I 
115TH CONGRESS 
1ST SESSION H. R. 2556 
To amend title XVIII of the Social Security Act to expand access to telehealth 
services, and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
MAY 19, 2017 
Mrs. BLACK (for herself, Mr. WELCH, Mr. HARPER, Mr. THOMPSON of Cali-
fornia, Mr. JOHNSON of Ohio, and Ms. MATSUI) 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 sub-
sequently 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 XVIII of the Social Security Act to expand 
access to telehealth services, and for other purposes. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE; TABLE OF CONTENTS. 
(a) SHORT TITLE.—This Act may be cited as the 
‘‘Creating Opportunities Now for Necessary and Effective 
Care Technologies for Health Act of 2017’’ or the ‘‘CON-
NECT for Health Act of 2017’’. 
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(b) TABLE OF CONTENTS.—The table of contents of 
this Act is as follows: 
Sec. 1. Short title; table of contents. 
Sec. 2. Providing accountable care organizations the ability to expand the use 
of telehealth. 
Sec. 3. Expanding access to home dialysis therapy. 
Sec. 4. Expanding the use of telehealth for individuals with stroke. 
Sec. 5. Increasing access to digital tools for Medicare Advantage enrollees 
through telehealth and remote patient monitoring. 
Sec. 6. Coverage of remote patient monitoring services furnished to certain in-
dividuals. 
Sec. 7. Rural health clinics and Federally qualified health centers. 
Sec. 8. Allowing Native American health service facilities as sites eligible for 
telehealth payment. 
Sec. 9. Clarification regarding telehealth and remote patient monitoring tech-
nologies provided to beneficiaries. 
Sec. 10. Allowing telehealth and remote patient monitoring services to be in-
cluded in bundled or global payments. 
Sec. 11. Expanding the use of telehealth through the waiver of certain require-
ments. 
Sec. 12. Expanding the use of telehealth for mental health services. 
Sec. 13. HHS evaluation and report on the use of telehealth and remote patient 
monitoring under all demonstration programs and pilots with 
a telehealth waiver. 
Sec. 14. Testing of models to examine the use of telehealth and remote patient 
monitoring under the Medicare program. 
Sec. 15. Sense of Congress regarding the remote practice of medicine. 
SEC. 2. PROVIDING ACCOUNTABLE CARE ORGANIZATIONS 
THE ABILITY TO EXPAND THE USE OF TELE-
HEALTH. 
(a) IN GENERAL.—Section 1899 of the Social Secu-
rity Act (42 U.S.C. 1395jjj) is amended by adding at the 
end the following new subsection: 
‘‘(l) PROVIDING ACOS THE ABILITY TO EXPAND 
THE USE OF TELEHEALTH SERVICES.— 
‘‘(1) IN GENERAL.— 
‘‘(A) EXPANDING
USE
OF
TELEHEALTH 
SERVICES.—In the case of telehealth services 
for which payment would otherwise be made 
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under this title furnished on or after January 
1, 2018, for purposes of this subsection only, 
the restrictions applicable to the coverage of 
telehealth services under section 1834(m) de-
scribed in subparagraph (B) shall not apply 
with respect to such services furnished to a 
Medicare fee-for-service beneficiary assigned to 
an applicable ACO (as defined in paragraph 
(2)). 
‘‘(B) 
RESTRICTIONS
DESCRIBED.—For 
purposes of this subsection, restrictions applica-
ble to the coverage of telehealth services under 
section 1834(m) shall include requirements re-
lating to qualifications for an originating site 
under paragraph (4)(C)(ii) of such section, any 
geographic 
limitations 
under 
paragraph 
(4)(C)(i) of such section (other than applicable 
State law requirements, including State licen-
sure requirements), any limitation on the use of 
store-and-forward technologies described in 
paragraph (1) of such section, any limitation on 
the type of health care provider who may fur-
nish such services (other than the requirement 
that the provider is a Medicare-enrolled pro-
vider), or any limitation on specific codes des-
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ignated as telehealth services that are covered 
under this title pursuant to such section (pro-
vided such codes are clinically appropriate to 
furnish remotely). 
