I 

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. 

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 Act’’. 


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1 TITLE I—VA MISSION 

2 TELEHEALTH CLARIFICATION 

3 SEC. 101. LICENSURE OF HEALTH CARE PROFESSIONALS 

4 PROVIDING TREATMENT VIA TELEMEDICINE. 

5 Section 1730C(b) of title 38, United States Code, is 

6 amended to read as follows: 

7 ‘‘(b) COVERED HEALTH CARE PROFESSIONALS.— 

8 For purposes of this section, a covered health care profes9 sional is any of the following individuals: 

10 ‘‘(1) A health care professional who— 

11 ‘‘(A) is an employee of the Department ap12 pointed under the authority under section 7306, 

13 7401, 7405, 7406, or 7408 of this title or title 

14 5; 

15 ‘‘(B) is authorized by the Secretary to pro16 vide health care under this chapter; 

17 ‘‘(C) is required to adhere to all standards 

18 for quality relating to the provision of medicine 

19 in accordance with applicable policies of the De20 partment; and 

21 ‘‘(D) has an active, current, full, and unre22 stricted license, registration, or certification in 

23 a State to practice the health care profession of 

24 the health care professional. 

25 ‘‘(2) A health professional trainee who— 


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1 ‘‘(A) is appointed under section 7405 or 

2 7406 of this title; and 

3 ‘‘(B) is under the clinical supervision of a 

4 health care professional described in paragraph 

5 (1).’’. 

6 TITLE II—ADVANCING 

7 TELEHEALTH BEYOND COVID–19 

8 SEC. 201. PERMITTING THE SECRETARY OF HEALTH AND 

9 HUMAN SERVICES TO WAIVE REQUIREMENTS 

10 RELATING TO THE FURNISHING OF TELE11 HEALTH SERVICES UNDER THE MEDICARE 

12 PROGRAM. 

13 Section 1834(m) of the Social Security Act (42 

14 U.S.C. 1395m(m)) is amended by adding at the end the 

15 following new paragraph: 

16 ‘‘(9) AUTHORITY TO WAIVE TELEHEALTH RE17 QUIREMENTS.—Notwithstanding any other provision 

18 of this subsection, the Secretary may waive any such 

19 provision for any area and time period specified by 

20 the Secretary.’’. 


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1 SEC. 202. MAKING PERMANENT THE ABILITY OF FEDER2 ALLY QUALIFIED HEALTH CENTERS AND 

3 RURAL HEALTH CLINICS TO FURNISH TELE4 HEALTH SERVICES UNDER THE MEDICARE 

5 PROGRAM. 

6 Section 1834(m)(8) of the Social Security Act (42 

7 U.S.C. 1395m(m)(8)) is amended— 

8 (1) in the header, by striking ‘‘DURING EMER9 GENCY PERIOD’’; 

10 (2) in subparagraph (A), in the matter pre11 ceding clause (i), by striking ‘‘During’’ and inserting 

12 ‘‘Beginning on the first day of’’; and 

13 (3) in subparagraph (B)(i), by striking ‘‘during 

14 such emergency period’’. 

15 SEC. 203. CLARIFICATION FOR FRAUD AND ABUSE LAWS 

16 REGARDING TECHNOLOGIES PROVIDED TO 

17 BENEFICIARIES. 

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

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

20 (1) in subparagraph (I), by striking ‘‘; or’’ and 

21 inserting a semicolon; 

22 (2) in subparagraph (J), by striking the period 

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

24 (3) by adding at the end the following new sub25 paragraph: 


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1 ‘‘(K) the provision of technologies (as de2 fined by the Secretary) on or after the date of 

3 the enactment of this subparagraph, by a pro4 vider of services or supplier (as such terms are 

5 defined for purposes of title XVIII) directly to 

6 an individual who is entitled to benefits under 

7 part A of title XVIII, enrolled under part B of 

8 such title, or both, for the purpose of furnishing 

9 telehealth services, remote patient monitoring 

10 services, or other services furnished through the 

11 use of technology (as defined by the Secretary), 

12 if— 

13 ‘‘(i) the technologies are not offered 

14 as part of any advertisement or solicita15 tion; and 

16 ‘‘(ii) the provision of the technologies 

17 meets any other requirements set forth in 

18 regulations promulgated by the Sec19 retary.’’. 

20 TITLE III—ENHANCE ACCESS TO 

21 SUPPORT ESSENTIAL BEHAV22 IORAL HEALTH SERVICES 

23 SEC. 301. FINDINGS. 

24 Congress finds as follows: 


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1 (1) Nearly 18 percent of adults in the United 

2 States reported a mental, behavioral, or emotional 

3 disorder in 2015. 

