profession of the 
                health care professional.
            ``(2) A health professional trainee who--
                    ``(A) is appointed under section 7405 or 7406 of 
                this title; and
                    ``(B) is under the clinical supervision of a health 
                care professional described in paragraph (1).''.

             TITLE II--ADVANCING TELEHEALTH BEYOND COVID-19

SEC. 201. PERMITTING THE SECRETARY OF HEALTH AND HUMAN SERVICES TO 
              WAIVE REQUIREMENTS RELATING TO THE FURNISHING OF 
              TELEHEALTH SERVICES UNDER THE MEDICARE PROGRAM.

    Section 1834(m) of the Social Security Act (42 U.S.C. 1395m(m)) is 
amended by adding at the end the following new paragraph:
            ``(9) Authority to waive telehealth requirements.--
        Notwithstanding any other provision of this subsection, the 
        Secretary may waive any such provision for any area and time 
        period specified by the Secretary.''.

SEC. 202. MAKING PERMANENT THE ABILITY OF FEDERALLY QUALIFIED HEALTH 
              CENTERS AND RURAL HEALTH CLINICS TO FURNISH TELEHEALTH 
              SERVICES UNDER THE MEDICARE PROGRAM.

    Section 1834(m)(8) of the Social Security Act (42 U.S.C. 
1395m(m)(8)) is amended--
            (1) in the header, by striking ``during emergency period'';
            (2) in subparagraph (A), in the matter preceding clause 
        (i), by striking ``During'' and inserting ``Beginning on the 
        first day of''; and
            (3) in subparagraph (B)(i), by striking ``during such 
        emergency period''.

SEC. 203. CLARIFICATION FOR FRAUD AND ABUSE LAWS REGARDING TECHNOLOGIES 
              PROVIDED TO BENEFICIARIES.

    Section 1128A(i)(6) of the Social Security Act (42 U.S.C. 1320a-
7a(i)(6)) is amended--
            (1) in subparagraph (I), by striking ``; or'' and inserting 
        a semicolon;
            (2) in subparagraph (J), by striking the period at the end 
        and inserting ``; or''; and
            (3) by adding at the end the following new subparagraph:
                    ``(K) the provision of technologies (as defined by 
                the Secretary) on or after the date of the enactment of 
                this subparagraph, by a provider of services or 
                supplier (as such terms are defined for purposes of 
                title XVIII) directly to an individual who is entitled 
                to benefits under part A of title XVIII, enrolled under 
                part B of such title, or both, for the purpose of 
                furnishing telehealth services, remote patient 
                monitoring services, or other services furnished 
                through the use of technology (as defined by the 
                Secretary), if--
                            ``(i) the technologies are not offered as 
                        part of any advertisement or solicitation; and
                            ``(ii) the provision of the technologies 
                        meets any other requirements set forth in 
                        regulations promulgated by the Secretary.''.

   TITLE III--ENHANCE ACCESS TO SUPPORT ESSENTIAL BEHAVIORAL HEALTH 
                                SERVICES

SEC. 301. FINDINGS.