‘‘(2) DEFINITION OF APPLICABLE ACO.—In this 
subsection, the term ‘applicable ACO’ means an 
ACO participating in a model tested or expanded 
under section 1115A or under this section— 
‘‘(A) that operates under a two-sided 
model— 
‘‘(i) described in section 425.600(a) of 
title 42, Code of Federal Regulations; or 
‘‘(ii) tested or expanded under section 
1115A; and 
‘‘(B) for which Medicare fee-for-service 
beneficiaries are assigned to the ACO using a 
prospective assignment method, as determined 
appropriate by the Secretary. 
‘‘(3) NO ORIGINATING SITE FACILITY FEE FOR 
NEW SITES.—The Secretary shall not pay an origi-
nating site facility fee (as described in paragraph 
(2)(B) of section 1834(m)) with respect to telehealth 
services described in paragraph (1) if such services 
would not have been covered under this title as of 
the date of enactment of this subsection. 
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‘‘(4) ANNUAL SUBMISSION OF DATA.—An appli-
cable ACO that furnishes telehealth services de-
scribed in paragraph (1) shall, on an annual basis, 
submit to the Secretary information requested by 
the Secretary for evaluation of the implementation 
of this subsection, including information on utiliza-
tion and expenditures for telehealth under this sub-
section during the preceding year and data on any 
applicable quality measures, consistent with sections 
1848 and 1833(z).’’. 
(b) EVALUATION AND REPORT.— 
(1) EVALUATION.— 
(A) 
IN
GENERAL.—The 
Secretary 
of 
Health and Human Services (in this subsection 
referred to as the ‘‘Secretary’’) shall conduct an 
evaluation on the implementation of section 
1899(l) of the Social Security Act, as added by 
subsection (a). Such evaluation shall include an 
analysis of the utilization of, and expenditures 
for, telehealth services under such section, in-
cluding a comparison of the utilization of, and 
expenditures for, the same services provided in 
the office setting. 
(B) COLLECTION
OF
DATA.—The Sec-
retary may collect such data as the Secretary 
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determines necessary to carry out the evalua-
tion under this paragraph. 
(2) REPORT.—Not later than January 1, 2025, 
the Secretary shall submit to Congress a report con-
taining the results of the evaluation conducted under 
paragraph (1), together with recommendations for 
such legislation and administrative action as the 
Secretary determines appropriate. 
SEC. 3. EXPANDING ACCESS TO HOME DIALYSIS THERAPY. 
(a) IN GENERAL.—Section 1881(b)(3) of the Social 
Security Act (42 U.S.C. 1395rr(b)(3)) is amended— 
(1) by redesignating subparagraphs (A) and 
(B) as clauses (i) and (ii), respectively; 
(2) in clause (ii), as redesignated by subpara-
graph (A), strike ‘‘on a comprehensive’’ and insert 
‘‘subject to subparagraph (B), on a comprehensive’’; 
(3) by striking ‘‘With respect to’’ and inserting 
‘‘(A) With respect to’’; and 
(4) by adding at the end the following new sub-
paragraph: 
‘‘(B) For purposes of subparagraph (A)(ii), an indi-
vidual determined to have end stage renal disease receiv-
ing home dialysis may choose to receive the monthly end 
stage renal disease-related visits furnished on or after 
January 1, 2018, via telehealth, if the individual receives 
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a face-to-face visit, without the use of telehealth, at least 
once every three consecutive months.’’. 
(b) ORIGINATING SITE REQUIREMENTS.— 
(1) IN GENERAL.—Section 1834(m) of the So-
cial Security Act (42 U.S.C. 1395m(m)) is amend-
ed— 
(A) in paragraph (4)(C)(ii), by adding at 
the end the following new subclauses: 
‘‘(IX) A renal dialysis facility, 
but only for purposes of section 
1881(b)(3)(B). 