4 (2) Children are also significantly impacted. Ac5 cording to the Centers for Disease Control and Pre6 vention, 1 in 6 children ages 2 years through 8 years 

7 have a diagnosed mental, behavioral, or develop8 mental disorder, indicating that disorders begin in 

9 early childhood and affect lifelong health. 

10 (3) Moreover, 1 in 7 children and adolescents 

11 have at least one treatable mental health disorder. 

12 (4) There is a critical link between mental 

13 health and substance use disorders. According to the 

14 Substance Abuse and Mental Health Services Ad15 ministration, 1 in 4 adults with severe mental illness 

16 had a substance use disorder in 2017. 

17 (5) Moreover, children who have had a major 

18 depressive episode are more than twice as likely to 

19 use illicit drugs. 

20 (6) In 2017, approximately 19.7 million people 

21 aged 12 years or older had a substance use disorder 

22 related to their use of alcohol or illicit drugs in the 

23 past year. 


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1 (7) Despite this overwhelming need, access to 

2 behavioral health services remains among the most 

3 pressing health care challenges in our country. 

4 (8) An estimated 56 percent of Americans with 

5 a mental health disorder did not receive treatment in 

6 2017. 

7 (9) Similarly, half of children and adolescents 

8 did not receive treatment for their mental health dis9 order in 2016. 

10 (10) Further complicating access to care, as de11 mand for behavioral health services increases in 

12 communities across the United States, the number 

13 of psychiatrists available to treat them continues to 

14 decline. 

15 (11) The population of practicing psychiatrists 

16 declined by more than 10 percent between the period 

17 of 2003 through 2013, while the population of pri18 mary care physicians and neurologists grew during 

19 the same period. 

20 (12) Technology has evolved to connect individ21 uals to health care services in new ways, including 

22 via telehealth. 

23 (13) Moreover, studies show that video visits 

24 are an effective strategy to provide mental health 


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1 treatment to children and, in fact, may be preferable 

2 in some cases. 

3 (14) During the 115th Congress, Congress rec4 ognized the potential of telehealth to ensure that 

5 those in urgent need of substance use disorder treat6 ment receive the care they require. 

7 (15) As passed and signed into law, sections 

8 2001 and 1009 of the SUPPORT for Patients and 

9 Communities Act (Public Law 115–271) expands 

10 the use of telehealth services for the treatment of 

11 opioid use disorder and other substance use dis12 orders. 

13 (16) It is widely recognized that there is a close 

14 relationship between mental health and substance 

15 use disorders. 

16 SEC. 302. MEDICARE TREATMENT OF BEHAVIORAL HEALTH 

17 SERVICES FURNISHED THROUGH TELE18 HEALTH. 

19 Section 1834(m) of the Social Security Act (42 

20 U.S.C. 1395m(m)), as amended by title II, is further 

21 amended— 

22 (1) in paragraph (4)(C)— 

23 (A) in clause (i), by striking ‘‘and (7)’’ and 

24 inserting ‘‘(7), and (10)’’; and 

25 (B) in clause (ii)(X)— 


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1 (i) by striking ‘‘or telehealth services’’ 

2 and inserting ‘‘, telehealth services’’; and 

3 (ii) by inserting ‘‘, or telehealth serv4 ices described in paragraph (10)’’ before 

5 the period at the end; and 

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

7 paragraph: 

8 ‘‘(10) TREATMENT OF BEHAVIORAL HEALTH

9 SERVICES FURNISHED THROUGH TELEHEALTH.— 

10 The geographic requirements described in paragraph 

11 (4)(C)(i) shall not apply with respect to telehealth 

12 services that are behavioral health services furnished 

13 on or after July 1, 2020, to eligible telehealth indi14 viduals, including initial patient evaluations, follow15 up medical management, and other behavioral health 

16 services, as determined by the Secretary, at an origi17 nating site described in paragraph (4)(C)(ii) (other 

18 than an originating site described in subclause (IX) 

19 of such paragraph).’’. 