    Congress finds as follows:
            (1) Nearly 18 percent of adults in the United States 
        reported a mental, behavioral, or emotional disorder in 2015.
            (2) Children are also significantly impacted. According to 
        the Centers for Disease Control and Prevention, 1 in 6 children 
        ages 2 years through 8 years have a diagnosed mental, 
        behavioral, or developmental disorder, indicating that 
        disorders begin in early childhood and affect lifelong health.
            (3) Moreover, 1 in 7 children and adolescents have at least 
        one treatable mental health disorder.
            (4) There is a critical link between mental health and 
        substance use disorders. According to the Substance Abuse and 
        Mental Health Services Administration, 1 in 4 adults with 
        severe mental illness had a substance use disorder in 2017.
            (5) Moreover, children who have had a major depressive 
        episode are more than twice as likely to use illicit drugs.
            (6) In 2017, approximately 19.7 million people aged 12 
        years or older had a substance use disorder related to their 
        use of alcohol or illicit drugs in the past year.
            (7) Despite this overwhelming need, access to behavioral 
        health services remains among the most pressing health care 
        challenges in our country.
            (8) An estimated 56 percent of Americans with a mental 
        health disorder did not receive treatment in 2017.
            (9) Similarly, half of children and adolescents did not 
        receive treatment for their mental health disorder in 2016.
            (10) Further complicating access to care, as demand for 
        behavioral health services increases in communities across the 
        United States, the number of psychiatrists available to treat 
        them continues to decline.
            (11) The population of practicing psychiatrists declined by 
        more than 10 percent between the period of 2003 through 2013, 
        while the population of primary care physicians and 
        neurologists grew during the same period.
            (12) Technology has evolved to connect individuals to 
        health care services in new ways, including via telehealth.
            (13) Moreover, studies show that video visits are an 
        effective strategy to provide mental health treatment to 
        children and, in fact, may be preferable in some cases.
            (14) During the 115th Congress, Congress recognized the 
        potential of telehealth to ensure that those in urgent need of 
        substance use disorder treatment receive the care they require.
            (15) As passed and signed into law, sections 2001 and 1009 
        of the SUPPORT for Patients and Communities Act (Public Law 
        115-271) expands the use of telehealth services for the 
        treatment of opioid use disorder and other substance use 
        disorders.
            (16) It is widely recognized that there is a close 
        relationship between mental health and substance use disorders.

SEC. 302. MEDICARE TREATMENT OF BEHAVIORAL HEALTH SERVICES FURNISHED 
              THROUGH TELEHEALTH.

    Section 1834(m) of the Social Security Act (42 U.S.C. 1395m(m)), as 
amended by title II, is further amended--
            (1) in paragraph (4)(C)--
                    (A) in clause (i), by striking ``and (7)'' and 
                inserting ``(7), and (10)''; and
                    (B) in clause (ii)(X)--
                            (i) by striking ``or telehealth services'' 
                        and inserting ``, telehealth services''; and
                            (ii) by inserting ``, or telehealth 
                        services described in paragraph (10)'' before 
                        the period at the end; and
            (2) by adding at the end the following new paragraph:
            ``(10) Treatment of behavioral health services furnished 
        through telehealth.--The geographic requirements described in 
        paragraph (4)(C)(i) shall not apply with respect to telehealth 
        services that are behavioral health services furnished on or 
        after July 1, 2020, to eligible telehealth individuals, 
        including initial patient evaluations, follow-up medical 
        management, and other behavioral health services, as determined 
        by the Secretary, at an originating site described in paragraph 
        (4)(C)(ii) (other than an originating site described in 
        subclause (IX) of such paragraph).''.

SEC. 303. MEDICAID MENTAL AND BEHAVIORAL HEALTH TREATMENT THROUGH 
              TELEHEALTH.