‘‘(X) The home of an individual, 
but only for purposes of section 
1881(b)(3)(B).’’; and 
(B) by adding at the end the following new 
paragraph: 
‘‘(5) TREATMENT OF HOME DIALYSIS MONTHLY 
ESRD-RELATED
VISIT.—The geographic require-
ments described in paragraph (4)(C)(i) shall not 
apply with respect to telehealth services furnished on 
or after January 1, 2018, for purposes of section 
1881(b)(3)(B), at an originating site described in 
subclause 
(VI), 
(IX), 
or 
(X) 
of 
paragraph 
(4)(C)(ii)), subject to applicable State law require-
ments, including State licensure requirements.’’. 
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(2) NO
FACILITY
FEE
IF
ORIGINATING
SITE 
FOR HOME DIALYSIS THERAPY IS THE HOME.—Sec-
tion 1834(m)(2)(B) of the Social Security (42 
U.S.C. 1395m(m)(2)(B)) is amended— 
(A) by redesignating clauses (i) and (ii) as 
subclauses (I) and (II), and indenting appro-
priately; 
(B) in subclause (II), as redesignated by 
subparagraph (A), by striking ‘‘clause (i) or 
this clause’’ and inserting ‘‘subclause (I) or this 
subclause’’; 
(C) by striking ‘‘SITE.—With respect to’’ 
and inserting ‘‘SITE.— 
‘‘(i) IN GENERAL.—Subject to clause 
(ii), with respect to’’; and 
(D) by adding at the end the following new 
clause: 
‘‘(ii) NO
FACILITY
FEE
IF
ORIGI-
NATING SITE FOR HOME DIALYSIS THER-
APY IS THE HOME.—No facility fee shall 
be paid under this subparagraph to an 
originating site described in paragraph 
(4)(C)(ii)(X).’’. 
(c) CONFORMING AMENDMENT.—Section 1881(b)(1) 
of the Social Security Act (42 U.S.C. 1395rr(b)(1)) is 
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amended by striking ‘‘paragraph (3)(A)’’ and inserting 
‘‘paragraph (3)(A)(i)’’. 
SEC. 4. EXPANDING THE USE OF TELEHEALTH FOR INDI-
VIDUALS WITH STROKE. 
Section 1834(m) of the Social Security Act (42 
U.S.C. 1395m(m)), as amended by section 3(b), is amend-
ed by adding at the end the following new paragraph: 
‘‘(6) TREATMENT
OF
STROKE
TELEHEALTH 
SERVICES.— 
‘‘(A) NONAPPLICATION
OF
ORIGINATING 
SITE
REQUIREMENTS.—The requirements de-
scribed in paragraph (4)(C) shall not apply with 
respect to telehealth services furnished on or 
after January 1, 2018, for purposes of evalua-
tion of an acute stroke, as determined by the 
Secretary, subject to applicable State law re-
quirements, including State licensure require-
ments. 
‘‘(B) NO ORIGINATING SITE FACILITY FEE 
FOR NEW SITES.—The Secretary shall not pay 
an originating site facility fee (as described in 
paragraph (2)(B)) with respect to telehealth 
services described in subparagraph (A) if the 
services would not have been covered under this 
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title as of the date of enactment of this para-
graph.’’. 
SEC. 5. INCREASING ACCESS TO DIGITAL TOOLS FOR MEDI-
CARE ADVANTAGE ENROLLEES THROUGH 
TELEHEALTH AND REMOTE PATIENT MONI-
TORING. 
(a) IN GENERAL.—Section 1852 of the Social Secu-
rity Act (42 U.S.C. 1395w–22) is amended— 
(1) in subsection (a)(1)(B)(i), by inserting ‘‘, 
subject to subsection (m),’’ after ‘‘means’’; and 
(2) by adding at the end the following new sub-
section: 
‘‘(m) PROVISION
OF
ADDITIONAL
TELEHEALTH 
BENEFITS AND TREATMENT OF REMOTE PATIENT MONI-
TORING.— 
‘‘(1) MA PLAN OPTION.—For plan year 2018 
and subsequent plan years, subject to the require-
ments of paragraph (3), an MA plan may provide 
additional telehealth benefits (as defined in para-
graph (2)) to individuals enrolled under this part. 