20 SEC. 303. MEDICAID MENTAL AND BEHAVIORAL HEALTH 

21 TREATMENT THROUGH TELEHEALTH. 

22 Section 1009 of the SUPPORT for Patients and 

23 Communities Act (Public Law 115–271) is amended— 

24 (1) in subsection (b)— 


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1 (A) in the header, by striking ‘‘TREAT2 MENT FOR SUBSTANCE USE DISORDERS’’ 

3 and inserting ‘‘TREATMENT FOR SUBSTANCE

4 USE DISORDERS AND MENTAL HEALTH

5 DISORDERS AND BEHAVIORAL HEALTH

6 DISORDERS’’; 

7 (B) in the matter preceding paragraph (1), 

8 by striking ‘‘Not later than 1 year after the 

9 date of enactment of this Act, the Secretary’’ 

10 and inserting ‘‘The Secretary’’; 

11 (C) in paragraph (1)— 

12 (i) by striking ‘‘treatment for sub13 stance use disorders’’ and inserting ‘‘treat14 ment for substance use disorders and men15 tal health disorders and behavioral health 

16 disorders’’; and 

17 (ii) by inserting ‘‘psychotherapy,’’ 

18 after ‘‘counseling,’’; 

19 (D) in paragraph (2), by inserting ‘‘or 

20 mental health disorders and behavioral health 

21 disorders’’ after ‘‘substance use disorders’’; 

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

23 mental health disorders and behavioral health 

24 disorders’’ after ‘‘substance use disorders’’; and 


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1 (F) by adding at the end, below and after 

2 paragraph (3), the following flush left text: 

3 ‘‘The Secretary shall issue the guidance under this sub4 section not later than 1 year after the date of the enact5 ment of this Act, with respect to the matters described 

6 in the previous provisions of this subsection relating to 

7 substance use disorders, and not later than 2 years after 

8 the date of the enactment of this Act, with respect to the 

9 matters described in such previous provisions relating to 

10 mental health disorders and behavioral health disorders.’’; 

11 (2) in subsection (c)— 

12 (A) in the header, by striking ‘‘TREAT13 MENT FOR SUBSTANCE USE DISORDERS’’ 

14 and inserting ‘‘TREATMENT FOR SUBSTANCE

15 USE DISORDERS AND MENTAL HEALTH

16 DISORDERS AND BEHAVIORAL HEALTH

17 DISORDERS’’; 

18 (B) in paragraph (1), by striking ‘‘treat19 ment for substance use disorders’’ and inserting 

20 ‘‘treatment for substance use disorders and 

21 mental health disorders and behavioral health 

22 disorders’’ each place it appears; and 

23 (C) in paragraph (2)— 


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1 (i) by inserting ‘‘with respect to sub2 stance use disorders,’’ after ‘‘paragraph 

3 (1),’’; and 

4 (ii) by adding at the end the following 

5 new sentence: ‘‘Not later than 2 years 

6 after the date of enactment of this Act, the 

7 Comptroller General shall submit to Con8 gress a report containing the results of the 

9 evaluation conducted under paragraph (1), 

10 with respect to mental health disorders and 

11 behavioral health disorders, together with 

12 recommendations for such legislation and 

13 administrative action as the Comptroller 

14 General determines appropriate.’’; and 

15 (3) in subsection (d)(1)— 

16 (A) in the matter preceding subparagraph 

17 (A), by inserting ‘‘and mental health disorders 

18 and behavioral health disorders’’ after ‘‘sub19 stance use disorders’’; 

20 (B) in subparagraph (A), by inserting ‘‘, 

21 and mental health disorders and behavioral 

22 health disorders’’ after ‘‘opioid use disorder’’; 

23 and 

24 (C) in subparagraph (B), by inserting 

25 ‘‘and mental health disorders and behavioral 


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1 health disorders’’ after ‘‘substance use dis2 orders’’. 

3 SEC. 304. EFFECTIVE DATE. 

4 The amendments made by this title shall take effect 

5 as if included in the enactment of the SUPPORT for Pa6 tients and Communities Act. 

7 TITLE IV—HELPING ENSURE 

8 ACCESS TO LOCAL TELEHEALTH 

9 SEC. 401. PROVIDING FOR PERMANENT COST-RELATED 

10 PAYMENTS FOR TELEHEALTH SERVICES FUR11 NISHED BY FEDERALLY QUALIFIED HEALTH 

12 CENTERS AND RURAL HEALTH CLINICS 

13 UNDER THE MEDICARE PROGRAM AND PER14 MANENTLY REMOVING ORIGINATING SITE 

15 FACILITY AND LOCATION REQUIREMENTS 

16 FOR DISTANT SITE TELEHEALTH SERVICES 

17 FURNISHED BY SUCH CENTERS AND SUCH 

18 CLINICS. 

19 (a) PERMANENT TELEHEALTH PAYMENTS.—Section 

20 1834(m)(8) of the Social Security Act (42 U.S.C. 