    Section 1009 of the SUPPORT for Patients and Communities Act 
(Public Law 115-271) is amended--
            (1) in subsection (b)--
                    (A) in the header, by striking ``treatment for 
                substance use disorders'' and inserting ``treatment for 
                substance use disorders and mental health disorders and 
                behavioral health disorders'';
                    (B) in the matter preceding paragraph (1), by 
                striking ``Not later than 1 year after the date of 
                enactment of this Act, the Secretary'' and inserting 
                ``The Secretary'';
                    (C) in paragraph (1)--
                            (i) by striking ``treatment for substance 
                        use disorders'' and inserting ``treatment for 
                        substance use disorders and mental health 
                        disorders and behavioral health disorders''; 
                        and
                            (ii) by inserting ``psychotherapy,'' after 
                        ``counseling,'';
                    (D) in paragraph (2), by inserting ``or mental 
                health disorders and behavioral health disorders'' 
                after ``substance use disorders'';
                    (E) in paragraph (3), by inserting ``and mental 
                health disorders and behavioral health disorders'' 
                after ``substance use disorders''; and
                    (F) by adding at the end, below and after paragraph 
                (3), the following flush left text:
``The Secretary shall issue the guidance under this subsection not 
later than 1 year after the date of the enactment of this Act, with 
respect to the matters described in the previous provisions of this 
subsection relating to substance use disorders, and not later than 2 
years after the date of the enactment of this Act, with respect to the 
matters described in such previous provisions relating to mental health 
disorders and behavioral health disorders.'';
            (2) in subsection (c)--
                    (A) in the header, by striking ``treatment for 
                substance use disorders'' and inserting ``treatment for 
                substance use disorders and mental health disorders and 
                behavioral health disorders'';
                    (B) in paragraph (1), by striking ``treatment for 
                substance use disorders'' and inserting ``treatment for 
                substance use disorders and mental health disorders and 
                behavioral health disorders'' each place it appears; 
                and
                    (C) in paragraph (2)--
                            (i) by inserting ``with respect to 
                        substance use disorders,'' after ``paragraph 
                        (1),''; and
                            (ii) by adding at the end the following new 
                        sentence: ``Not later than 2 years after the 
                        date of enactment of this Act, the Comptroller 
                        General shall submit to Congress a report 
                        containing the results of the evaluation 
                        conducted under paragraph (1), with respect to 
                        mental health disorders and behavioral health 
                        disorders, together with recommendations for 
                        such legislation and administrative action as 
                        the Comptroller General determines 
                        appropriate.''; and
            (3) in subsection (d)(1)--
                    (A) in the matter preceding subparagraph (A), by 
                inserting ``and mental health disorders and behavioral 
                health disorders'' after ``substance use disorders'';
                    (B) in subparagraph (A), by inserting ``, and 
                mental health disorders and behavioral health 
                disorders'' after ``opioid use disorder''; and
                    (C) in subparagraph (B), by inserting ``and mental 
                health disorders and behavioral health disorders'' 
                after ``substance use disorders''.

SEC. 304. EFFECTIVE DATE.

    The amendments made by this title shall take effect as if included 
in the enactment of the SUPPORT for Patients and Communities Act.

          TITLE IV--HELPING ENSURE ACCESS TO LOCAL TELEHEALTH

SEC. 401. 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) Permanent Telehealth Payments.--Section 1834(m)(8) of the 
Social Security Act (42 U.S.C. 1395m(m)(8)) is amended--
            (1) in the header, by striking ``during emergency period'';
            (2) in subparagraph (A), in the matter preceding clause 
        (i), by striking ``During the emergency period described in 
        section 1135(g)(1)(B)'' 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
            (3) 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.''.
    (b) 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 (a) and titles 
        II and III, is further amended--
                    (A) in paragraph (4)(C)(i), by striking ``(7), and 
                (10)'' and inserting ``(7), (8), and (10)''; and
                    (B) 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) of paragraph 
                        (4)(C)(ii).''.
    (c) Treatment of FQHC and RHC Telehealth Services as a Visit.--The 
Secretary of Health and Human Services shall revise section 405.2463 of 
title 42, Code of Federal Regulations (or a successor regulation) to 
provide that, in the case of a Federally qualified health center or a 
rural health clinic serving as a distant site furnishing telehealth 
services to an individual in accordance with section 1834(m) of the 
Social Security Act (42 U.S.C. 1395m(m)), such services so furnished 
are considered to constitute a visit to such center or such clinic (as 
applicable) by such individual.

                 TITLE V--TELEHEALTH ACROSS STATE LINES

SEC. 501. NATIONAL TELEHEALTH PROGRAM.

    Subpart I of part D of title III of the Public Health Service Act 
(42 U.S.C. 254b et seq.) is amended by adding at the end the following:

``SEC. 330N. NATIONAL TELEHEALTH PROGRAM.