‘‘(2) ADDITIONAL TELEHEALTH BENEFITS DE-
FINED.— 
‘‘(A) IN GENERAL.—For purposes of this 
subsection and section 1854: 
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‘‘(i) DEFINITION.—The term ‘addi-
tional telehealth benefits’ means services 
for which benefits are available under part 
B, notwithstanding the restrictions applica-
ble to the coverage of telehealth services 
under section 1834(m) described in sub-
paragraph (B). 
‘‘(ii) EXCLUSION OF CAPITAL AND IN-
FRASTRUCTURE
COSTS
AND
INVEST-
MENTS.—The term ‘additional telehealth 
benefits’ does not include capital and infra-
structure costs and investments relating to 
such benefits. 
‘‘(B) 
RESTRICTIONS
DESCRIBED.—For 
purposes of this subsection, restrictions applica-
ble to the coverage of telehealth services under 
section 1834(m) shall include requirements re-
lating to qualifications for an originating site 
under paragraph (4)(C)(ii) of such section, any 
geographic 
limitations 
under 
paragraph 
(4)(C)(i) of such section (other than applicable 
State law requirements, including State licen-
sure requirements), any limitation on the use of 
store-and-forward technologies described in 
paragraph (1) of such section, any limitation on 
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the type of health care provider who may fur-
nish such services (other than the requirement 
that the provider is a Medicare-enrolled pro-
vider), or any limitation on specific codes des-
ignated as telehealth services that are covered 
under this title pursuant to such section (pro-
vided such codes are clinically appropriate to 
furnish remotely). 
‘‘(C) PUBLIC COMMENT.—Not later than 
November 30, 2017, the Secretary shall solicit 
comments on what types of telehealth services 
should be considered to meet the definition of 
additional telehealth benefits under this para-
graph. 
‘‘(3) REQUIREMENTS FOR ADDITIONAL TELE-
HEALTH BENEFITS.—The Secretary shall specify re-
quirements for the provision or furnishing of addi-
tional telehealth benefits, including with respect to 
the following: 
‘‘(A) Physician, practitioner, or other 
health care provider licensure consistent with 
State law and other requirements such as spe-
cific training. 
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‘‘(B) Factors necessary to ensure the co-
ordination of such benefits with items and serv-
ices furnished in person. 
‘‘(C) Such other areas as determined by 
the Secretary. 
‘‘(4) ENROLLEE CHOICE.—If an MA plan pro-
vides a service as an additional telehealth benefit (as 
defined in paragraph (2)), an individual enrollee 
shall have discretion as to whether to receive such 
service as an additional telehealth benefit. 
‘‘(5) CONSTRUCTION REGARDING NETWORK AC-
CESS ADEQUACY.—The provision of additional tele-
health benefits under this subsection shall not be 
construed as making such benefits available and ac-
cessible for purposes of compliance with subsection 
(d). 
‘‘(6) TREATMENT UNDER MA.—For purposes of 
this subsection and section 1854, additional tele-
health benefits shall be treated as if they were bene-
fits under the original Medicare fee-for-service pro-
gram option. 
‘‘(7) CONSTRUCTION.—Nothing in this sub-
section shall be construed as affecting the require-
ment under subsection (a)(1) that MA plans provide 
enrollees with items and services (other than hospice 
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care) for which benefits are available under parts A 
and B, including benefits available under section 
1834(m). 
‘‘(8) CLARIFICATION REGARDING REMOTE PA-
TIENT
MONITORING
SERVICES.—For purposes of 
this subsection and section 1854, remote patient 
monitoring services shall be treated as if they were 
benefits under the original Medicare fee-for-service 
program option so long as such treatment does not 
increase the bid amount attributable to such benefits 
from the amount it would otherwise be, as deter-
mined by the Secretary. 
‘‘(9) PROVISION OF DATA.—An MA plan that 
provides additional telehealth benefits or remote pa-
tient monitoring services with respect to a plan year 
shall provide to the Secretary (at such time and in 
such manner as the Secretary may specify) data on 
expenditures and utilization for telehealth or remote 
patient monitoring services under the plan for enroll-
ees during that plan year.’’. 
