II 

108TH CONGRESS 

2D SESSION S. 2325 

To strengthen telehealth programs. 

IN THE SENATE OF THE UNITED STATES 

APRIL 21, 2004 

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

to the Committee on Health, Education, Labor, and Pensions 

A BILL 

To strengthen telehealth programs. 

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 Act of 2004’’. 

6 SEC. 2. FINDINGS. 

7 Congress makes the following findings: 

8 (1) 36,000,000 people of the United States lack 

9 access to doctors who are willing or able to care for 

10 them. 

11 (2) Many individuals lack access to treatment 

12 because appropriate transportation is too expensive 
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1 or limited by weather factors, or because the patient 

2 involved is too sick to use the options that are avail3 able. 

4 (3) Telehealth services can improve access to 

5 quality health care and can help control skyrocketing 

6 medical costs. 

7 (4) Sophisticated audio and video telehealth 

8 services link physicians and nurses with patients for 

9 checkups and diagnoses. Those services give patients 

10 access to quality health care without having to travel 

11 to a hospital or doctor’s office, which is critical for 

12 patients in rural and underserved urban areas and 

13 for patients who have difficulty leaving their homes. 

14 (5) Telehealth services have also been pivotal in 

15 protecting lives during emergency situations, includ16 ing large-scale natural disasters. 

17 (6) The Department of Commerce found that 

18 the United States maintains a ‘‘competitive advan19 tage for exporting telehealth technologies and serv20 ices’’, yet the ‘‘international market for telehealth 

21 technologies and major projects has been largely 

22 overlooked by U.S. industry’’. A 2003 report by the 

23 Department of Commerce stated that ‘‘with effective 

24 marketing and responsiveness to sales opportunities, 
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1 American firms can also lead in world market 

2 share’’. 

3 SEC. 3. INCREASING TYPES OF ORIGINATING TELEHEALTH 

4 SITES AND FACILITATING THE PROVISION OF 

5 TELEHEALTH SERVICES ACROSS STATE 

6 LINES. 

7 (a) INCREASING TYPES OF ORIGINATING SITES.— 

8 Section 1834(m)(4)(C)(ii) of the Social Security Act (42 

9 U.S.C. 1395m(m)(4)(C)(ii)) is amended by adding at the 

10 end the following: 

11 ‘‘(VI) A skilled nursing facility 

12 (as defined in section 1819(a)). 

13 ‘‘(VII) An assisted-living facility 

14 (as defined by the Secretary). 

15 ‘‘(VIII) A board-and-care home 

16 (as defined by the Secretary). 

17 ‘‘(IX) A county or community 

18 health clinic (as defined by the Sec19 retary). 

20 ‘‘(X) A community mental health 

21 center (as described in section 

22 1861(ff)(2)(B)). 

23 ‘‘(XI) A facility operated by the 

24 Indian Health Service or by an Indian 

25 tribe, tribal organization, or an urban 
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1 Indian organization (as such terms 

2 are defined in section 4 of the Indian 

3 Health Care Improvement Act (25 

4 U.S.C. 1603)) directly, or under con5 tract or other arrangement. 

6 ‘‘(XII) A site in a State in which 

7 the respective State medical board has 

8 adopted a formal policy regarding li9 censing or certification requirements 

10 for providers at distant sites who do 

11 not have a license to practice medicine 

12 at the originating site.’’. 

13 (b) EXPANDING ELIGIBILITY FOR REIMBURSE14 MENT.—Section 1834(m)(4)(C)(i)(I) of the Social Secu15 rity Act (42 U.S.C. 1395m(m)(4)(C)(i)(I)) is amended by 

16 striking ‘‘rural’’. 

17 SEC. 4. STRENGTHENING TELEHEALTH SERVICES IN 

18 RURAL AND UNDERSERVED URBAN AMERICA. 

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

20 Service Act (42 U.S.C. 254b et seq.) is amended— 

21 (1) in section 330L— 

22 (A) by redesignating subsection (b) as sub23 section (c); and 

24 (B) by inserting after subsection (a) the 

25 following: 
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1 ‘‘(b) CONFERENCE.—Within 1 year of the date of en2 actment of the Telehealth Improvement Act of 2004, the 

3 Secretary shall convene a conference of State licensing 

4 boards, local telehealth projects, health care practitioners, 

5 and patient advocates to promote interstate licensure for 

6 telehealth projects.’’; and 

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

8 ‘‘SEC. 330M. INTEGRATIVE ELDERCARE TELEHEALTH DEM9 ONSTRATION PROJECT. 