21 1395m(m)(8)) is amended— 

22 (1) in the header, by striking ‘‘DURING EMER23 GENCY PERIOD’’; 

24 (2) in subparagraph (A), in the matter pre25 ceding clause (i), by striking ‘‘During the emergency 


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1 period described in section 1135(g)(1)(B)’’ and in2 serting ‘‘With respect to telehealth services furnished 

3 on or after the date of the beginning of the emer4 gency period described in section 1135(g)(1)(B)’’; 

5 and 

6 (3) by striking subparagraph (B) and inserting 

7 the following new subparagraph: 

8 ‘‘(B) PAYMENT.— 

9 ‘‘(i) IN GENERAL.—A telehealth serv10 ice furnished by a rural health clinic or a 

11 Federally qualified health center serving as 

12 a distant site to an individual shall be 

13 deemed to be so furnished to such indi14 vidual as an outpatient of such clinic or fa15 cility (as applicable) for purposes of para16 graph (1) or (3), respectively, of section 

17 1861(aa) and payable as a rural health 

18 clinic service or Federally qualified health 

19 center service (as applicable) under section 

20 1833(a)(3) or under the prospective pay21 ment system established under section 

22 1834(o), respectively. 

23 ‘‘(ii) TREATMENT OF COSTS FOR

24 FQHC PPS CALCULATIONS AND RHC AIR

25 CALCULATIONS.—Costs associated with the 


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1 delivery of telehealth services by a Feder2 ally qualified health center or rural health 

3 clinic serving as a distant site pursuant to 

4 this paragraph shall be considered allow5 able costs for purposes of the prospective 

6 payment system established under section 

7 1834(o) and any payment methodologies 

8 developed under section 1833(a)(3), as ap9 plicable.’’. 

10 (b) ELIMINATION OF ORIGINATING SITE REQUIRE11 MENTS FOR TELEHEALTH SERVICES FURNISHED BY

12 FQHCS OR RHCS.— 

13 (1) IN GENERAL.—Section 1834(m) of the So14 cial Security Act (42 U.S.C. 1395m(m)), as amend15 ed by subsection (a) and titles II and III, is further 

16 amended— 

17 (A) in paragraph (4)(C)(i), by striking 

18 ‘‘(7), and (10)’’ and inserting ‘‘(7), (8), and 

19 (10)’’; and 

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

21 subparagraph: 

22 ‘‘(C) NONAPPLICATION OF ORIGINATING

23 SITE REQUIREMENTS.—The geographic and site 

24 requirements described in paragraph (4)(C) 

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1 ices furnished by a Federally qualified health 

2 center or a rural health clinic serving as a dis3 tant site.’’. 

4 (2) SPECIAL PAYMENT RULE FOR ORIGINATING

5 SITES WITH RESPECT TO TELEHEALTH SERVICES

6 FURNISHED BY AN FQHC OR RHC.—Section 

7 1834(m)(2)(B) of the Social Security Act (42 U.S.C. 

8 1395m(m)(2)(B)) is amended— 

9 (A) in clause (i), by striking ‘‘clause (ii)’’ 

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

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

12 clause: 

13 ‘‘(iii) SPECIAL RULE FOR TELE14 HEALTH SERVICES FURNISHED BY FQHCS

15 AND RHCS.—No facility fee shall be paid 

16 under this subparagraph to an originating 

17 site with respect to telehealth services fur18 nished by a Federally qualified health cen19 ter or rural health clinic serving as a dis20 tant site unless such originating site is a 

21 site described in any of subclauses (I) 

22 through (IX) of paragraph (4)(C)(ii).’’. 

23 (c) TREATMENT OF FQHC AND RHC TELEHEALTH

24 SERVICES AS A VISIT.—The Secretary of Health and 

25 Human Services shall revise section 405.2463 of title 42, 


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1 Code of Federal Regulations (or a successor regulation) 

2 to provide that, in the case of a Federally qualified health 

3 center or a rural health clinic serving as a distant site 

4 furnishing telehealth services to an individual in accord5 ance with section 1834(m) of the Social Security Act (42 

6 U.S.C. 1395m(m)), such services so furnished are consid7 ered to constitute a visit to such center or such clinic (as 

8 applicable) by such individual. 

9 TITLE V—TELEHEALTH ACROSS 

10 STATE LINES 

11 SEC. 501. NATIONAL TELEHEALTH PROGRAM. 

12 Subpart I of part D of title III of the Public Health 

13 Service Act (42 U.S.C. 254b et seq.) is amended by adding 

14 at the end the following: 

15 ‘‘SEC. 330N. NATIONAL TELEHEALTH PROGRAM. 