(b) CLARIFICATION REGARDING INCLUSION IN BID 
AMOUNT.—Section 1854(a)(6)(A)(ii)(I) of the Social Se-
curity Act (42 U.S.C. 1395w–24(a)(6)(A)(ii)(I)) is 
amended by inserting ‘‘, including, for plan year 2019 and 
subsequent plan years, the provision of additional tele-
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health benefits and remote patient monitoring as described 
in section 1852(m)’’ before the semicolon at the end. 
SEC. 6. COVERAGE OF REMOTE PATIENT MONITORING 
SERVICES FURNISHED TO CERTAIN INDIVID-
UALS. 
(a) IN GENERAL.—Section 1848(b) of the Social Se-
curity Act (42 U.S.C. 1395w–4(b)) is amended by adding 
at the end the following new paragraph: 
‘‘(12) COVERAGE OF REMOTE PATIENT MONI-
TORING SERVICES FURNISHED TO CERTAIN INDIVID-
UALS.— 
‘‘(A) IN GENERAL.—The Secretary shall, 
subject to subparagraph (B), make payment (as 
the Secretary determines to be appropriate) 
under this section for remote patient moni-
toring services (as defined in subparagraph 
(C)(iii)) furnished on or after January 1, 2018, 
to an applicable individual (as defined in sub-
paragraph (C)(i)) by an eligible provider (as de-
fined in subparagraph (C)(ii)). 
‘‘(B) REQUIREMENTS.—The following shall 
apply with respect to remote patient monitoring 
services under this paragraph: 
‘‘(i) Coverage of such remote patient 
monitoring services shall be in addition to 
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coverage for chronic care management 
services or transitional care management 
services furnished to an applicable indi-
vidual under this section. 
‘‘(ii) The Secretary shall consult with 
public and private stakeholders in deter-
mining the amount of payment for remote 
patient monitoring services under this sec-
tion. 
‘‘(iii) Payment, pricing, and coverage 
for such remote patient monitoring services 
may occur through the unbundling, modi-
fication, or establishment of certain codes. 
‘‘(iv) Such remote patient monitoring 
services (other than those services that are 
physicians’ services) shall be furnished 
under the general supervision of an eligible 
provider. 
‘‘(C) DEFINITIONS.—In this paragraph: 
‘‘(i) APPLICABLE
INDIVIDUAL.—The 
term ‘applicable individual’ means an indi-
vidual— 
‘‘(I) receiving chronic care man-
agement services or transitional care 
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management services under this sec-
tion; 
‘‘(II) who is in the top five per-
cent of Medicare cost utilization and 
has two or more chronic diseases, as 
determined on a yearly basis by the 
Secretary; or 
‘‘(III) who has any other condi-
tion or with respect to an episode of 
care that the Secretary may specify, 
so long as the Chief Actuary of the 
Centers for Medicare & Medicaid 
Services certifies that providing cov-
erage for remote patient monitoring 
services with respect to such individ-
uals would— 
‘‘(aa) reduce spending under 
this title without reducing the 
quality of care; or 
‘‘(bb) improve the quality of 
patient care without increasing 
spending. 
‘‘(ii) ELIGIBLE PROVIDER.—The term 
‘eligible provider’ means a physician (as 
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defined in section 1861(r)) or a practi-
tioner described in section 1842(b)(18)(C). 
‘‘(iii) REMOTE PATIENT MONITORING 
SERVICES.—The 
term 
‘remote 
patient 
monitoring services’ means clinical data 
transmitted from an applicable individual 
in one location via electronic communica-
tions technologies that are devices as de-
fined in section 201(h) of the Federal 
Food, Drug, and Cosmetic Act to an eligi-
ble provider in a different location and 
used by the eligible provider in furnishing 
such services to such individual that com-
plies with the Federal regulations (con-
cerning the privacy and security of individ-
ually identifiable health information) pro-
mulgated under section 264(c) of the 
Health Insurance Portability and Account-
ability Act of 1996, as part of an estab-
lished plan of care for the applicable indi-
vidual that includes the review and inter-
pretation of that data by an eligible pro-
vider. Such term includes those services 
furnished in a Federally qualified health 
center or a rural health clinic. Such term 
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shall not include a communication that 
consists solely of a telephone audio con-
versation, facsimile, or electronic text mes-
sage between an eligible provider and the 
applicable individual.’’. 