    ``(a) Uniform National Best Practices.--
            ``(1) In general.--The Secretary shall, in consultation 
        with a range of stakeholders including the entities listed in 
        paragraph (3), issue guidance on uniform best practices for the 
        provision of telehealth across State lines.
            ``(2) Objective.--The objective of the best practices 
        issued under paragraph (1) shall be to, not later than 5 years 
        after the date of enactment of this section, provide high-
        quality telehealth in rural areas across the United States.
            ``(3) Consultation.--The entities listed in this paragraph 
        include--
                    ``(A) technology experts;
                    ``(B) data security experts;
                    ``(C) primary care providers;
                    ``(D) specialist providers;
                    ``(E) mental health providers;
                    ``(F) academic medical centers;
                    ``(G) Federally qualified health centers, as 
                defined in section 1861(aa) of the Social Security Act;
                    ``(H) State, local, or tribal health departments;
                    ``(I) critical access hospitals;
                    ``(J) any Federal agency with expertise in the 
                provision of telecommunications or telehealth; and
                    ``(K) consumers of telehealth.
            ``(4) Reports.--The Secretary shall, not less than once 
        every year beginning 1 year after the date of enactment of this 
        section and ending on the date on which the guidance under 
        paragraph (1) is issued, report to the Committee on Health, 
        Education, Labor, and Pensions of the Senate and the Committee 
        on Energy and Commerce of the House of Representatives on the 
        progress of such guidance.
    ``(b) Grant Program.--
            ``(1) In general.--The Secretary shall for each of fiscal 
        years 2020 through 2024 award grants to eligible entities 
        described in paragraph (2) for the expansion of telehealth 
        programs to rural areas.
            ``(2) Eligible entity.--To be eligible to receive a grant 
        under this subsection, an entity shall--
                    ``(A) demonstrate that it is operating, on the date 
                on which the entity submits an application under 
                subparagraph (B), an effective telehealth program (as 
                determined in accordance with criteria established by 
                the Secretary); and
                    ``(B) submit an application to the Secretary at 
                such time, in such manner, and containing such 
                information as the Secretary may reasonably require, 
                including a plan to expand the telehealth program 
                operated by the entity to rural areas.
            ``(3) Study.--Not later than 3 years after the date of 
        enactment of this section, the Secretary shall--
                    ``(A) complete a study on the grant program under 
                this subsection, including the successes and challenges 
                of the program, lessons the Secretary has learned with 
                respect to the program, and best practices for 
                telehealth programs; and
                    ``(B) submit a report on such study to the 
                Committee on Health, Education, Labor, and Pensions of 
                the Senate and the Committee on Energy and Commerce of 
                the House of Representatives.
            ``(4) Authorization of appropriations.--There is authorized 
        to be appropriated to carry out this subsection, $20,000,000 
        for each of fiscal years 2020 through 2024.
    ``(c) Definition of Rural Area.--In this section, the term `rural 
area' has the meaning given the term in section 330J(e).''.

SEC. 502. CENTER FOR MEDICARE AND MEDICAID INNOVATION (CMMI) MODEL TO 
              INCENTIVIZE THE ADOPTION OF TELEHEALTH IN ORDER TO 
              INCREASE ACCESS TO CARE IN RURAL AREAS.

    Section 1115A(b)(2)(B) of the Social Security Act (42 U.S.C. 
1395a(b)(2)(B)) is amended by adding at the end the following new 
clause:
                            ``(xxviii) Providing incentives under title 
                        XVIII to encourage the adoption of telehealth 
                        in order to increase access to care in rural 
                        areas.''.

          TITLE VI--ENHANCING PREPAREDNESS THROUGH TELEHEALTH

SEC. 601. TELEHEALTH ENHANCEMENTS FOR EMERGENCY RESPONSE.