10 ‘‘(a) PURPOSES.—The purposes of this section are to 

11 encourage the creation of programs to— 

12 ‘‘(1) evaluate the use of telehealth services in 

13 an integrative eldercare setting; 

14 ‘‘(2) eliminate fragmented service delivery while 

15 promoting enhanced continuity of care and more 

16 simplified access to services; 

17 ‘‘(3) develop community-based options that pro18 mote patient independence and leverage telehealth 

19 services and equipment to enable the use of the most 

20 cost-effective, least restrictive care settings; and 

21 ‘‘(4) promote access for elderly patients in rural 

22 and underserved urban areas to improvements in 

23 medical technology and training across an integrated 

24 spectrum of care; and to make health care services 
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1 more flexible and responsive to the diverse and chang2 ing needs of elderly patients in rural areas. 

3 ‘‘(b) GRANTS AUTHORIZED— 

4 ‘‘(1) IN GENERAL.—The Director may award 

5 grants to eligible providers for projects to dem6 onstrate how telehealth technologies can be used 

7 through telehealth networks in rural areas, frontier 

8 communities, and medically underserved areas, and 

9 for medically underserved populations, to— 

10 ‘‘(A) expand access to, coordinate, and im11 prove the quality of health care services; 

12 ‘‘(B) improve and expand the training of 

13 health care providers; and 

14 ‘‘(C) expand and improve the quality of 

15 health information available to health care pro16 viders, and patients and their families, for deci17 sionmaking. 

18 ‘‘(2) GRANT PERIOD.—The Director shall 

19 award grants under this subsection for a period of 

20 up to 4 years. 

21 ‘‘(3) NUMBER OF GRANTS.—Not to exceed 20 

22 grants shall be awarded under this subsection, of 

which at least 1 23 ⁄2 shall be dedicated to providing 

24 services in rural communities. 
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1 ‘‘(c) USE OF FUNDS.—Grants awarded pursuant to 

2 subsection (b) may be used for activities including— 

3 ‘‘(1) improving access to coordinated health 

4 care services at the lowest intensity and resource 

5 level of care consistent with quality health care serv6 ices and optimal patient outcomes, improving the 

7 quality of such care, increasing patient satisfaction 

8 with such care, and reducing the cost of such care 

9 through advanced telecommunication technologies; 

10 ‘‘(2) developing effective care management 

11 practices and educational curricula to train health 

12 care professionals, paraprofessionals, and caregivers, 

13 including family members, and to increase the gen14 eral level of competency of such individuals through 

15 such training; and 

16 ‘‘(3) developing curricula to train health care 

17 professionals, paraprofessionals, and caregivers, in18 cluding family members, serving integrative 

19 eldercare patients in the use of telecommunications. 

20 ‘‘(d) APPLICATIONS.—To be eligible to receive a 

21 grant under subsection (b), an eligible provider, in con22 sultation with the appropriate State office of rural health 

23 or another appropriate State entity, shall prepare and sub24 mit to the Director an application, at such time, in such 
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1 manner, and containing such information as the Director 

2 may require, including— 

3 ‘‘(1) a description of the project that the eligi4 ble entity will carry out using the funds provided 

5 under the grant; 

6 ‘‘(2) a description of the manner in which the 

7 project funded under the grant will meet the health 

8 care needs of rural or other populations to be served 

9 through the project, or improve the access to serv10 ices of, and the quality of the services received by, 

11 those populations; 

12 ‘‘(3) evidence of local support for the project, 

13 and a description of how the areas, communities, or 

14 populations to be served will be involved in the devel15 opment and ongoing operations of the project; 

16 ‘‘(4) a plan for sustaining the project after Fed17 eral support for the project has ended; 

18 ‘‘(5) information on the source and amount of 

19 non-Federal funds that the entity will provide for 

20 the project; 

21 ‘‘(6) information demonstrating the long-term 

22 viability of the project, and other evidence of institu23 tional commitment of the entity to the project; 

24 ‘‘(7) in the case of an application for a project 

25 involving a telehealth network, information dem-
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1 onstrating how the project will promote the integra2 tion of telehealth technologies into the operations of 

3 health care providers, to avoid redundancy, and im4 prove access to and the quality of care; and 

5 ‘‘(8) other such information as the Director de6 termines to be appropriate. 

