Protecting Access to Post-COVID–19 Telehealth Act of 2021

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. Short title This Act may be cited as the Protecting Access to Post-COVID–19 Telehealth Act of 2021 2. Authorization for the Secretary of Health and Human Services to waive or modify application of Medicare requirements with respect to telehealth services (a) Secretarial authority to temporarily waive or modify Medicare requirements with respect to telehealth services furnished during any emergency period Section 1135 of the Social Security Act ( 42 U.S.C. 1320b–5 (h) Waiver or modification of certain requirements with respect to telehealth services (1) In general Notwithstanding any other provision of this section, during the period described paragraph (2), the Secretary may waive or modify any requirement with respect to a telehealth service payable under section 1834(m)(1) for such period. (2) Period described For purposes of paragraph (1), the period described in this paragraph is the period— (A) beginning on the first day of— (i) an emergency or disaster declared by the President pursuant to the National Emergencies Act or the Robert T. Stafford Disaster Relief and Emergency Assistance Act; or (ii) a public health emergency declared by the Secretary pursuant to section 319 of the Public Health Service Act; and (B) ending on the day that is 90 days after the last day of an emergency, disaster, or public health emergency described in subparagraph (A). . (b) Report (1) Definitions In this subsection: (A) COVID–19 public health emergency The term COVID–19 public health emergency 42 U.S.C. 247d (B) Secretary The term Secretary (2) Data collection and reports on the use of telehealth during the COVID–19 public health emergency (A) Data collection and analysis (i) In general Beginning not later than 30 days after the date of enactment of this Act, the Secretary shall collect and analyze qualitative and quantitative data on the impact of telehealth services, virtual check-ins, digital health, and remote patient monitoring technologies on health care delivery permitted by the waiver or modification of certain requirements under titles XVIII of the Social Security Act ( 42 U.S.C. 1395 42 U.S.C. 1320b–5 (I) health care utilization rates across the Medicare program under title XVIII of the Social Security Act ( 42 U.S.C. 1395 (aa) patient access to telehealth services in medically underserved communities; or (bb) individuals receiving telehealth services through federally qualified health centers (as defined in section 1861(aa)(4) of the Social Security Act ( 42 U.S.C. 1395x(aa)(4) 42 U.S.C. 1395x(aa)(2) (II) health care quality for individuals confirmed or suspected to have COVID–19 and individuals seeking care unrelated to COVID–19 as measured by— (aa) quality of care metrics, such as hospital readmission rates, missed appointment rates, or wellness visits, and (bb) engagement metrics, such as voluntary patient satisfaction surveys and voluntary provider satisfaction surveys; (III) audio-only telehealth utilization rates when other video-based telehealth was not an option or any other telehealth services that were not provided in real-time (including text-messaging or through online chat platforms), the types of visits, and the types of providers treating individuals; (IV) telehealth utilization rates used to treat individuals across State lines; (V) the health outcomes of any individual who utilizes telehealth services to treat an underlying health condition such as diabetes, end-stage renal disease, chronic lung disease, obstructive pulmonary disease, coronary artery disease, or cirrhosis and the types of technology utilized to receive care, including text-messaging, online chat platforms, audio-only, or video conferencing; (VI) the health outcomes of any individual who utilizes mental health care and substance use disorder treatment services, and the types of technology utilized to receive care, including text-messaging, online chat platforms, audio-only, or video conferencing; (VII) the impact of State and Federal privacy and security protections on the delivery of care and patient safety, including the security of the various technologies utilized to deliver or receive telehealth care; (VIII) how telehealth access differs by race, ethnicity, or income levels; (IX) the types of technologies utilized to deliver or receive telehealth care, including Zoom, Skype, FaceTime, text messaging, online chat platforms, or other technologies, as observed by the Secretary, and utilization rates, disaggregated by type of technology (as applicable); (X) the investments necessary for providers to develop a platform to effectively provide telehealth services to their patients, including the costs of the necessary technology and the costs of training staff; and (XI) any additional information determined appropriate by the Secretary. (ii) Broadband availability data Upon request by the Secretary, the Assistant Secretary of Commerce for Communications and Information and the Federal Communications Commission shall provide the Secretary any relevant data regarding the availability of broadband internet access service (as defined in section 801 of the Communications Act of 1934 ( 47 U.S.C. 641 (B) Interim report to congress Not later than 90 days after the date of enactment of this Act, the Secretary shall submit to the Committees on Finance and