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 with-
in the jurisdiction of the committee concerned 
A BILL 
To make permanent certain telehealth flexibilities established 
in response to COVID–19. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Ensuring Telehealth 
Expansion Act of 2021’’. 
SEC. 
2. 
MAKING 
PERMANENT 
CERTAIN 
TELEHEALTH 
FLEXIBILITIES ESTABLISHED IN RESPONSE 
TO COVID–19. 
(a) EXEMPTION FOR TELEHEALTH SERVICES.— 
VerDate Sep 11 2014 
18:57 Feb 08, 2021
Jkt 019200
PO 00000
Frm 00001
Fmt 6652
Sfmt 6201
E:\BILLS\H341.IH
H341
pamtmann on DSKBC07HB2PROD with BILLS
(1) IN GENERAL.—Subparagraph (E) of section 
223(c)(2) of the Internal Revenue Code of 1986 is 
amended by striking ‘‘In the case of plan years be-
ginning on or before December 31, 2021, a plan’’ 
and inserting ‘‘A plan’’. 
(2) 
CERTAIN
COVERAGE
DISREGARDED.— 
Clause (ii) of section 223(c)(1)(B) of the Internal 
Revenue Code of 1986 is amended by striking ‘‘(in 
the case of plan years beginning on or before De-
cember 31, 2021)’’. 
(b) INCREASING MEDICARE TELEHEALTH FLEXI-
BILITIES.—Section 1834(m) of the Social Security Act 
(42 U.S.C. 1395m(m)) is amended by adding at the end 
the following new paragraph: 
‘‘(9) WAIVER AUTHORITY.—The Secretary may 
waive any requirement of this subsection if deter-
mined appropriate by the Secretary.’’. 
(c) ENHANCING MEDICARE TELEHEALTH SERVICES 
FOR FEDERALLY QUALIFIED HEALTH CENTERS
AND 
RURAL HEALTH CLINICS; ELIMINATING SPECIAL PAY-
MENT RULE FOR SUCH SERVICES.— 
(1) IN
GENERAL.—Paragraph (8) of section 
1834(m) of the Social Security Act (42 U.S.C. 
1395m(m)) is amended to read as follows: 
VerDate Sep 11 2014 
18:57 Feb 08, 2021
Jkt 019200
PO 00000
Frm 00002
Fmt 6652
Sfmt 6201
E:\BILLS\H341.IH
H341
pamtmann on DSKBC07HB2PROD with BILLS
‘‘(8) ENHANCING TELEHEALTH SERVICES FOR 
FEDERALLY
QUALIFIED
HEALTH
CENTERS
AND 
RURAL HEALTH CLINICS.— 
‘‘(A) IN GENERAL.—With respect to serv-
ices furnished on or after the first day of the 
emergency 
period 
described 
in 
section 
1135(g)(1)(B), the Secretary shall pay for tele-
health services that are furnished via a tele-
communications system by a Federally qualified 
health center or a rural health clinic to an eligi-
ble telehealth individual enrolled under this part 
notwithstanding that the Federally qualified 
health center or rural clinic providing the tele-
health service is not at the same location as the 
beneficiary. 
‘‘(B) PAYMENT.— 
‘‘(i) IN GENERAL.—A telehealth serv-
ice furnished by a rural health clinic or a 
Federally qualified health center serving as 
a distant site to an individual shall be 
deemed to be so furnished to such indi-
vidual as an outpatient of such clinic or 
center (as applicable) for purposes of sec-
tion 1861(aa) and payable as a rural 
health clinic service or Federally qualified 
VerDate Sep 11 2014 
18:57 Feb 08, 2021
Jkt 019200
PO 00000
Frm 00003
Fmt 6652
Sfmt 6201
E:\BILLS\H341.IH
H341
pamtmann on DSKBC07HB2PROD with BILLS
health center service (as applicable) under 
section 1833(a)(3) or under the prospec-
tive payment system established under sec-
tion 1834(o) (as applicable). 
‘‘(ii) TREATMENT
OF
COSTS
FOR 
FQHC
PPS
CALCULATIONS
AND
RHC
AIR 
CALCULATIONS.—Costs associated with the 
delivery of telehealth services by a Feder-
ally qualified health center or rural health 
clinic serving as a distant site pursuant to 
this paragraph shall be considered allow-
able costs for purposes of the prospective 
payment system established under section 
1834(o) and any payment methodologies 
developed under section 1833(a)(3), as ap-
plicable. 