7 ‘‘(e) REPORT.— 

8 ‘‘(1) FINAL REPORT.—Not later than 9 months 

9 after the date of termination of the last grant to be 

10 awarded under this section, the Director shall sub11 mit to Congress a final report— 

12 ‘‘(A) describing the results of the programs 

13 funded by grants awarded pursuant to this sec14 tion; and 

15 ‘‘(B) evaluating the impact of the use of 

16 telehealth services in an integrative eldercare 

17 setting on— 

18 ‘‘(i) access to care for patients served 

19 by integrative eldercare programs; and 

20 ‘‘(ii) the quality of, patient satisfac21 tion with, and the cost of, such care. 

22 ‘‘(2) ENSURING ACCESS TO QUALITY CARE.—In 

23 conducting the evaluation under paragraph (1)(B), 

24 the Director shall— 
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1 ‘‘(A) give special consideration to the im2 pact of programs funded under this section on 

3 face-to-face access to medical providers; and 

4 ‘‘(B) develop specific measures to evaluate 

5 the quality of care provided to those partici6 pating in such programs to ensure that tele7 health augments the plan of care. 

8 ‘‘(f) ELIGIBLE PROVIDER.—The term ‘eligible pro9 vider’ means a consortia of home and facility-based care 

10 providers that includes providers from no less than 2 of 

11 the following: 

12 ‘‘(1) An adult congregate care facility. 

13 ‘‘(2) A continuing care retirement community. 

14 ‘‘(3) An assisted living facility. 

15 ‘‘(4) An Alzheimer’s facility. 

16 ‘‘(5) An institutional hospice facility. 

17 ‘‘(6) A residential care facility. 

18 ‘‘(7) An adult foster home. 

19 ‘‘(8) A State-licensed nursing home, including a 

20 skilled nursing facility, an intermediate care facility, 

21 licensed home health provider or other health care 

22 provider that the Director deems appropriate and 

23 consistent with the purposes of this section. 

24 ‘‘(g) DEFINITIONS.—In this section: 
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1 ‘‘(1) DIRECTOR; OFFICE.—The terms ‘Director’ 

2 and ‘Office’ mean the Director of the Office for the 

3 Advancement of Telehealth and the Office for the 

4 Advancement of Telehealth. 

5 ‘‘(2) INTEGRATIVE ELDERCARE.—The term ‘in6 tegrative eldercare’ includes case management and 

7 coordination of care for elderly patients recovering 

8 from acute illness or coping with chronic disease at 

9 the lowest intensity and resource level of care con10 sistent with quality health care services and optimal 

11 patient outcomes. 

12 ‘‘(3) TELEHEALTH SERVICES.—The term ‘tele13 health services’ means services provided through 

14 telehealth technologies. 

15 ‘‘(4) TELEHEALTH TECHNOLOGIES.—The term 

16 ‘telehealth technologies’ means technologies relating 

17 to the use of electronic information, and tele18 communications technologies, to support and pro19 mote, at a distance, health care, patient and profes20 sional health-related education, health administra21 tion, and public health. 

22 ‘‘(h) AUTHORIZATION OF APPROPRIATIONS.—There 

23 are authorized to be appropriated to the Office for the Ad24 vancement of Telehealth to carry out this section 
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1 $30,000,000 for fiscal year 2005 and such sums as may 

2 be necessary for each of fiscal years 2006 through 2008. 

3 ‘‘SEC. 330N. AMERICAN INDIAN AND ALASKA NATIVE TELE4 HEALTH DEMONSTRATION PROJECT. 

5 ‘‘(a) PURPOSE.—The purpose of this section is to 

6 evaluate the use of telehealth services in areas under the 

7 jurisdiction of Indian tribes or tribal organizations, includ8 ing efforts to develop more effective case management for 

9 chronic and acute disease and preventive health care pro10 grams. 

11 ‘‘(b) GRANTS AUTHORIZED.— 

12 ‘‘(1) IN GENERAL.—The Director may award 

13 grants to eligible providers, individually or as part of 

14 a network of eligible providers, for the provision of 

15 telehealth services to improve patient care, prevent 

16 health care complications, improve patient outcomes, 

17 and achieve efficiencies in the delivery of care to pa18 tients who reside in areas under the jurisdiction of 

19 Indian tribes or tribal organizations. 

20 ‘‘(2) GRANT PERIOD.—The Director shall 

21 award grants under this section for a period of up 

22 to 4 years. 