Health, Education, Labor, and Pensions of the Senate and the Committees on Ways and Means and Energy and Commerce of the House of Representatives an interim report on the impact of telehealth based on the data collected and analyzed under subparagraph (A). For the purposes of the interim report, the Secretary may determine which data collected and analyzed under subparagraph (A) is most appropriate to complete such report. (C) Final report to congress Not later than 180 days after the date of enactment of this Act, the Secretary shall submit to the Committees on Finance and Health, Education, Labor, and Pensions of the Senate and the Committees on Ways and Means and Energy and Commerce of the House of Representatives a final report on the impact of telehealth based on the data collected and analyzed under subparagraph (A) that includes— (i) conclusions regarding the impact of telehealth services on health care delivery during the COVID–19 public health emergency; and (ii) an estimation for total Medicare spending on telehealth services, including total spending for each specific type of service for which Medicare reimbursed. (D) Stakeholder input (i) In general For purposes of subparagraph (A), (B), and (C), the Secretary shall seek input from the Medicare Payment Advisory Commission, the Medicaid and CHIP Payment and Access Commission and nongovernmental stakeholders, including patient organizations, providers, and experts in telehealth. (ii) Comment period For the purposes of this subsection, the Secretary shall establish a comment period not later than 14 days after the date of enactment of this Act. 3. Rural health clinics and federally qualified health centers (a) Expansion of distant sites Section 1834(m) of the Social Security Act ( 42 U.S.C. 1395m(m) (1) in the first sentence of paragraph (1)— (A) by striking or a practitioner (described in section 1842(b)(18)(C)) , a practitioner (described in section 1842(b)(18)(C)), a federally qualified health center, or a rural health clinic (B) by striking or practitioner , practitioner, federally qualified health center, or rural health clinic (2) in paragraph (2)(A)— (A) by inserting or to a federally qualified health center or rural health clinic that serves as a distant site a distant site (B) by striking such physician or practitioner such physician, practitioner, federally qualified health center, or rural health clinic (3) in paragraph (4)— (A) in subparagraph (A), by inserting and includes a federally qualified health center or rural health clinic that furnishes a telehealth service to an eligible individual (B) in subparagraph (F), by adding at the end the following new clause: (iii) Inclusion of rural health clinic services and federally qualified health center services furnished using telehealth For purposes of this subparagraph, the term telehealth services . (b) Effective date The amendments made by this section shall apply to services furnished on or after January 1, 2022. 4. Elimination of restrictions relating to telehealth services (a) Elimination of geographic restrictions of originating sites Section 1834(m)(4)(C)(i) of the Social Security Act ( 42 U.S.C. 1395m(m)(4)(C)(i) (1) by striking the service is furnished via a telecommunications system and only if such site is located— the service— (2) by redesignating subclauses (I) through (III) as items (aa) through (cc), respectively, and moving the margins two ems to the right; and (3) by inserting before item (aa), as redesignated by paragraph (2), the following new subclauses: (I) is furnished via a telecommunications system; and (II) for the period beginning on the date of the enactment of this subclause and ending on December 31, 2021, only if such site is located— . (b) Elimination of restrictions in which telehealth services may be furnished in the home Section 1834(m)(4)(C)(ii)(X)) of the Social Security Act ( 42 U.S.C. 1395m(m)(4)(C)(ii)(X) (X) (aa) For the period beginning on the date of the enactment of this subclause and ending on December 31, 2021, the home of an individual but only for purposes of section 1881(b)(3)(B) or telehealth services described in paragraph (7). (bb) For the period beginning on or after January 1, 2022, the home of an individual. . (c) Inclusion of additional originating sites as determined by the Secretary Section 1834(m)(4)(C)(ii) of the Social Security Act ( 42 U.S.C. 1395m(m)(4)(C)(ii) (XI) Any other location determined by the Secretary. .

Summary: Protecting Access to Post-COVID-19 Telehealth Act of 2021 This bill makes permanent several telehealth flexibilities that were initially authorized during the public health emergency relating to COVID-19 (i.e., coronavirus disease 2019), particularly with respect to Medicare coverage of telehealth services. For example, the bill permanently allows federally qualified health centers and rural health clinics to serve as the distant site (i.e., the location of the health care practitioner) for telehealth services under Medicare. Payment must be made in the same manner as for non-telehealth services, rather than in accordance with a separate methodology determined by the Centers for Medicare & Medicaid Services (CMS). The bill also permanently allows beneficiaries to receive Medicare telehealth services at any site, regardless of type or location, and grants the CMS general authority to waive any other requirements during any emergency period.