I 

117TH CONGRESS 

1ST SESSION H. R. 341 

To make permanent certain telehealth flexibilities established in response 

to COVID–19. 

IN THE HOUSE OF REPRESENTATIVES 

JANUARY 15, 2021 

Mr. WILLIAMS of Texas introduced the following bill; which was referred to 

the Committee on Ways and Means, and in addition to the Committee 

on Energy and Commerce, 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 make permanent certain telehealth flexibilities established 

in response to COVID–19. 

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 ‘‘Ensuring Telehealth 

5 Expansion Act of 2021’’. 

6 SEC. 2. MAKING PERMANENT CERTAIN TELEHEALTH 

7 FLEXIBILITIES ESTABLISHED IN RESPONSE 

8 TO COVID–19. 

9 (a) EXEMPTION FOR TELEHEALTH SERVICES.— 


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1 (1) IN GENERAL.—Subparagraph (E) of section 

2 223(c)(2) of the Internal Revenue Code of 1986 is 

3 amended by striking ‘‘In the case of plan years be4 ginning on or before December 31, 2021, a plan’’ 

5 and inserting ‘‘A plan’’. 

6 (2) CERTAIN COVERAGE DISREGARDED.— 

7 Clause (ii) of section 223(c)(1)(B) of the Internal 

8 Revenue Code of 1986 is amended by striking ‘‘(in 

9 the case of plan years beginning on or before De10 cember 31, 2021)’’. 

11 (b) INCREASING MEDICARE TELEHEALTH FLEXI12 BILITIES.—Section 1834(m) of the Social Security Act 

13 (42 U.S.C. 1395m(m)) is amended by adding at the end 

14 the following new paragraph: 

15 ‘‘(9) WAIVER AUTHORITY.—The Secretary may 

16 waive any requirement of this subsection if deter17 mined appropriate by the Secretary.’’. 

18 (c) ENHANCING MEDICARE TELEHEALTH SERVICES

19 FOR FEDERALLY QUALIFIED HEALTH CENTERS AND

20 RURAL HEALTH CLINICS; ELIMINATING SPECIAL PAY21 MENT RULE FOR SUCH SERVICES.— 

22 (1) IN GENERAL.—Paragraph (8) of section 

23 1834(m) of the Social Security Act (42 U.S.C. 

24 1395m(m)) is amended to read as follows: 


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1 ‘‘(8) ENHANCING TELEHEALTH SERVICES FOR

2 FEDERALLY QUALIFIED HEALTH CENTERS AND

3 RURAL HEALTH CLINICS.— 

4 ‘‘(A) IN GENERAL.—With respect to serv5 ices furnished on or after the first day of the 

6 emergency period described in section 

7 1135(g)(1)(B), the Secretary shall pay for tele8 health services that are furnished via a tele9 communications system by a Federally qualified 

10 health center or a rural health clinic to an eligi11 ble telehealth individual enrolled under this part 

12 notwithstanding that the Federally qualified 

13 health center or rural clinic providing the tele14 health service is not at the same location as the 

15 beneficiary. 

16 ‘‘(B) PAYMENT.— 

17 ‘‘(i) IN GENERAL.—A telehealth serv18 ice furnished by a rural health clinic or a 

19 Federally qualified health center serving as 

20 a distant site to an individual shall be 

21 deemed to be so furnished to such indi22 vidual as an outpatient of such clinic or 

23 center (as applicable) for purposes of sec24 tion 1861(aa) and payable as a rural 

25 health clinic service or Federally qualified 


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1 health center service (as applicable) under 

2 section 1833(a)(3) or under the prospec3 tive payment system established under sec4 tion 1834(o) (as applicable). 

5 ‘‘(ii) TREATMENT OF COSTS FOR

6 FQHC PPS CALCULATIONS AND RHC AIR

7 CALCULATIONS.—Costs associated with the 

8 delivery of telehealth services by a Feder9 ally qualified health center or rural health 

10 clinic serving as a distant site pursuant to 

11 this paragraph shall be considered allow12 able costs for purposes of the prospective 

13 payment system established under section 

14 1834(o) and any payment methodologies 

15 developed under section 1833(a)(3), as ap16 plicable. 