16 ‘‘(a) UNIFORM NATIONAL BEST PRACTICES.— 

17 ‘‘(1) IN GENERAL.—The Secretary shall, in con18 sultation with a range of stakeholders including the 

19 entities listed in paragraph (3), issue guidance on 

20 uniform best practices for the provision of telehealth 

21 across State lines. 

22 ‘‘(2) OBJECTIVE.—The objective of the best 

23 practices issued under paragraph (1) shall be to, not 

24 later than 5 years after the date of enactment of 


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1 this section, provide high-quality telehealth in rural 

2 areas across the United States. 

3 ‘‘(3) CONSULTATION.—The entities listed in 

4 this paragraph include— 

5 ‘‘(A) technology experts; 

6 ‘‘(B) data security experts; 

7 ‘‘(C) primary care providers; 

8 ‘‘(D) specialist providers; 

9 ‘‘(E) mental health providers; 

10 ‘‘(F) academic medical centers; 

11 ‘‘(G) Federally qualified health centers, as 

12 defined in section 1861(aa) of the Social Secu13 rity Act; 

14 ‘‘(H) State, local, or tribal health depart15 ments; 

16 ‘‘(I) critical access hospitals; 

17 ‘‘(J) any Federal agency with expertise in 

18 the provision of telecommunications or tele19 health; and 

20 ‘‘(K) consumers of telehealth. 

21 ‘‘(4) REPORTS.—The Secretary shall, not less 

22 than once every year beginning 1 year after the date 

23 of enactment of this section and ending on the date 

24 on which the guidance under paragraph (1) is 

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1 cation, Labor, and Pensions of the Senate and the 

2 Committee on Energy and Commerce of the House 

3 of Representatives on the progress of such guidance. 

4 ‘‘(b) GRANT PROGRAM.— 

5 ‘‘(1) IN GENERAL.—The Secretary shall for 

6 each of fiscal years 2020 through 2024 award 

7 grants to eligible entities described in paragraph (2) 

8 for the expansion of telehealth programs to rural 

9 areas. 

10 ‘‘(2) ELIGIBLE ENTITY.—To be eligible to re11 ceive a grant under this subsection, an entity shall— 

12 ‘‘(A) demonstrate that it is operating, on 

13 the date on which the entity submits an appli14 cation under subparagraph (B), an effective 

15 telehealth program (as determined in accord16 ance with criteria established by the Secretary); 

17 and 

18 ‘‘(B) submit an application to the Sec19 retary at such time, in such manner, and con20 taining such information as the Secretary may 

21 reasonably require, including a plan to expand 

22 the telehealth program operated by the entity to 

23 rural areas. 


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1 ‘‘(3) STUDY.—Not later than 3 years after the 

2 date of enactment of this section, the Secretary 

3 shall— 

4 ‘‘(A) complete a study on the grant pro5 gram under this subsection, including the suc6 cesses and challenges of the program, lessons 

7 the Secretary has learned with respect to the 

8 program, and best practices for telehealth pro9 grams; and 

10 ‘‘(B) submit a report on such study to the 

11 Committee on Health, Education, Labor, and 

12 Pensions of the Senate and the Committee on 

13 Energy and Commerce of the House of Rep14 resentatives. 

15 ‘‘(4) AUTHORIZATION OF APPROPRIATIONS.— 

16 There is authorized to be appropriated to carry out 

17 this subsection, $20,000,000 for each of fiscal years 

18 2020 through 2024. 

19 ‘‘(c) DEFINITION OF RURAL AREA.—In this section, 

20 the term ‘rural area’ has the meaning given the term in 

21 section 330J(e).’’. 


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1 SEC. 502. CENTER FOR MEDICARE AND MEDICAID INNOVA2 TION (CMMI) MODEL TO INCENTIVIZE THE 

3 ADOPTION OF TELEHEALTH IN ORDER TO IN4 CREASE ACCESS TO CARE IN RURAL AREAS. 

5 Section 1115A(b)(2)(B) of the Social Security Act 

6 (42 U.S.C. 1395a(b)(2)(B)) is amended by adding at the 

7 end the following new clause: 

8 ‘‘(xxviii) Providing incentives under 

9 title XVIII to encourage the adoption of 

10 telehealth in order to increase access to 

11 care in rural areas.’’. 