(b) EXPANDING
THE USE
OF REMOTE PATIENT 
MONITORING SERVICES UNDER ALTERNATIVE PAYMENT 
MODELS.—Section 1848(b)(12) of the Social Security Act 
(42 U.S.C. 1395w–4(b)(12)), as added by subsection (a), 
is amended by adding at the end the following new sub-
paragraph: 
‘‘(D) APPLICATION TO ALTERNATIVE PAY-
MENT MODELS.—For purposes of applying this 
paragraph with respect to remote patient moni-
toring services furnished by an eligible provider 
participating in an alternative payment model 
(as defined in section 1833(z)(3)(C)), the term 
‘applicable individual’ shall mean any bene-
ficiary assigned to the alternative payment 
model.’’. 
SEC. 7. RURAL HEALTH CLINICS AND FEDERALLY QUALI-
FIED HEALTH CENTERS. 
(a) EXPANSION
OF ORIGINATING SITES.—Section 
1834(m)(4)(C) of the Social Security Act (42 U.S.C. 
1395m(m)(4)(C)) is amended— 
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(1) in clause (i), by striking ‘‘The term’’ and 
inserting ‘‘Subject to clause (iii), the term’’; and 
(2) by adding at the end the following new 
clause: 
‘‘(iii) RURAL
HEALTH
CLINICS
AND 
FEDERALLY
QUALIFIED
HEALTH
CEN-
TERS.—In the case of a service furnished 
on or after the date that is 6 months after 
the date of the enactment of the CON-
NECT for Health Act of 2017, the term 
‘originating site’ shall also include any 
Federally qualified health center and any 
rural health clinic (as such terms are de-
fined in section 1861(aa)) at which the eli-
gible telehealth individual is located at the 
time the service is furnished via a tele-
communications system, whether or not 
they are located in an area described in 
clause (i), insofar as such sites are not oth-
erwise included in the definition of origi-
nating site under such clause, subject to 
applicable State law requirements, includ-
ing State licensure requirements.’’. 
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(b) 
EXPANSION
OF
DISTANT
SITES.—Section 
1834(m) of the Social Security Act (42 U.S.C. 1395m(m)) 
is amended— 
(1) in the first sentence of paragraph (1)— 
(A) by striking ‘‘or a practitioner (de-
scribed in section 1842(b)(18)(C))’’ and insert-
ing ‘‘, a practitioner (described in section 
1842(b)(18)(C)), a Federally qualified health 
center, or a rural health clinic’’; and 
(B) by striking ‘‘or practitioner’’ and in-
serting ‘‘, practitioner, Federally qualified 
health center, or rural health clinic’’; 
(2) in paragraph (2)(A)— 
(A) by inserting after ‘‘eligible telehealth 
individual’’ the following: ‘‘or to a Federally 
qualified health center or rural health clinic 
that serves as a distant site and furnishes a 
telehealth service to an eligible telehealth indi-
vidual’’; and 
(B) by striking ‘‘such physician or practi-
tioner’’ and inserting ‘‘such physician, practi-
tioner, Federally qualified health center, or 
rural health clinic’’; and 
(3) in paragraph (4)(A), by inserting the fol-
lowing before the period at the end: ‘‘and includes 
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a Federally qualified health center or rural health 
clinic that furnishes a telehealth service to an eligi-
ble individual’’. 
(c) EFFECTIVE DATE.—The amendments made by 
this section shall apply to services furnished on or after 
January 1, 2018. 
SEC. 8. ALLOWING NATIVE AMERICAN HEALTH SERVICE 
FACILITIES AS SITES ELIGIBLE FOR TELE-
HEALTH PAYMENT. 