‘‘(C) DEFINITIONS.—For purposes of this 
subsection— 
‘‘(i) the term ‘distant site’ includes a 
Federally qualified health center or rural 
health clinic that furnishes a telehealth 
service to an eligible telehealth individual; 
and 
‘‘(ii) the term ‘telehealth services’ in-
cludes a rural health clinic service or Fed-
VerDate Sep 11 2014 
18:57 Feb 08, 2021
Jkt 019200
PO 00000
Frm 00004
Fmt 6652
Sfmt 6201
E:\BILLS\H341.IH
H341
pamtmann on DSKBC07HB2PROD with BILLS
erally qualified health center service that is 
furnished using telehealth to the extent 
that payment codes corresponding to serv-
ices identified by the Secretary under 
clause (i) or (ii) of paragraph (4)(F) are 
listed on the corresponding claim for such 
rural health clinic service or Federally 
qualified health center service.’’. 
(2) 
CONFORMING
AMENDMENT.—Section 
1834(m)(2)(A) of the Social Security Act (42 U.S.C. 
1395m(m)(2)(A)) is amended by striking ‘‘Subject 
to paragraph (8), the’’ and inserting ‘‘The’’. 
(3) EFFECTIVE DATE.—The amendments made 
by this subsection shall take effect as if included in 
the enactment of the CARES Act (Public Law 116– 
136). 
(d) WAIVER OF REQUIREMENTS FOR FACE-TO-FACE 
VISITS BETWEEN HOME DIALYSIS PATIENTS AND PHYSI-
CIANS.—Section 1881(b)(3)(B)(iii) of the Social Security 
Act (42 U.S.C. 1395rr(b)(3)(B)(iii)) is amended by strik-
ing ‘‘during the emergency period described in section 
1135(g)(1)(B)’’ and inserting ‘‘during any period begin-
ning on or after the first day of the emergency period de-
scribed in section 1135(g)(1)(B)’’. 
VerDate Sep 11 2014 
18:57 Feb 08, 2021
Jkt 019200
PO 00000
Frm 00005
Fmt 6652
Sfmt 6201
E:\BILLS\H341.IH
H341
pamtmann on DSKBC07HB2PROD with BILLS
(e) USE OF TELEHEALTH TO CONDUCT FACE-TO- 
FACE ENCOUNTER PRIOR TO RECERTIFICATION OF ELI-
GIBILITY
FOR
HOSPICE
CARE.—Section 
1814(a)(7)(D)(i)(II) of the Social Security Act (42 U.S.C. 
1395f(a)(7(D)(i)(II)) is amended by striking ‘‘during the 
emergency period described in section 1135(g)(1)(B)’’ and 
inserting ‘‘during any period beginning on or after the 
first day of the emergency period described in section 
1135(g)(1)(B)’’. 
(f) ENCOURAGING USE OF TELECOMMUNICATIONS 
SYSTEMS FOR HOME HEALTH SERVICES.—Section 3707 
of the CARES Act (Public Law 116–136) is amended by 
striking ‘‘during the emergency period described in section 
1135(g)(1)(B) 
of 
such 
Act 
(42 
U.S.C. 
1320b– 
5(g)(1)(B))’’ and inserting ‘‘on or after the first day of 
the emergency period described in section 1135(g)(1)(B) 
of such Act (42 U.S.C. 1320b–5(g)(1)(B))’’. 
SEC. 3. NONAPPLICATION OF ORIGINATING SITE REQUIRE-
MENTS 
WITH 
RESPECT 
TO 
TELEHEALTH 
SERVICES UNDER MEDICARE PROGRAM. 
Section 1834(m)(4)(C) of the Social Security Act (42 
U.S.C. 1395m(m)(4)(C)) is amended— 
(1) in clause (i), by inserting before ‘‘para-
graphs (5), (6), and (7)’’ the following: ‘‘clause (iii) 
and’’; and 
VerDate Sep 11 2014 
18:57 Feb 08, 2021
Jkt 019200
PO 00000
Frm 00006
Fmt 6652
Sfmt 6201
E:\BILLS\H341.IH
H341
pamtmann on DSKBC07HB2PROD with BILLS
(2) by adding at the end the following new 
clause: 
‘‘(iii) NONAPPLICATION
OF
ORIGI-
NATING SITE REQUIREMENTS.—Beginning 
on the first day of the emergency period 
described in section 1135(g)(1)(B), the 
term ‘originating site’ means any site at 
which the eligible telehealth individual is 
located at the time the service is furnished 
via a telecommunications system.’’. 
SEC. 4. REPORT BY COMPTROLLER GENERAL. 
Not later than 5 years after the date of the enact-
ment of this Act, the Comptroller General of the United 
States shall submit to Congress a report on the successes 
and limitations of implementing the statutory provisions 
amended by sections 2 and 3, including— 
(1) details of any savings or costs to the Fed-
eral Government that are attributable to the imple-
mentation of such provisions; and 
(2) an analysis of how the implementation of 
such provisions have impacted rural hospitals. 
Æ 
VerDate Sep 11 2014 
18:57 Feb 08, 2021
Jkt 019200
PO 00000
Frm 00007
Fmt 6652
Sfmt 6301
E:\BILLS\H341.IH
H341
pamtmann on DSKBC07HB2PROD with BILLS