I 

117TH CONGRESS 

1ST SESSION H. R. 366 

To amend title XI of the Social Security Act to authorize the Secretary 

of Health and Human Services to waive or modify application of Medicare requirements with respect to telehealth services during any emergency period, and for other purposes. 

IN THE HOUSE OF REPRESENTATIVES 

JANUARY 19, 2021 

Mr. THOMPSON of California (for himself, Ms. MATSUI, Mr. SCHWEIKERT, 

Mr. JOHNSON of Ohio, Mr. CURTIS, and Mr. WELCH) introduced the following bill; which was referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, 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 amend title XI of the Social Security Act to authorize 

the Secretary of Health and Human Services to waive 

or modify application of Medicare requirements with respect to telehealth services during any emergency period, 

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 ‘‘Protecting Access to 

5 Post-COVID–19 Telehealth Act of 2021’’. 


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1 SEC. 2. AUTHORIZATION FOR THE SECRETARY OF HEALTH 

2 AND HUMAN SERVICES TO WAIVE OR MODIFY 

3 APPLICATION OF MEDICARE REQUIREMENTS 

4 WITH RESPECT TO TELEHEALTH SERVICES. 

5 (a) SECRETARIAL AUTHORITY TO TEMPORARILY

6 WAIVE OR MODIFY MEDICARE REQUIREMENTS WITH RE7 SPECT TO TELEHEALTH SERVICES FURNISHED DURING

8 ANY EMERGENCY PERIOD.—Section 1135 of the Social 

9 Security Act (42 U.S.C. 1320b–5) is amended by adding 

10 at the end the following new subsection: 

11 ‘‘(h) WAIVER OR MODIFICATION OF CERTAIN RE12 QUIREMENTS WITH RESPECT TO TELEHEALTH SERV13 ICES.— 

14 ‘‘(1) IN GENERAL.—Notwithstanding any other 

15 provision of this section, during the period described 

16 paragraph (2), the Secretary may waive or modify 

17 any requirement with respect to a telehealth service 

18 payable under section 1834(m)(1) for such period. 

19 ‘‘(2) PERIOD DESCRIBED.—For purposes of 

20 paragraph (1), the period described in this para21 graph is the period— 

22 ‘‘(A) beginning on the first day of— 

23 ‘‘(i) an emergency or disaster declared 

24 by the President pursuant to the National 

25 Emergencies Act or the Robert T. Stafford 


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1 Disaster Relief and Emergency Assistance 

2 Act; or 

3 ‘‘(ii) a public health emergency de4 clared by the Secretary pursuant to section 

5 319 of the Public Health Service Act; and 

6 ‘‘(B) ending on the day that is 90 days 

7 after the last day of an emergency, disaster, or 

8 public health emergency described in subpara9 graph (A).’’. 

10 (b) REPORT.— 

11 (1) DEFINITIONS.—In this subsection: 

12 (A) COVID–19 PUBLIC HEALTH EMER13 GENCY.—The term ‘‘COVID–19 public health 

14 emergency’’ means the outbreak and public 

15 health response pertaining to Coronavirus Dis16 ease 2019 (COVID–19), associated with the 

17 emergency declared by the Secretary on Janu18 ary 31, 2020, under section 319 of the Public 

19 Health Service Act (42 U.S.C. 247d), and any 

20 renewals thereof and any subsequent declara21 tions by the Secretary related to COVID–19. 

22 (B) SECRETARY.—The term ‘‘Secretary’’ 

23 means the Secretary of Health and Human 

24 Services. 


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1 (2) DATA COLLECTION AND REPORTS ON THE

2 USE OF TELEHEALTH DURING THE COVID–19 PUB3 LIC HEALTH EMERGENCY.— 

4 (A) DATA COLLECTION AND ANALYSIS.— 

5 (i) IN GENERAL.—Beginning not later 

6 than 30 days after the date of enactment 

7 of this Act, the Secretary shall collect and 

8 analyze qualitative and quantitative data 

9 on the impact of telehealth services, virtual 

10 check-ins, digital health, and remote pa11 tient monitoring technologies on health 

12 care delivery permitted by the waiver or 

13 modification of certain requirements under 

14 titles XVIII of the Social Security Act (42 

15 U.S.C. 1395 et seq.), and any regulations 

16 thereunder, pursuant to section 1135 of 

17 such Act (42 U.S.C. 1320b–5) during the 

18 COVID–19 public health emergency, which 

19 may include the collection of data regard20 ing— 

21 (I) health care utilization rates 

22 across the Medicare program under 

23 title XVIII of the Social Security Act 

24 (42 U.S.C. 1395 et seq.) for individ25 uals confirmed or suspected to have 


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1 COVID–19 and individuals seeking 

2 care unrelated to COVID–19, includ3 ing— 

4 (aa) patient access to tele5 health services in medically un6 derserved communities; or 