17 ‘‘(C) DEFINITIONS.—For purposes of this 

18 subsection— 

19 ‘‘(i) the term ‘distant site’ includes a 

20 Federally qualified health center or rural 

21 health clinic that furnishes a telehealth 

22 service to an eligible telehealth individual; 

23 and 

24 ‘‘(ii) the term ‘telehealth services’ in25 cludes a rural health clinic service or FedVerDate Sep 11 2014 18:57 Feb 08, 2021 Jkt 019200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\H341.IH H341

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1 erally qualified health center service that is 

2 furnished using telehealth to the extent 

3 that payment codes corresponding to serv4 ices identified by the Secretary under 

5 clause (i) or (ii) of paragraph (4)(F) are 

6 listed on the corresponding claim for such 

7 rural health clinic service or Federally 

8 qualified health center service.’’. 

9 (2) CONFORMING AMENDMENT.—Section 

10 1834(m)(2)(A) of the Social Security Act (42 U.S.C. 

11 1395m(m)(2)(A)) is amended by striking ‘‘Subject 

12 to paragraph (8), the’’ and inserting ‘‘The’’. 

13 (3) EFFECTIVE DATE.—The amendments made 

14 by this subsection shall take effect as if included in 

15 the enactment of the CARES Act (Public Law 116– 

16 136). 

17 (d) WAIVER OF REQUIREMENTS FOR FACE-TO-FACE

18 VISITS BETWEEN HOME DIALYSIS PATIENTS AND PHYSI19 CIANS.—Section 1881(b)(3)(B)(iii) of the Social Security 

20 Act (42 U.S.C. 1395rr(b)(3)(B)(iii)) is amended by strik21 ing ‘‘during the emergency period described in section 

22 1135(g)(1)(B)’’ and inserting ‘‘during any period begin23 ning on or after the first day of the emergency period de24 scribed in section 1135(g)(1)(B)’’. 


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1 (e) USE OF TELEHEALTH TO CONDUCT FACE-TO2 FACE ENCOUNTER PRIOR TO RECERTIFICATION OF ELI3 GIBILITY FOR HOSPICE CARE.—Section 

4 1814(a)(7)(D)(i)(II) of the Social Security Act (42 U.S.C. 

5 1395f(a)(7(D)(i)(II)) is amended by striking ‘‘during the 

6 emergency period described in section 1135(g)(1)(B)’’ and 

7 inserting ‘‘during any period beginning on or after the 

8 first day of the emergency period described in section 

9 1135(g)(1)(B)’’. 

10 (f) ENCOURAGING USE OF TELECOMMUNICATIONS

11 SYSTEMS FOR HOME HEALTH SERVICES.—Section 3707 

12 of the CARES Act (Public Law 116–136) is amended by 

13 striking ‘‘during the emergency period described in section 

14 1135(g)(1)(B) of such Act (42 U.S.C. 1320b– 

15 5(g)(1)(B))’’ and inserting ‘‘on or after the first day of 

16 the emergency period described in section 1135(g)(1)(B) 

17 of such Act (42 U.S.C. 1320b–5(g)(1)(B))’’. 

18 SEC. 3. NONAPPLICATION OF ORIGINATING SITE REQUIRE19 MENTS WITH RESPECT TO TELEHEALTH 

20 SERVICES UNDER MEDICARE PROGRAM. 

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

22 U.S.C. 1395m(m)(4)(C)) is amended— 

23 (1) in clause (i), by inserting before ‘‘para24 graphs (5), (6), and (7)’’ the following: ‘‘clause (iii) 

25 and’’; and 


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

2 clause: 

3 ‘‘(iii) NONAPPLICATION OF ORIGI4 NATING SITE REQUIREMENTS.—Beginning 

5 on the first day of the emergency period 

6 described in section 1135(g)(1)(B), the 

7 term ‘originating site’ means any site at 

8 which the eligible telehealth individual is 

9 located at the time the service is furnished 

10 via a telecommunications system.’’. 

11 SEC. 4. REPORT BY COMPTROLLER GENERAL. 

12 Not later than 5 years after the date of the enact13 ment of this Act, the Comptroller General of the United 

14 States shall submit to Congress a report on the successes 

15 and limitations of implementing the statutory provisions 

16 amended by sections 2 and 3, including— 

17 (1) details of any savings or costs to the Fed18 eral Government that are attributable to the imple19 mentation of such provisions; and 

20 (2) an analysis of how the implementation of 

21 such provisions have impacted rural hospitals. 

Æ 


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