23 ‘‘(3) NUMBER OF GRANTS.—Not to exceed 20 

24 grants shall be awarded under this section, of which 
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at least 1 1 ⁄2 shall be dedicated to providing services 

2 in rural communities. 

3 ‘‘(c) USE OF FUNDS.—Grants awarded under this 

4 section may be used for activities including— 

5 ‘‘(1) improving access to care for home care pa6 tients served by eligible providers, improving the 

7 quality of such care, increasing patient satisfaction 

8 with such care, and reducing the cost of such care 

9 through advanced telecommunication technologies; 

10 ‘‘(2) developing effective telehealth management 

11 practices and educational curricula to train health 

12 professionals and paraprofessionals and increase 

13 their general level of competency through such train14 ing; and 

15 ‘‘(3) developing curricula to train health care 

16 professionals and paraprofessionals serving patients 

17 of eligible providers in the use of telecommuni18 cations. 

19 ‘‘(d) COLLABORATION.—The Director shall ensure 

20 that eligible providers receiving grants under this section 

21 collaborate to enable comparisons across programs and to 

22 share relevant, de-identified information to better facili23 tate program performance evaluation. 

24 ‘‘(e) APPLICATIONS.—To be eligible to receive a grant 

25 under subsection (b), an eligible entity, in consultation 
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1 with the appropriate State office of rural health or another 

2 appropriate State entity, shall prepare and submit to the 

3 Director an application, at such time, in such manner, and 

4 containing such information as the Director may require, 

5 including— 

6 ‘‘(1) a description of the project that the eligi7 ble entity will carry out using the funds provided 

8 under the grant; 

9 ‘‘(2) a description of the manner in which the 

10 project funded under the grant will meet the health 

11 care needs of rural or other populations to be served 

12 through the project, or improve the access to serv13 ices of, and the quality of the services received by, 

14 those populations; 

15 ‘‘(3) evidence of local support for the project, 

16 and a description of how the areas, communities, or 

17 populations to be served will be involved in the devel18 opment and ongoing operations of the project; 

19 ‘‘(4) a plan for sustaining the project after Fed20 eral support for the project has ended; 

21 ‘‘(5) information on the source and amount of 

22 non-Federal funds that the entity will provide for 

23 the project; 
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1 ‘‘(6) information demonstrating the long-term 

2 viability of the project, and other evidence of institu3 tional commitment of the entity to the project; 

4 ‘‘(7) in the case of an application for a project 

5 involving a telehealth network, information dem6 onstrating how the project will promote the integra7 tion of telehealth technologies into the operations of 

8 health care providers, to avoid redundancy, and im9 prove access to and the quality of care; and 

10 ‘‘(8) other such information as the Director de11 termines to be appropriate. 

12 ‘‘(f) REPORT.— 

13 ‘‘(1) FINAL REPORT.—Not later than 9 months 

14 after the date of termination of the last grant to be 

15 awarded under this section, the Director shall sub16 mit to Congress a final report— 

17 ‘‘(A) describing the results of the programs 

18 funded by grants awarded pursuant to this sec19 tion; and 

20 ‘‘(B) evaluating the impact of telehealth 

21 services in an institutional long-term care set22 ting on— 

23 ‘‘(i) access to care for patients of eli24 gible providers; and 
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1 ‘‘(ii) the quality of, patient satisfac2 tion with, and the cost of, such care. 

3 ‘‘(2) ENSURING ACCESS TO QUALITY CARE.—In 

4 conducting the evaluation under paragraph (1)(B), 

5 the Director shall— 

6 ‘‘(A) give special consideration to the im7 pact of programs funded under this section on 

8 face-to-face access to medical providers; and 

9 ‘‘(B) develop specific measures to evaluate 

10 the quality of care provided to those partici11 pating in such programs to ensure that tele12 medicine augments the plan of care. 

13 ‘‘(g) DEFINITIONS.—In this section: 

14 ‘‘(1) DIRECTOR; OFFICE.—The terms ‘Director’ 

15 and ‘Office’ mean the Director of the Office for the 

16 Advancement of Telehealth and the Office for the 

17 Advancement of Telehealth. 

18 ‘‘(2) ELIGIBLE PROVIDER.—The term ‘eligible 

19 provider’ includes any public or private nonprofit 

20 health care provider a majority of whose patient 

21 practice is Native American or any Indian tribe or 

22 tribal organization that provides health care services 

23 for its members. 

