Safe Testing at Residence Telehealth Act of 2021

To amend title XVIII to provide coverage and payment for certain tests and assistive telehealth consultations during the COVID–19 emergency period, and for other purposes. 1. Short title This Act may be cited as the Safe Testing at Residence Telehealth Act of 2021 2. Coverage and payment for certain tests and assistive telehealth consultations during the COVID–19 emergency period (a) Coverage and payment rule (1) In general Section 1834(m) of the Social Security Act ( 42 U.S.C. 1395m(m) (9) Coverage and payment for certain tests and assistive telehealth consultations during COVID–19 emergency period (A) In general During the emergency period described in section 1135(g)(1)(B), the Secretary shall pay for a test described in subparagraph (C) that is ordered and an assistive telehealth consultation that is furnished via a telecommunications system by a physician or practitioner to an eligible telehealth individual enrolled under this part notwithstanding that the individual physician or practitioner ordering the test did not furnish the test or that the individual physician or practitioner providing the assistive telehealth consultation is not at the same location as the beneficiary. (B) Payment amount During the emergency period described in section 1135(g)(1)(B), the Secretary shall pay to a physician or practitioner located at a distant site that— (i) orders a test described in subparagraph (C) to an eligible telehealth individual an amount equal to the amount that such physician or practitioner would have been paid for a diagnostic laboratory test under section 1833(h); and (ii) furnishes an assistive telehealth consultation to an eligible telehealth individual an amount equal to the amount that a physician or practitioner would have been paid for such telehealth service under paragraph (2). (C) Tests described For purposes of subparagraphs (A) and (B), a test described in this subparagraph is a medical device (as defined in section 201(h) of the Federal Food, Drug, and Cosmetic Act) or is a test approved under an emergency use authorization under section 564 of such Act and is either— (i) a diagnostic laboratory test for the diagnosis of influenza or a similar respiratory condition that is required to obtain a final diagnosis of COVID–19 for an individual when such test is ordered by a physician or practitioner in conjunction with a COVID–19 diagnostic laboratory test for purposes of discounting a diagnosis of influenza or a related diagnosis for such individual; or (ii) a serology test for COVID–19. (D) Other matters relating to documentation and claims review The requirements of paragraphs (2) and (3) of section 410.32(d) of title 42, Code of Federal Regulations (as in effect on the date of the enactment of this paragraph), relating to documentation and claims review, respectively, shall apply to a test described in subparagraph (C) and an assistive telehealth consultation. (E) Demographic data To be eligible for reimbursement under this paragraph, each claim for reimbursement shall include, with respect to such an eligible telehealth individual, the following demographic data: (i) Age. (ii) Race and ethnicity. (iii) Gender. (iv) An affirmative or negative statement of the existence of any chronic condition. (v) Any other information the Secretary determines appropriate. (F) Assistive telehealth consultation In this paragraph, the term assistive telehealth consultation (i) an evaluation and management service; (ii) an assessment of any evidence of systems which would make a diagnostic laboratory test necessary to be furnished in the home of an eligible telehealth individual; (iii) the ordering of a diagnostic laboratory test; (iv) an assessment of an individual succeeding the delivery of a diagnostic laboratory test; (v) any assistance in the collection of a sample necessary for a diagnostic laboratory test and securing the sample for shipping; (vi) the referral of an eligible telehealth individual to a physician or practitioner for in-person treatment; or (vii) the review of a diagnostic laboratory test by a physician or practitioner. . (2) Report (A) In general During the period beginning 20 days after the date of the enactment of this Act and ending on the last day of the emergency period, each physician and practitioner, who furnishes a test or an assistive telehealth consultation during such period, shall, on a monthly basis during such period, submit to the Administrator of the Centers for Medicare & Medicaid Services and the appropriate State health agency demographic data specified under section 1834(m)(9)(E) of the Social Security Act ( 42 U.S.C. 1395m(m)(9)(E) (B) Definitions In this paragraph: (i) Assistive telehealth consultation The term assistive telehealth consultation 42 U.S.C. 1395m(m)(9)(F) (ii) Emergency period The term emergency period 42 U.S.C. 1320b–5(g)(1)(B) (iii) HIPAA privacy regulation The term HIPAA privacy regulation 42 U.S.C. 1320d–9(b)(3) (iv) Test The term test 42 U.S.C. 1395m(m)(9)(C) .(b) No payment for certain in-Person test after telehealth test during the COVID–19 emergency period (1) In general Section 1833(h) of the Social Security Act ( 42 U.S.C. 1395l(h) (A) in paragraph (1)(A), by striking Subject to section 1834(d)(1) Subject to section 1834(a)(1) and paragraph (10) (B) by adding at the end the following new paragraph: (10) During the emergency period described in section 1135(g)(1)(B), the Secretary may not make payment for a test described in section 1834(m)(9)(C) that is furnished in-person by a physician or practitioner to an individual if a physician or practitioner has previously ordered such a test via a telecommunications system pursuant to section 1834(m)(9)(A), unless the physician or practitioner determines such a test is medically necessary and appropriate (as determined by the Secretary). . (2) Report Not later than 1 year after the termination of the emergency period described in section 1135(g)(1)(B) of the Social Security Act ( 42 U.S.C. 1320b–5(g)(1)(B) 42 U.S.C. 1395m(m)(9)(C) (c) Conforming amendments Section 1834(m) of the Social Security Act ( 42 U.S.C. 1395m(m)(4)(C)(ii)(X) (1) in paragraph (1), by striking Subject to paragraph (8) Subject to paragraphs (8) and (9) (2) in paragraph (2), by striking Subject to paragraph (8) Subject to paragraphs (8) and (9) (3) in paragraph (4)(C)(ii)(X), by striking telehealth services described in paragraph (7) telehealth services described in paragraph (7) or (9)

Summary: Safe Testing at Residence Telehealth Act of 2021 This bill provides for Medicare payment of certain at-home diagnostic tests and telehealth assessments that are provided in relation to COVID-19 (i.e., coronavirus disease 2019). Specifically, during the public health emergency, the bill requires Medicare payment of diagnostic tests for respiratory conditions other than COVID-19 (e.g., influenza) that are used to finalize a COVID-19 diagnosis and of COVID-19 blood tests that are ordered via telehealth, as well as for related telehealth assessments, regardless of whether the practitioner who orders the test is the one who furnishes it and regardless of the location of the practitioner. The bill requires practitioners to report specified demographic data with respect to such tests and services in order to receive payment, and prohibits payment for in-person tests that were already ordered via telehealth.