    Subsection (e) of section 319D of the Public Health Service Act (42 
U.S.C. 247d-4) is amended to read as follows:
    ``(e) Telehealth Enhancements for Emergency Response.--
            ``(1) Evaluation.--The Secretary, in consultation with the 
        Federal Communications Commission and other relevant Federal 
        agencies, shall, every 5 years--
                    ``(A) conduct an inventory of telehealth 
                initiatives in existence on the date of enactment of 
                the Enhancing Preparedness through Telehealth Act, 
                including the--
                            ``(i) specific location of networks and 
                        health information technology infrastructure 
                        that support such initiatives;
                            ``(ii) medical, technological, and 
                        communications capabilities of such 
                        initiatives;
                            ``(iii) functionality of such initiatives; 
                        and
                            ``(iv) capacity and ability of such 
                        initiatives to handle increased volume during 
                        the response to a public health emergency;
                    ``(B) identify methods to expand and interconnect 
                the State and regional health information networks 
                funded by the Secretary, the State and regional 
                broadband networks funded by the Federal Communications 
                Commission, including such networks supported by the 
                rural health care support mechanism pilot program, and 
                other telehealth networks;
                    ``(C) evaluate ways to prepare for, monitor, 
                respond rapidly to, or manage the events of, a public 
                health emergency through the enhanced use of telehealth 
                technologies, including--
                            ``(i) mechanisms for payment or 
                        reimbursement for use of such technologies and 
                        personnel during public health emergencies;
                            ``(ii) the use of telehealth technologies 
                        and services by health care providers in recent 
                        public health emergencies;
                            ``(iii) ways in which States used 
                        telehealth technologies and services in State 
                        responses to public health emergencies; and
                            ``(iv) infrastructure and resource needs to 
                        ensure providers have the necessary tools, 
                        training, and technical assistance to provide 
                        telehealth services;
                    ``(D) identify methods for reducing legal barriers 
                that deter health care professionals from providing 
                telehealth services, such as by utilizing State 
                emergency health care professional credentialing 
                verification systems, encouraging States to establish 
                and implement mechanisms to improve interstate medical 
                licensure cooperation, facilitating the exchange of 
                information among States regarding investigations and 
                adverse actions, and encouraging States to waive the 
                application of licensing requirements during a public 
                health emergency;
                    ``(E) evaluate ways to integrate the practice of 
                telehealth within the National Disaster Medical System 
                or any recent actions taken related to such 
                integration;
                    ``(F) promote greater coordination among existing 
                Federal interagency telehealth and health information 
                technology initiatives; and
                    ``(G) make recommendations related to updates on 
                the use of telehealth in public health emergencies in 
                Federal and State public health preparedness plans and 
                any actions taken to implement such recommendations.
            ``(2) Report.--
                    ``(A) In general.--
                            ``(i) Initial report.--Not later than 1 
                        year after the date of enactment of the 
                        Enhancing Preparedness through Telehealth Act, 
                        the Secretary shall prepare and submit a report 
                        to the Committee on Health, Education, Labor, 
                        and Pensions of the Senate and the Committee on 
                        Energy and Commerce of the House of 
                        Representatives regarding the findings and 
                        recommendations pursuant to paragraph (1).
                            ``(ii) Subsequent reports.--The Secretary 
                        shall submit updated reports described in 
                        clause (i) to the committees described in such 
                        clause not later than January 1, 2023, and 
                        every 5 years thereafter.
                    ``(B) Considerations.--In preparing the reports 
                under subparagraph (A), the Secretary shall take into 
                consideration potential barriers to the adoption of 
                telehealth by patients and providers during a public 
                health emergency, including--
                            ``(i) provider reimbursement;
                            ``(ii) insurance coverage;
                            ``(iii) provider licensure;
                            ``(iv) accessibility of telehealth and 
                        remote technologies; and
                            ``(v) concerns around violating relevant 
                        privacy, security, and patient safety 
                        regulations.''.

TITLE VII--KNOWING THE EFFICIENCY AND EFFICACY OF PERMANENT TELEHEALTH 
                                OPTIONS

SEC. 701. FINDINGS.