12 TITLE VI—ENHANCING PRE13 PAREDNESS THROUGH TELE14 HEALTH 

15 SEC. 601. TELEHEALTH ENHANCEMENTS FOR EMERGENCY 

16 RESPONSE. 

17 Subsection (e) of section 319D of the Public Health 

18 Service Act (42 U.S.C. 247d–4) is amended to read as 

19 follows: 

20 ‘‘(e) TELEHEALTH ENHANCEMENTS FOR EMER21 GENCY RESPONSE.— 

22 ‘‘(1) EVALUATION.—The Secretary, in consulta23 tion with the Federal Communications Commission 

24 and other relevant Federal agencies, shall, every 5 

25 years— 


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1 ‘‘(A) conduct an inventory of telehealth ini2 tiatives in existence on the date of enactment of 

3 the Enhancing Preparedness through Tele4 health Act, including the— 

5 ‘‘(i) specific location of networks and 

6 health information technology infrastruc7 ture that support such initiatives; 

8 ‘‘(ii) medical, technological, and com9 munications capabilities of such initiatives; 

10 ‘‘(iii) functionality of such initiatives; 

11 and 

12 ‘‘(iv) capacity and ability of such ini13 tiatives to handle increased volume during 

14 the response to a public health emergency; 

15 ‘‘(B) identify methods to expand and inter16 connect the State and regional health informa17 tion networks funded by the Secretary, the 

18 State and regional broadband networks funded 

19 by the Federal Communications Commission, 

20 including such networks supported by the rural 

21 health care support mechanism pilot program, 

22 and other telehealth networks; 

23 ‘‘(C) evaluate ways to prepare for, monitor, 

24 respond rapidly to, or manage the events of, a 


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1 public health emergency through the enhanced 

2 use of telehealth technologies, including— 

3 ‘‘(i) mechanisms for payment or reim4 bursement for use of such technologies and 

5 personnel during public health emer6 gencies; 

7 ‘‘(ii) the use of telehealth technologies 

8 and services by health care providers in re9 cent public health emergencies; 

10 ‘‘(iii) ways in which States used tele11 health technologies and services in State 

12 responses to public health emergencies; 

13 and 

14 ‘‘(iv) infrastructure and resource 

15 needs to ensure providers have the nec16 essary tools, training, and technical assist17 ance to provide telehealth services; 

18 ‘‘(D) identify methods for reducing legal 

19 barriers that deter health care professionals 

20 from providing telehealth services, such as by 

21 utilizing State emergency health care profes22 sional credentialing verification systems, en23 couraging States to establish and implement 

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1 formation among States regarding investiga2 tions and adverse actions, and encouraging 

3 States to waive the application of licensing re4 quirements during a public health emergency; 

5 ‘‘(E) evaluate ways to integrate the prac6 tice of telehealth within the National Disaster 

7 Medical System or any recent actions taken re8 lated to such integration; 

9 ‘‘(F) promote greater coordination among 

10 existing Federal interagency telehealth and 

11 health information technology initiatives; and 

12 ‘‘(G) make recommendations related to up13 dates on the use of telehealth in public health 

14 emergencies in Federal and State public health 

15 preparedness plans and any actions taken to 

16 implement such recommendations. 

17 ‘‘(2) REPORT.— 

18 ‘‘(A) IN GENERAL.— 

19 ‘‘(i) INITIAL REPORT.—Not later than 

20 1 year after the date of enactment of the 

21 Enhancing Preparedness through Tele22 health Act, the Secretary shall prepare and 

23 submit a report to the Committee on 

24 Health, Education, Labor, and Pensions of 

25 the Senate and the Committee on Energy 


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1 and Commerce of the House of Represent2 atives regarding the findings and rec3 ommendations pursuant to paragraph (1). 

4 ‘‘(ii) SUBSEQUENT REPORTS.—The 

5 Secretary shall submit updated reports de6 scribed in clause (i) to the committees de7 scribed in such clause not later than Janu8 ary 1, 2023, and every 5 years thereafter. 

9 ‘‘(B) CONSIDERATIONS.—In preparing the 

10 reports under subparagraph (A), the Secretary 

11 shall take into consideration potential barriers 

12 to the adoption of telehealth by patients and 

13 providers during a public health emergency, in14 cluding— 

15 ‘‘(i) provider reimbursement; 

16 ‘‘(ii) insurance coverage; 

17 ‘‘(iii) provider licensure; 

18 ‘‘(iv) accessibility of telehealth and re19 mote technologies; and 

20 ‘‘(v) concerns around violating rel21 evant privacy, security, and patient safety 

22 regulations.’’. 