7 (bb) individuals receiving 

8 telehealth services through feder9 ally qualified health centers (as 

10 defined in section 1861(aa)(4) of 

11 the Social Security Act (42 

12 U.S.C. 1395x(aa)(4)) or rural 

13 health clinics (as defined in sec14 tion 1861(aa)(2) of such Act (42 

15 U.S.C. 1395x(aa)(2))) serving as 

16 originating sites or distant sites, 

17 and any challenges for providers 

18 furnishing telehealth services in 

19 these communities; 

20 (II) health care quality for indi21 viduals confirmed or suspected to have 

22 COVID–19 and individuals seeking 

23 care unrelated to COVID–19 as meas24 ured by— 


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1 (aa) quality of care metrics, 

2 such as hospital readmission 

3 rates, missed appointment rates, 

4 or wellness visits, and 

5 (bb) engagement metrics, 

6 such as voluntary patient satis7 faction surveys and voluntary 

8 provider satisfaction surveys; 

9 (III) audio-only telehealth utiliza10 tion rates when other video-based tele11 health was not an option or any other 

12 telehealth services that were not pro13 vided in real-time (including text-mes14 saging or through online chat plat15 forms), the types of visits, and the 

16 types of providers treating individuals; 

17 (IV) telehealth utilization rates 

18 used to treat individuals across State 

19 lines; 

20 (V) the health outcomes of any 

21 individual who utilizes telehealth serv22 ices to treat an underlying health con23 dition such as diabetes, end-stage 

24 renal disease, chronic lung disease, 

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1 nary artery disease, or cirrhosis and 

2 the types of technology utilized to re3 ceive care, including text-messaging, 

4 online chat platforms, audio-only, or 

5 video conferencing; 

6 (VI) the health outcomes of any 

7 individual who utilizes mental health 

8 care and substance use disorder treat9 ment services, and the types of tech10 nology utilized to receive care, includ11 ing text-messaging, online chat plat12 forms, audio-only, or video confer13 encing; 

14 (VII) the impact of State and 

15 Federal privacy and security protec16 tions on the delivery of care and pa17 tient safety, including the security of 

18 the various technologies utilized to de19 liver or receive telehealth care; 

20 (VIII) how telehealth access dif21 fers by race, ethnicity, or income lev22 els; 

23 (IX) the types of technologies 

24 utilized to deliver or receive telehealth 

25 care, including Zoom, Skype, 


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1 FaceTime, text messaging, online chat 

2 platforms, or other technologies, as 

3 observed by the Secretary, and utiliza4 tion rates, disaggregated by type of 

5 technology (as applicable); 

6 (X) the investments necessary for 

7 providers to develop a platform to ef8 fectively provide telehealth services to 

9 their patients, including the costs of 

10 the necessary technology and the costs 

11 of training staff; and 

12 (XI) any additional information 

13 determined appropriate by the Sec14 retary. 

15 (ii) BROADBAND AVAILABILITY

16 DATA.—Upon request by the Secretary, the 

17 Assistant Secretary of Commerce for Com18 munications and Information and the Fed19 eral Communications Commission shall 

20 provide the Secretary any relevant data re21 garding the availability of broadband inter22 net access service (as defined in section 

23 801 of the Communications Act of 1934 

24 (47 U.S.C. 641)) for the purposes of com25 pleting the report under clause (i). 


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1 (B) INTERIM REPORT TO CONGRESS.—Not 

2 later than 90 days after the date of enactment 

3 of this Act, the Secretary shall submit to the 

4 Committees on Finance and Health, Education, 

5 Labor, and Pensions of the Senate and the 

6 Committees on Ways and Means and Energy 

7 and Commerce of the House of Representatives 

8 an interim report on the impact of telehealth 

9 based on the data collected and analyzed under 

10 subparagraph (A). For the purposes of the in11 terim report, the Secretary may determine 

12 which data collected and analyzed under sub13 paragraph (A) is most appropriate to complete 

14 such report. 

15 (C) FINAL REPORT TO CONGRESS.—Not 

16 later than 180 days after the date of enactment 

17 of this Act, the Secretary shall submit to the 

18 Committees on Finance and Health, Education, 

19 Labor, and Pensions of the Senate and the 

20 Committees on Ways and Means and Energy 

21 and Commerce of the House of Representatives 

22 a final report on the impact of telehealth based 

23 on the data collected and analyzed under sub24 paragraph (A) that includes— 


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1 (i) conclusions regarding the impact 

2 of telehealth services on health care deliv3 ery during the COVID–19 public health 

4 emergency; and 

5 (ii) an estimation for total Medicare 

6 spending on telehealth services, including 

7 total spending for each specific type of 

8 service for which Medicare reimbursed. 

9 (D) STAKEHOLDER INPUT.— 

10 (i) IN GENERAL.—For purposes of 

11 subparagraph (A), (B), and (C), the Sec12 retary shall seek input from the Medicare 

13 Payment Advisory Commission, the Med14 icaid and CHIP Payment and Access Com15 mission and nongovernmental stakeholders, 

16 including patient organizations, providers, 

17 and experts in telehealth. 

