I 

117TH CONGRESS 

1ST SESSION H. R. 1397 

To provide for strategies to increase access to telehealth under the Medicaid 

program and Children’s Health Insurance Program, and for other purposes. 

IN THE HOUSE OF REPRESENTATIVES 

FEBRUARY 26, 2021 

Ms. BLUNT ROCHESTER (for herself and Mr. BURGESS) introduced the 

following bill; which was referred to the Committee on Energy and Commerce 

A BILL 

To provide for strategies to increase access to telehealth 

under the Medicaid program and Children’s Health Insurance Program, 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 Improve5 ment for Kids’ Essential Services Act’’ or the ‘‘TIKES 

6 Act’’. 


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1 SEC. 2. STRATEGIES TO INCREASE ACCESS TO TELE2 HEALTH UNDER MEDICAID AND CHILDREN’S 

3 HEALTH INSURANCE PROGRAM. 

4 (a) GUIDANCE.—Not later than 1 year after the date 

5 of the enactment of this Act, the Secretary of Health and 

6 Human Services shall issue and disseminate guidance to 

7 States to clarify strategies to overcome existing barriers 

8 and increase access to telehealth under the Medicaid pro9 gram under title XIX of the Social Security Act (42 

10 U.S.C. 1396 et seq.) and the Children’s Health Insurance 

11 Program under title XXI of such Act (42 U.S.C. 1397aa 

12 et seq.). Such guidance shall include technical assistance 

13 and best practices regarding— 

14 (1) telehealth delivery of covered services; 

15 (2) recommended voluntary billing codes, modi16 fiers, and place-of-service designations for telehealth 

17 and other virtual health care services; 

18 (3) the simplification or alignment (including 

19 through reciprocity) of provider licensing, 

20 credentialing, and enrollment protocols with respect 

21 to telehealth across States, State Medicaid plans 

22 under such title XIX, and Medicaid managed care 

23 organizations, including during national public 

24 health emergencies; 


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1 (4) existing strategies States can use to inte2 grate telehealth and other virtual health care serv3 ices into value-based health care models; and 

4 (5) examples of States that have used waivers 

5 under the Medicaid program to test expanded access 

6 to telehealth, including during the emergency period 

7 described in section 1135(g)(1)(B) of the Social Se8 curity Act (42 U.S.C. 1320b–5(g)(1)(B)). 

9 (b) STUDIES.— 

10 (1) TELEHEALTH IMPACT ON HEALTH CARE

11 ACCESS.—Not later than 1 year after the date of the 

12 enactment of this Act, the Medicaid and CHIP Pay13 ment and Access Commission shall conduct a study, 

14 with respect to a minimum of 10 States across geo15 graphic regions of the United States, and submit to 

16 Congress a report, on the impact of telehealth on 

17 health care access, utilization, cost, and outcomes, 

18 broken down by race, ethnicity, sex, age, disability 

19 status, and zip code. Such report shall— 

20 (A) evaluate cost, access, utilization, out21 comes, and patient experience data from across 

22 the health care field, including States, Medicaid 

23 managed care organizations, provider organiza24 tions, and other organizations that provide or 


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1 pay for telehealth under the Medicaid program 

2 and Children’s Health Insurance Program; 

3 (B) identify barriers and potential solu4 tions to provider entry and participation in tele5 health that States are experiencing, as well as 

6 barriers to providing telehealth across State 

7 lines, including during times of public health 

8 crisis or public health emergency; 

9 (C) determine the frequency at which out10 of-State telehealth is provided to patients en11 rolled in the Medicaid program and the poten12 tial impact on access to telehealth if State Med13 icaid policies were more aligned; and 

14 (D) identify and evaluate opportunities for 

15 more alignment among such policies to promote 

16 access to telehealth across all States, State 

17 Medicaid plans under title XIX of the Social 

18 Security Act (42 U.S.C. 1396 et seq.), State 

19 child health plans under title XXI of such Act 

20 (42 U.S.C. 1397aa et seq.), and Medicaid man21 aged care organizations, including the potential 

22 for regional compacts or reciprocity agreements. 

23 (2) FEDERAL AGENCY TELEHEALTH COLLABO24 RATION.—Not later than 1 year after the date of the 

25 enactment of this Act, the Comptroller General of 


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1 the United States shall conduct a study and submit 

2 to Congress a report evaluating collaboration be3 tween Federal agencies with respect to telehealth 

4 services furnished under the Medicaid or CHIP pro5 gram to individuals under the age of 18, including 

6 such services furnished to such individuals in early 

7 care and education settings. Such report shall in8 clude recommendations on— 

9 (A) opportunities for Federal agencies to 

10 improve collaboration with respect to such tele11 health services; and 

12 (B) opportunities for collaboration between 

13 Federal agencies to expand telehealth access to 

14 such individuals enrolled under the Medicaid or 

15 CHIP program, including in early care and 

16 education settings. 

Æ 


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