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1 TITLE VII—KNOWING THE EFFI2 CIENCY AND EFFICACY OF 

3 PERMANENT TELEHEALTH 

4 OPTIONS 

5 SEC. 701. FINDINGS. 

6 Congress finds the following: 

7 (1) On January 21, 2020, the United States 

8 confirmed the Nation’s first case of the 2019 novel 

9 coronavirus (which presents as the disease COVID– 

10 19). 

11 (2) On January 31, 2020, the Secretary of 

12 Health and Human Services (in this title referred to 

13 as the ‘‘Secretary’’) declared a public health emer14 gency in response to COVID–19. 

15 (3) By March, the disease reached the pan16 demic level according to the World Health Organiza17 tion, and the President proclaimed the COVID–19 

18 outbreak in the United States to constitute a na19 tional emergency. 

20 (4) This emergency declaration authorizes the 

21 Secretary ‘‘to temporarily waive or modify certain 

22 requirements of the Medicare, Medicaid, and State 

23 Children’s Health Insurance programs and of the 

24 Health Insurance Portability and Accountability Act 

25 Privacy Rule throughout the duration of the public 


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1 health emergency declared in response to the 

2 COVID–19 outbreak’’. 

3 (5) Under this authority, the Secretary, and the 

4 Administrator of the Centers for Medicare & Med5 icaid Services (in this title referred to as the ‘‘Ad6 ministrator’’) acting under the Secretary’s authority, 

7 issued numerous rules, regulations, and waivers ena8 bling the expansion of telehealth services during the 

9 public health emergency. 

10 (6) Telehealth services play a critical role in en11 hancing access to care for patients while simulta12 neously reducing the risk of exposure to the corona13 virus for both patients and providers. 

14 (7) The Administrator expanded access to tele15 health services under the public health emergency to 

16 all Medicare beneficiaries (including clinician-pro17 vided services to new and established patients). 

18 (8) On April 23, 2020, the Administrator re19 leased a telehealth toolkit to assist States in expand20 ing the use of telehealth through Medicaid and 

21 CHIP. 

22 (9) Expanded telehealth options are valuable 

23 for all Americans during this public health crisis, 

24 but especially for high-risk patients and rural Ameri25 cans who already have difficulty accessing care. 


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1 SEC. 702. STUDIES AND REPORTS ON THE EXPANSION OF 

2 ACCESS TO TELEHEALTH SERVICES DURING 

3 THE COVID–19 EMERGENCY. 

4 (a) HHS.— 

5 (1) IN GENERAL.—Not later than 180 days 

6 after the date of the enactment of this Act, the Sec7 retary, in consultation with the Administrator, shall 

8 conduct a study and submit to Congress a report on 

9 actions taken by the Secretary during the emergency 

10 period described in section 1135(g)(1)(B) of the So11 cial Security Act (42 U.S.C. 1320b–5(g)(1)(B)) to 

12 expand access to telehealth services under the Medi13 care program, the Medicaid program, and the Chil14 dren’s Health Insurance program. Such report shall 

15 include the following: 

16 (A) A comprehensive list of telehealth serv17 ices available under the programs described in 

18 paragraph (1) and an explanation of all actions 

19 undertaken by the Secretary during the emer20 gency period described in such paragraph to ex21 pand access to such services. 

22 (B) A comprehensive list of types of pro23 viders that may be reimbursed for such services 

24 furnished under such programs during such pe25 riod, including a list of services which may only 

26 be reimbursed under such programs during 


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1 such period if furnished by such providers in2 person. 

3 (C) A quantitative analysis of the use of 

4 such telehealth services under such programs 

5 during such period, including data points on 

6 use by rural, minority, low-income, and elderly 

7 populations. 

8 (D) A quantitative analysis of the use of 

9 such services under such programs during such 

10 period for mental and behavioral health treat11 ments. 

12 (E) An analysis of the public health im13 pacts of the actions described in subparagraph 

14 (A). 

15 (2) PUBLICATION OF REPORT.—Not later than 

16 180 days after the date of the enactment of this Act, 

17 the Secretary shall publish on the public website of 

18 the Department of Health and Human Services the 

19 report described in paragraph (1). 

20 (b) GAO.— 

21 (1) IN GENERAL.—Not later than 210 days 

22 after the date of enactment of this Act, the Comp23 troller General of the United States shall conduct a 

24 study and submit to Congress a report on— 


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1 (A) the efficiency, management, and suc2 cess and failures of the expansion of access to 

3 telehealth services under the Medicare, Med4 icaid, and Children’s Health Insurance pro5 grams during the emergency period described in 

6 subsection (a)(1); and 

7 (B) any risk in increased fraudulent activ8 ity, and types of fraudulent activity, associated 

9 with such expansion. 