(a) IN GENERAL.—Section 1834(m)(4)(C) of the So-
cial Security Act (42 U.S.C. 1395m(m)(4)(C)), as amend-
ed by section 7, is amended— 
(1) in clause (i), by striking ‘‘clause (iii)’’ and 
inserting ‘‘clauses (iii) and (iv)’’; and 
(2) by adding at the end the following new 
clause: 
‘‘(iv) 
NATIVE
AMERICAN
HEALTH 
SERVICE FACILITIES.—The originating site 
requirements described in clauses (i) and 
(ii) shall not apply with respect to a facil-
ity of the Indian Health Service, whether 
operated by such Service, or by an Indian 
tribe (as that term is defined in section 4 
of the Indian Health Care Improvement 
Act (25 U.S.C. 1603)) or a tribal organiza-
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tion (as that term is defined in section 4 
of the Indian Self-Determination and Edu-
cation Assistance Act (25 U.S.C. 450b)), 
or a facility of the Native Hawaiian health 
care systems authorized under the Native 
Hawaiian Health Care Improvement Act 
(42 U.S.C. 11701 et seq.).’’. 
(b) NO ORIGINATING SITE FACILITY FEE FOR NEW 
SITES.—Section 1834(m)(2)(B) of the Social Security Act 
(42 U.S.C. 1395m(m)(2)(B)) is amended, in the matter 
preceding clause (i), by inserting ‘‘(other than an origi-
nating site that is only described in clause (iv) of para-
graph (4)(C), and does not meet the requirement for an 
originating site under clause (i) of such paragraph)’’ after 
‘‘the originating site’’. 
(c) EFFECTIVE DATE.—The amendments made by 
this section shall apply to services furnished on or after 
January 1, 2018. 
SEC. 9. CLARIFICATION REGARDING TELEHEALTH AND RE-
MOTE PATIENT MONITORING TECHNOLOGIES 
PROVIDED TO BENEFICIARIES. 
Section 1128A(i)(6) of the Social Security Act (42 
U.S.C. 1320a–7a(i)(6)) is amended— 
(1) in subparagraph (H), by striking ‘‘; or’’ and 
inserting a semicolon; 
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(2) in subparagraph (I), by striking the period 
at the end and inserting ‘‘; or’’; and 
(3) by adding at the end the following new sub-
paragraph: 
‘‘(J) the provision of telehealth or remote 
patient monitoring technologies to individuals 
under title XVIII by a health care provider for 
the purpose of furnishing telehealth or remote 
patient monitoring services.’’. 
SEC. 10. ALLOWING TELEHEALTH AND REMOTE PATIENT 
MONITORING SERVICES TO BE INCLUDED IN 
BUNDLED OR GLOBAL PAYMENTS. 
Title XVIII of the Social Security Act (42 U.S.C. 
1395 et seq.) is amended by adding at the end the fol-
lowing new section: 
‘‘SEC. 1899C. ALLOWING TELEHEALTH AND REMOTE PA-
TIENT MONITORING SERVICES TO BE IN-
CLUDED 
IN 
BUNDLED 
OR 
GLOBAL 
PAY-
MENTS. 
‘‘Notwithstanding any other provision of this title, 
the Secretary may include under any bundled or global 
payment under this title the following: 
‘‘(1) 
TELEHEALTH
SERVICES.—Notwith-
standing requirements otherwise applicable under 
section 1834(m), including any requirements relat-
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srobinson on DSKBC5CHB2PROD with BILLS
ing to qualifications for an originating site under 
paragraph (4)(C)(ii) of such section, any geographic 
limitations under paragraph (4)(C)(i) of such section 
(other than applicable State law requirements, in-
cluding State licensure requirements), any limitation 
on the use of store-and-forward technologies de-
scribed in paragraph (1) of such section, any limita-
tion on the type of health care provider who may 
furnish such services (other than the requirement 
that the provider is a Medicare-enrolled provider), 
any items and services for which payment would oth-
erwise be made under this title that are furnished 
using telehealth, or any limitation on specific codes 
designated as telehealth services that are covered 
under this title pursuant to section 1834(m) (pro-
vided such codes are clinically appropriate to furnish 
remotely). 
‘‘(2) REMOTE
PATIENT
MONITORING
SERV-
ICES.—Notwithstanding section 1848(b)(12), remote 
patient monitoring services (as defined in such sec-
tion) furnished to any individual under this title.’’. 
SEC. 11. EXPANDING THE USE OF TELEHEALTH THROUGH 
THE WAIVER OF CERTAIN REQUIREMENTS. 