24 ‘‘(3) INDIAN TRIBE.—The term ‘Indian tribe’ 

25 has the meaning given such term in section 4 of the 
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1 Indian Self-Determination and Education Assistance 

2 Act (25 U.S.C. 450b). 

3 ‘‘(4) NATIVE AMERICAN.—The term ‘Native 

4 American’ means a member of an Indian tribe, a 

5 Native Hawaiian (as defined in section 338K(c)), or 

6 a Native American Pacific Islander. 

7 ‘‘(5) NATIVE AMERICAN PACIFIC ISLANDER.— 

8 The term ‘Native American Pacific Islander’ means 

9 an individual who is indigenous to a United States 

10 territory or possession located in the Pacific Ocean. 

11 ‘‘(6) TRIBAL ORGANIZATION.—The term ‘‘tribal 

12 organization’’ has the meaning given such term in 

13 section 4 of the Indian Self-Determination and Edu14 cation Assistance Act (25 U.S.C. 450b). 

15 ‘‘(h) AUTHORIZATION OF APPROPRIATIONS.—There 

16 are authorized to be appropriated to carry out this section 

17 $30,000,000 for fiscal year 2005 and such sums as may 

18 be necessary for each of fiscal years 2006 through 2008. 

19 ‘‘SEC. 330O. ORAL HEALTH TELEHEALTH DEMONSTRATION 

20 PROJECT. 

21 ‘‘(a) PURPOSE.—The purpose of this section is to 

22 evaluate the use of telehealth services to expand access 

23 to oral health services and improve oral health outcomes 

24 among rural and underserved urban patients. 

25 ‘‘(b) GRANTS AUTHORIZED.— 
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1 ‘‘(1) IN GENERAL.—The Director is authorized 

2 to award competitive grants to eligible providers, in3 dividually or as part of a network of eligible pro4 viders, for the provision of oral health services to im5 prove patient care, prevent health care complica6 tions, improve patient outcomes, and achieve effi7 ciencies in the delivery of oral health care to patients 

8 who reside in rural areas. 

9 ‘‘(2) GRANT PERIOD.—The Director shall 

10 award grants under this section for a period of up 

11 to 4 years. 

12 ‘‘(3) NUMBER OF GRANTS.—The number of 

13 grants awarded under this section shall not exceed 

14 10 grants. 

15 ‘‘(c) USE OF FUNDS.—Grants awarded pursuant to 

16 subsection (b) may be used for activities including— 

17 ‘‘(1) improving access to care for rural and un18 derserved urban patients served by eligible providers, 

19 improving the quality of that care, increasing patient 

20 satisfaction with that care, and reducing the cost of 

21 that care through advanced telecommunication tech22 nologies; 

23 ‘‘(2) developing effective oral telehealth care 

24 management practices and educational curricula to 

25 train oral health professionals and paraprofessionals 
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1 and increase their general level of competency 

2 through that training; and 

3 ‘‘(3) developing curricula to train health care 

4 professionals and paraprofessionals, serving rural 

5 and underserved urban patients in the use of tele6 communications. 

7 ‘‘(d) APPLICATIONS.—To be eligible to receive a 

8 grant under subsection (b), an eligible entity, in consulta9 tion with the appropriate State office of rural health or 

10 another appropriate State entity, shall prepare and submit 

11 to the Director an application, at such time, in such man12 ner, and containing such information as the Director may 

13 require, including— 

14 ‘‘(1) a description of the project that the eligi15 ble entity will carry out using the funds provided 

16 under the grant; 

17 ‘‘(2) a description of the manner in which the 

18 project funded under the grant will meet the health 

19 care needs of rural or other populations to be served 

20 through the project, or improve the access to serv21 ices of, and the quality of the services received by, 

22 those populations; 

23 ‘‘(3) evidence of local support for the project, 

24 and a description of how the areas, communities, or 
20 

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1 populations to be served will be involved in the devel2 opment and ongoing operations of the project; 

3 ‘‘(4) a plan for sustaining the project after Fed4 eral support for the project has ended; 

5 ‘‘(5) information on the source and amount of 

6 non-Federal funds that the entity will provide for 

7 the project; 

8 ‘‘(6) information demonstrating the long-term 

9 viability of the project, and other evidence of institu10 tional commitment of the entity to the project; 

11 ‘‘(7) in the case of an application for a project 

12 involving a telehealth network, information dem13 onstrating how the project will promote the integra14 tion of telehealth technologies into the operations of 

15 health care providers, to avoid redundancy, and im16 prove access to and the quality of care; and 

17 ‘‘(8) other such information as the Director de18 termines to be appropriate. 