10 (2) RECOMMENDATIONS.—The report submit11 ted under paragraph (1) shall include recommenda12 tions on— 

13 (A) potential improvements to telehealth 

14 services, and expansions of such services, under 

15 the programs described in paragraph (1)(A); 

16 and 

17 (B) ways to address any fraudulent activ18 ity described in paragraph (1)(B). 


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1 TITLE VIII—TELEMEDICINE EV2 ERYWHERE LIFTING EVERY3 ONE’S HEALTHCARE EXPERI4 ENCE AND LONG TERM 

5 HEALTH HSA 

6 SEC. 801. PERMANENT EXEMPTION FOR TELEHEALTH 

7 SERVICES. 

8 (a) IN GENERAL.—Subparagraph (E) of section 

9 223(c)(2) of the Internal Revenue Code of 1986 is amend10 ed by striking ‘‘In the case of plan years beginning on 

11 or before December 31, 2021, a plan’’ and inserting ‘‘A 

12 plan’’. 

13 (b) CONFORMING AMENDMENT.—Clause (ii) of sec14 tion 223(c)(1)(B) of the Internal Revenue Code of 1986 

15 is amended by striking ‘‘(in the case of plan years begin16 ning on or before December 31, 2021)’’. 

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

18 this section shall apply to plan years beginning after De19 cember 31, 2021. 


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1 TITLE IX—TELEHEALTH RE2 SPONSE FOR E-PRESCRIBING 

3 ADDICTION THERAPY SERV4 ICES 

5 SEC. 901. TELEHEALTH FOR SUBSTANCE USE DISORDER 

6 TREATMENT. 

7 (a) SUBSTANCE USE DISORDER SERVICES FUR8 NISHED THROUGH TELEHEALTH UNDER MEDICARE.— 

9 Section 1834(m)(7) of the Social Security Act (42 U.S.C. 

10 1395m(m)(7)) is amended by adding at the end the fol11 lowing: ‘‘With respect to telehealth services described in 

12 the preceding sentence that are furnished on or after Jan13 uary 1, 2020, nothing shall preclude the furnishing of 

14 such services through audio or telephone only technologies 

15 in the case where a physician or practitioner has already 

16 conducted an in-person medical evaluation or a telehealth 

17 evaluation that utilizes both audio and visual capabilities 

18 with the eligible telehealth individual.’’. 

19 (b) CONTROLLED SUBSTANCES DISPENSED BY

20 MEANS OF THE INTERNET.—Section 309(e)(2) of the 

21 Controlled Substances Act (21 U.S.C. 829(e)(2)) is 

22 amended— 

23 (1) in subparagraph (A)(i)— 


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1 (A) by striking ‘‘at least 1 in-person med2 ical evaluation’’ and inserting the following: ‘‘at 

3 least— 

4 ‘‘(I) 1 in-person medical evalua5 tion’’; and 

6 (B) by adding at the end the following: 

7 ‘‘(II) for purposes of prescribing 

8 a controlled substance in schedule III 

9 or IV, 1 telehealth evaluation; or’’; 

10 and 

11 (2) by adding at the end the following: 

12 ‘‘(D)(i) The term ‘telehealth evaluation’ 

13 means a medical evaluation that is conducted in 

14 accordance with applicable Federal and State 

15 laws by a practitioner (other than a phar16 macist) who is at a location remote from the 

17 patient and is communicating with the patient 

18 using a telecommunications system referred to 

19 in section 1834(m) of the Social Security Act 

20 (42 U.S.C. 1395m(m)) that includes, at a min21 imum, audio and video equipment permitting 

22 two-way, real-time interactive communication 

23 between the patient and distant site practi24 tioner. 


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1 ‘‘(ii) Nothing in clause (i) shall be con2 strued to imply that 1 telehealth evaluation 

3 demonstrates that a prescription has been 

4 issued for a legitimate medical purpose within 

5 the usual course of professional practice. 

6 ‘‘(iii) A practitioner who prescribes the 

7 drugs or combination of drugs that are covered 

8 under section 303(g)(2)(C) using the authority 

9 under subparagraph (A)(i)(II) of this para10 graph shall adhere to nationally recognized evi11 dence-based guidelines for the treatment of pa12 tients with opioid use disorders and a diversion 

13 control plan, as those terms are defined in sec14 tion 8.2 of title 42, Code of Federal Regula15 tions, as in effect on the date of enactment of 

16 this subparagraph.’’. 

Æ 


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