18 (ii) COMMENT PERIOD.—For the pur19 poses of this subsection, the Secretary 

20 shall establish a comment period not later 

21 than 14 days after the date of enactment 

22 of this Act. 


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1 SEC. 3. RURAL HEALTH CLINICS AND FEDERALLY QUALI2 FIED HEALTH CENTERS. 

3 (a) EXPANSION OF DISTANT SITES.—Section 

4 1834(m) of the Social Security Act (42 U.S.C. 1395m(m)) 

5 is amended— 

6 (1) in the first sentence of paragraph (1)— 

7 (A) by striking ‘‘or a practitioner (de8 scribed in section 1842(b)(18)(C))’’ and insert9 ing ‘‘, a practitioner (described in section 

10 1842(b)(18)(C)), a federally qualified health 

11 center, or a rural health clinic’’; and 

12 (B) by striking ‘‘or practitioner’’ and in13 serting ‘‘, practitioner, federally qualified health 

14 center, or rural health clinic’’; 

15 (2) in paragraph (2)(A)— 

16 (A) by inserting ‘‘or to a federally qualified 

17 health center or rural health clinic that serves 

18 as a distant site’’ after ‘‘a distant site’’; and 

19 (B) by striking ‘‘such physician or practi20 tioner’’ and inserting ‘‘such physician, practi21 tioner, federally qualified health center, or rural 

22 health clinic’’; and 

23 (3) in paragraph (4)— 

24 (A) in subparagraph (A), by inserting 

25 ‘‘and includes a federally qualified health center 

26 or rural health clinic that furnishes a telehealth 


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1 service to an eligible individual’’ before the pe2 riod at the end; and 

3 (B) in subparagraph (F), by adding at the 

4 end the following new clause: 

5 ‘‘(iii) INCLUSION OF RURAL HEALTH

6 CLINIC SERVICES AND FEDERALLY QUALI7 FIED HEALTH CENTER SERVICES FUR8 NISHED USING TELEHEALTH.—For pur9 poses of this subparagraph, the term ‘tele10 health services’ includes a rural health 

11 clinic service or Federally qualified health 

12 center service that is furnished using tele13 health to the extent that payment codes 

14 corresponding to services identified by the 

15 Secretary under clause (i) or (ii) are listed 

16 on the corresponding claim for such rural 

17 health clinic service or Federally qualified 

18 health center service.’’. 

19 (b) EFFECTIVE DATE.—The amendments made by 

20 this section shall apply to services furnished on or after 

21 January 1, 2022. 

22 SEC. 4. ELIMINATION OF RESTRICTIONS RELATING TO 

23 TELEHEALTH SERVICES. 

24 (a) ELIMINATION OF GEOGRAPHIC RESTRICTIONS OF

25 ORIGINATING SITES.—Section 1834(m)(4)(C)(i) of the 


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1 Social Security Act (42 U.S.C. 1395m(m)(4)(C)(i)) is 

2 amended— 

3 (1) by striking ‘‘the service is furnished via a 

4 telecommunications system and only if such site is 

5 located—’’ and inserting ‘‘the service—’’; 

6 (2) by redesignating subclauses (I) through 

7 (III) as items (aa) through (cc), respectively, and 

8 moving the margins two ems to the right; and 

9 (3) by inserting before item (aa), as redesig10 nated by paragraph (2), the following new sub11 clauses: 

12 ‘‘(I) is furnished via a tele13 communications system; and 

14 ‘‘(II) for the period beginning on 

15 the date of the enactment of this sub16 clause and ending on December 31, 

17 2021, only if such site is located—’’. 

18 (b) ELIMINATION OF RESTRICTIONS IN WHICH

19 TELEHEALTH SERVICES MAY BE FURNISHED IN THE

20 HOME.—Section 1834(m)(4)(C)(ii)(X)) of the Social Se21 curity Act (42 U.S.C. 1395m(m)(4)(C)(ii)(X) is amended 

22 to read as follows: 

23 ‘‘(X)(aa) For the period begin24 ning on the date of the enactment of 

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1 ber 31, 2021, the home of an indi2 vidual but only for purposes of section 

3 1881(b)(3)(B) or telehealth services 

4 described in paragraph (7). 

5 ‘‘(bb) For the period beginning 

6 on or after January 1, 2022, the 

7 home of an individual.’’. 

8 (c) INCLUSION OF ADDITIONAL ORIGINATING SITES

9 AS DETERMINED BY THE SECRETARY.—Section 

10 1834(m)(4)(C)(ii) of the Social Security Act (42 U.S.C. 

11 1395m(m)(4)(C)(ii)) is amended by adding at the end the 

12 following new subclause: 

13 ‘‘(XI) Any other location deter14 mined by the Secretary.’’. 

Æ 


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