19 ‘‘(e) REPORT.— 

20 ‘‘(1) FINAL REPORT.—Not later than 9 months 

21 after the date of termination of the last grant to be 

22 awarded under this section, the Director shall sub23 mit to Congress a final report— 
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1 ‘‘(A) describing the results of the programs 

2 funded by grants awarded pursuant to this sec3 tion; and 

4 ‘‘(B) including an evaluation of the impact 

5 of the use of oral telehealth services on— 

6 ‘‘(i) access to oral health care for 

7 rural patients; and 

8 ‘‘(ii) the quality of, patient satisfac9 tion with, and the cost of, that care. 

10 ‘‘(2) ENSURING ACCESS TO QUALITY CARE.—In 

11 conducting the evaluation under paragraph (1)(B), 

12 the Director shall— 

13 ‘‘(A) give special consideration to the im14 pact of programs funded under this section on 

15 face-to-face access to medical providers; and 

16 ‘‘(B) develop specific measures to evaluate 

17 the quality of care provided to those partici18 pating in such programs to ensure that tele19 medicine augments the plan of care. 

20 ‘‘(f) DEFINITION OF ELIGIBLE PROVIDER.—In this 

21 section the term ‘eligible provider’ includes dentists, 

22 periodontists, orthodontists, dental and oral health clinics, 

23 and schools of dentistry and oral health, where a majority 

24 of the patient population resides in a rural area, and may 
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1 include other rural oral health providers that the Director 

2 deems appropriate. 

3 ‘‘(g) AUTHORIZATION OF APPROPRIATIONS.—There 

4 are authorized to be appropriated to carry out this section 

5 $30,000,000 for fiscal year 2005 and such sums as may 

6 be necessary for each of fiscal years 2006 through 2008.’’. 

7 SEC. 5. JOINT WORKING GROUP ON TELEHEALTH. 

8 (a) IN GENERAL.— 

9 (1) REPRESENTATION OF RURAL AREAS.—The 

10 Secretary of Health and Human Services shall es11 tablish, within the Health Resources and Services 

12 Administration Office for the Advancement of Tele13 health, and under the leadership of the Director of 

14 the Office for the Advancement of Telehealth, a 

15 Joint Working Group on Telehealth. In establishing 

16 such Group, the Secretary shall ensure that all rel17 evant Federal agencies are represented and that 

18 input from relevant industry groups, including rep19 resentatives of rural areas and medically under20 served areas, is fully considered. 

21 (2) MISSION.—The mission of the Joint Work22 ing Group on Telehealth is— 

23 (A) to identify, monitor, and coordinate 

24 Federal telehealth projects, data sets, and pro25 grams; 
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1 (B) to analyze— 

2 (i) how telehealth systems are expand3 ing access to health care services, edu4 cation, and information; 

5 (ii) the clinical, educational, or admin6 istrative efficacy and cost-effectiveness of 

7 telehealth applications; and 

8 (iii) the quality of the telehealth serv9 ices delivered; and 

10 (C) to make further recommendations for 

11 coordinating Federal and State efforts to in12 crease access to health services, education, and 

13 information in rural and medically underserved 

14 areas. 

15 (3) ANNUAL REPORTS.—Not later than 2 years 

16 after the date of enactment of this Act, and each 

17 January 1 thereafter, the Joint Working Group on 

18 Telehealth shall submit to Congress a report on the 

19 status of the Group’s mission and the state of the 

20 telehealth field generally. 

21 (b) REPORT SPECIFICS.—The annual report required 

22 under subsection (a)(3) shall provide— 

23 (1) an analysis of— 

24 (A) the matters described in subsection 

25 (a)(2)(B); 
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1 (B) Federal activities with respect to tele2 health; and 

3 (C) the process of the Joint Working 

4 Group on Telehealth’s efforts to coordinate 

5 Federal telehealth programs; and 

6 (2) recommendations for a coordinated Federal 

7 strategy to increase health care access through tele8 health. 

9 (c) AUTHORIZATION OF APPROPRIATIONS.—There 

10 are authorized to be appropriated such sums as may be 

11 necessary to enable the Joint Working Group on Tele12 health to carry out this section. 

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