    Congress finds the following:
            (1) On January 21, 2020, the United States confirmed the 
        Nation's first case of the 2019 novel coronavirus (which 
        presents as the disease COVID-19).
            (2) On January 31, 2020, the Secretary of Health and Human 
        Services (in this title referred to as the ``Secretary'') 
        declared a public health emergency in response to COVID-19.
            (3) By March, the disease reached the pandemic level 
        according to the World Health Organization, and the President 
        proclaimed the COVID-19 outbreak in the United States to 
        constitute a national emergency.
            (4) This emergency declaration authorizes the Secretary 
        ``to temporarily waive or modify certain requirements of the 
        Medicare, Medicaid, and State Children's Health Insurance 
        programs and of the Health Insurance Portability and 
        Accountability Act Privacy Rule throughout the duration of the 
        public health emergency declared in response to the COVID-19 
        outbreak''.
            (5) Under this authority, the Secretary, and the 
        Administrator of the Centers for Medicare & Medicaid Services 
        (in this title referred to as the ``Administrator'') acting 
        under the Secretary's authority, issued numerous rules, 
        regulations, and waivers enabling the expansion of telehealth 
        services during the public health emergency.
            (6) Telehealth services play a critical role in enhancing 
        access to care for patients while simultaneously reducing the 
        risk of exposure to the coronavirus for both patients and 
        providers.
            (7) The Administrator expanded access to telehealth 
        services under the public health emergency to all Medicare 
        beneficiaries (including clinician-provided services to new and 
        established patients).
            (8) On April 23, 2020, the Administrator released a 
        telehealth toolkit to assist States in expanding the use of 
        telehealth through Medicaid and CHIP.
            (9) Expanded telehealth options are valuable for all 
        Americans during this public health crisis, but especially for 
        high-risk patients and rural Americans who already have 
        difficulty accessing care.

SEC. 702. STUDIES AND REPORTS ON THE EXPANSION OF ACCESS TO TELEHEALTH 
              SERVICES DURING THE COVID-19 EMERGENCY.

    (a) HHS.--
            (1) In general.--Not later than 180 days after the date of 
        the enactment of this Act, the Secretary, in consultation with 
        the Administrator, shall conduct a study and submit to Congress 
        a report on actions taken by the Secretary during the emergency 
        period described in section 1135(g)(1)(B) of the Social 
        Security Act (42 U.S.C. 1320b-5(g)(1)(B)) to expand access to 
        telehealth services under the Medicare program, the Medicaid 
        program, and the Children's Health Insurance program. Such 
        report shall include the following:
                    (A) A comprehensive list of telehealth services 
                available under the programs described in paragraph (1) 
                and an explanation of all actions undertaken by the 
                Secretary during the emergency period described in such 
                paragraph to expand access to such services.
                    (B) A comprehensive list of types of providers that 
                may be reimbursed for such services furnished under 
                such programs during such period, including a list of 
                services which may only be reimbursed under such 
                programs during such period if furnished by such 
                providers in-person.
                    (C) A quantitative analysis of the use of such 
                telehealth services under such programs during such 
                period, including data points on use by rural, 
                minority, low-income, and elderly populations.
                    (D) A quantitative analysis of the use of such 
                services under such programs during such period for 
                mental and behavioral health treatments.
                    (E) An analysis of the public health impacts of the 
                actions described in subparagraph (A).
            (2) Publication of report.--Not later than 180 days after 
        the date of the enactment of this Act, the Secretary shall 
        publish on the public website of the Department of Health and 
        Human Services the report described in paragraph (1).
    (b) GAO.--
            (1) In general.--Not later than 210 days after the date of 
        enactment of this Act, the Comptroller General of the United 
        States shall conduct a study and submit to Congress a report 
        on--
                    (A) the efficiency, management, and success and 
                failures of the expansion of access to telehealth 
                services under the Medicare, Medicaid, and Children's 
                Health Insurance programs during the emergency period 
                described in subsection (a)(1); and
                    (B) any risk in increased fraudulent activity, and 
                types of fraudulent activity, associated with such 
                expansion.
            (2) Recommendations.--The report submitted under paragraph 
        (1) shall include recommendations on--
                    (A) potential improvements to telehealth services, 
                and expansions of such services, under the programs 
                described in paragraph (1)(A); and
                    (B) ways to address any fraudulent activity 
                described in paragraph (1)(B).