Section 1834(m) of the Social Security Act (42 
U.S.C. 1395m(m)), as amended by sections 3(b) and 4, 
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is amended by adding at the end the following new para-
graph: 
‘‘(7) AUTHORITY
TO
WAIVE
REQUIREMENTS 
AND LIMITATIONS IF CERTAIN CONDITIONS MET.— 
‘‘(A) IN GENERAL.—In the case of tele-
health services furnished on or after January 1, 
2018, the Secretary may waive any restriction 
applicable to the coverage of telehealth services 
under this subsection described in subpara-
graph (B) with respect to certain providers of 
services, suppliers, provider groups, sites of 
care, services, conditions, individuals receiving 
the services, or States, as determined by the 
Secretary, if each of the requirements described 
in subparagraph (C) is met with respect to the 
waiver. 
‘‘(B) 
RESTRICTIONS
DESCRIBED.—For 
purposes of this paragraph, restrictions applica-
ble to the coverage of telehealth services under 
this subsection shall include requirements relat-
ing to qualifications for an originating site 
under paragraph (4)(C)(ii), any geographic lim-
itations under paragraph (4)(C)(i) (other than 
applicable State law requirements, including 
State licensure requirements), any limitation on 
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the use of store-and-forward technologies de-
scribed in paragraph (1), any limitation on the 
type of health care provider who may furnish 
such services (other than the requirement that 
the provider is a Medicare-enrolled provider), or 
any limitation on specific codes designated as 
telehealth services that are covered under this 
title pursuant to this subsection (provided such 
codes are clinically appropriate to furnish re-
motely). 
‘‘(C) REQUIREMENTS FOR WAIVER.—The 
requirements described in this subparagraph 
are, with respect to the waiver of a restriction 
described in subparagraph (B), the following: 
‘‘(i) The Secretary determines that 
the waiver is expected to— 
‘‘(I) reduce spending under this 
title without reducing the quality of 
care; or 
‘‘(II) improve the quality of pa-
tient care without increasing spend-
ing. 
‘‘(ii) The Chief Actuary of the Centers 
for Medicare & Medicaid Services certifies 
that such waiver would reduce (or would 
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not result in any increase in) net program 
spending under this title. 
‘‘(iii) The Secretary determines that 
such waiver would not deny or limit the 
coverage or provision of benefits under this 
title for individuals. 
‘‘(D) PUBLIC
COMMENT.—The Secretary 
shall establish a process by which stakeholders 
may (on at least an annual basis) submit re-
quests for a waiver under this paragraph.’’. 
SEC. 12. EXPANDING THE USE OF TELEHEALTH FOR MEN-
TAL HEALTH SERVICES. 
Section 1834(m) of the Social Security Act (42 
U.S.C. 1395m(m)), as amended by sections 3(b), 4, and 
11, is amended by adding at the end the following new 
paragraph: 
‘‘(8) TREATMENT OF MENTAL HEALTH SERV-
ICES DELIVERED VIA TELEHEALTH.— 
‘‘(A) IN GENERAL.—Restrictions applicable 
to the coverage of telehealth services under this 
subsection described in subparagraph (B) shall 
not apply with respect to telehealth services 
that are mental health services (as determined 
by the Secretary) and are furnished on or after 
January 1, 2018. 
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‘‘(B) 
RESTRICTIONS
DESCRIBED.—For 
purposes of this paragraph, restrictions applica-
ble to the coverage of telehealth services under 
this subsection shall include requirements relat-
ing to qualifications for an originating site 
under paragraph (4)(C)(ii), any geographic lim-
itations under paragraph (4)(C)(i) (other than 
applicable State law requirements, including 
State licensure requirements), any limitation on 
the use of store-and-forward technologies de-
scribed in paragraph (1), any limitation on the 
type of health care provider who may furnish 
such services (other than the requirement that 
the provider is a Medicare-enrolled provider), or 
any limitation on specific codes designated as 
telehealth services that are covered under this 
title pursuant to this subsection (provided such 
codes are clinically appropriate to furnish re-
motely).’’. 
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