   TITLE VIII--TELEMEDICINE EVERYWHERE LIFTING EVERYONE'S HEALTHCARE 
                  EXPERIENCE AND LONG TERM HEALTH HSA

SEC. 801. PERMANENT EXEMPTION FOR TELEHEALTH SERVICES.

    (a) In General.--Subparagraph (E) of section 223(c)(2) of the 
Internal Revenue Code of 1986 is amended by striking ``In the case of 
plan years beginning on or before December 31, 2021, a plan'' and 
inserting ``A plan''.
    (b) Conforming Amendment.--Clause (ii) of section 223(c)(1)(B) of 
the Internal Revenue Code of 1986 is amended by striking ``(in the case 
of plan years beginning on or before December 31, 2021)''.
    (c) Effective Date.--The amendments made by this section shall 
apply to plan years beginning after December 31, 2021.

   TITLE IX--TELEHEALTH RESPONSE FOR E-PRESCRIBING ADDICTION THERAPY 
                                SERVICES

SEC. 901. TELEHEALTH FOR SUBSTANCE USE DISORDER TREATMENT.

    (a) Substance Use Disorder Services Furnished Through Telehealth 
Under Medicare.--Section 1834(m)(7) of the Social Security Act (42 
U.S.C. 1395m(m)(7)) is amended by adding at the end the following: 
``With respect to telehealth services described in the preceding 
sentence that are furnished on or after January 1, 2020, nothing shall 
preclude the furnishing of such services through audio or telephone 
only technologies in the case where a physician or practitioner has 
already conducted an in-person medical evaluation or a telehealth 
evaluation that utilizes both audio and visual capabilities with the 
eligible telehealth individual.''.
    (b) Controlled Substances Dispensed by Means of the Internet.--
Section 309(e)(2) of the Controlled Substances Act (21 U.S.C. 
829(e)(2)) is amended--
            (1) in subparagraph (A)(i)--
                    (A) by striking ``at least 1 in-person medical 
                evaluation'' and inserting the following: ``at least--
                                    ``(I) 1 in-person medical 
                                evaluation''; and
                    (B) by adding at the end the following:
                                    ``(II) for purposes of prescribing 
                                a controlled substance in schedule III 
                                or IV, 1 telehealth evaluation; or''; 
                                and
            (2) by adding at the end the following:
                    ``(D)(i) The term `telehealth evaluation' means a 
                medical evaluation that is conducted in accordance with 
                applicable Federal and State laws by a practitioner 
                (other than a pharmacist) who is at a location remote 
                from the patient and is communicating with the patient 
                using a telecommunications system referred to in 
                section 1834(m) of the Social Security Act (42 U.S.C. 
                1395m(m)) that includes, at a minimum, audio and video 
                equipment permitting two-way, real-time interactive 
                communication between the patient and distant site 
                practitioner.
                    ``(ii) Nothing in clause (i) shall be construed to 
                imply that 1 telehealth evaluation demonstrates that a 
                prescription has been issued for a legitimate medical 
                purpose within the usual course of professional 
                practice.
                    ``(iii) A practitioner who prescribes the drugs or 
                combination of drugs that are covered under section 
                303(g)(2)(C) using the authority under subparagraph 
                (A)(i)(II) of this paragraph shall adhere to nationally 
                recognized evidence-based guidelines for the treatment 
                of patients with opioid use disorders and a diversion 
                control plan, as those terms are defined in section 8.2 
                of title 42, Code of Federal Regulations, as in effect 
                on the date of enactment of this subparagraph.''.
                                 <all>
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