I 
117TH CONGRESS 
1ST SESSION H. R. 1677 
To direct the Secretary of Health and Human Services, the Medicare Payment 
Advisory Commission, and the Medicaid and CHIP Payment and Access 
Commission to conduct studies and report to Congress on actions taken 
to expand access to telehealth services under the Medicare, Medicaid, 
and Children’s Health Insurance programs during the COVID–19 emer-
gency. 
IN THE HOUSE OF REPRESENTATIVES 
MARCH 9, 2021 
Mr. BALDERSON (for himself, Mrs. AXNE, Mr. STIVERS, Mr. GIBBS, Mr. 
RYAN, Mr. BERGMAN, Mr. CROW, Mr. BUCK, and Mrs. HINSON) intro-
duced 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 direct the Secretary of Health and Human Services, 
the Medicare Payment Advisory Commission, and the 
Medicaid and CHIP Payment and Access Commission 
to conduct studies and report to Congress on actions 
taken to expand access to telehealth services under the 
Medicare, Medicaid, and Children’s Health Insurance 
programs during the COVID–19 emergency. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
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SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Knowing the Efficiency 
and Efficacy of Permanent Telehealth Options Act of 
2021’’ or the ‘‘KEEP Telehealth Options Act of 2021’’. 
SEC. 2. FINDINGS. 
Congress finds the following: 
(1) On January 21, 2020, the United States 
confirmed the Nation’s first case of the 2019 novel 
coronavirus (which presents as the disease COVID– 
19). 
(2) On January 31, 2020, the Secretary of 
Health and Human Services (in this Act referred to 
as the ‘‘Secretary’’) declared a public health emer-
gency in response to COVID–19. 
(3) By March, the disease reached the pan-
demic level according to the World Health Organiza-
tion, and the President proclaimed the COVID–19 
outbreak in the United States to constitute a na-
tional emergency. 
(4) This emergency declaration authorizes the 
Secretary ‘‘to temporarily waive or modify certain 
requirements of the Medicare, Medicaid, and State 
Children’s Health Insurance programs and of the 
Health Insurance Portability and Accountability Act 
Privacy Rule throughout the duration of the public 
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health emergency declared in response to the 
COVID–19 outbreak’’. 
(5) Under this authority, the Secretary, and the 
Administrator of the Centers for Medicare & Med-
icaid Services (in this Act referred to as the ‘‘Ad-
ministrator’’) acting under the Secretary’s authority, 
issued numerous rules, regulations, and waivers ena-
bling the expansion of telehealth services during the 
public health emergency. 
(6) Telehealth services play a critical role in en-
hancing access to care for patients while simulta-
neously reducing the risk of exposure to the corona-
virus for both patients and providers. 
(7) The Administrator expanded access to tele-
health services under the public health emergency to 
all Medicare beneficiaries (including clinician-pro-
vided services to new and established patients). 
(8) On April 23, 2020, the Administrator re-
leased a telehealth toolkit to assist States in expand-
ing the use of telehealth through Medicaid and 
CHIP. 
(9) Expanded telehealth options are valuable 
for all Americans during this public health crisis, 
but especially for high-risk patients and rural Ameri-
cans who already have difficulty accessing care. 
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SEC. 3. STUDIES AND REPORTS ON THE EXPANSION OF AC-
CESS TO TELEHEALTH SERVICES DURING 
THE COVID–19 EMERGENCY. 
(a) HHS.— 
(1) IN
GENERAL.—Not later than 180 days 
after the date of the enactment of this Act, the Sec-
retary, in consultation with the Administrator, shall 
conduct a study and submit to Congress a report on 
actions taken by the Secretary during the emergency 
period described in section 1135(g)(1)(B) of the So-
cial Security Act (42 U.S.C. 1320b–5(g)(1)(B)) to 
expand access to telehealth services under the Medi-
care program, the Medicaid program, and the Chil-
dren’s Health Insurance program. Such report shall 
include the following: 
(A) A comprehensive list of telehealth serv-
ices available under the programs described in 
paragraph (1) and an explanation of all actions 
undertaken by the Secretary during the emer-
gency period described in such paragraph to ex-
pand access to such services. 
(B) A comprehensive list of types of pro-
viders that may be reimbursed for such services 
furnished under such programs during such pe-
riod, including a list of services which may only 
be reimbursed under such programs during 
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such period if furnished by such providers in- 
person. 
(C) A quantitative analysis of the use of 
such telehealth services under such programs 
during such period, including data points on 
use by rural, minority, low-income, and elderly 
populations. 
(D) A quantitative analysis of the use of 
such services under such programs during such 
period for mental and behavioral health treat-
ments. 
(E) An analysis of the public health im-
pacts of the actions described in subparagraph 
(A). 
(2) PUBLICATION OF REPORT.—Not later than 
180 days after the date of the enactment of this Act, 
the Secretary shall publish on the public website of 
the Department of Health and Human Services the 
report described in paragraph (1). 
(b) MEDPAC AND MACPAC.— 
(1) IN GENERAL.—Not later than 1 year after 
the date of enactment of this Act, the Medicare Pay-
ment Advisory Commission and the Medicaid and 
CHIP Payment and Access Commission, in consulta-
tion with the Inspector General of the Department 
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of Health and Human Services, shall each conduct 
a study and submit to Congress a report on— 
(A) any improvements to, or barriers in, 
access to telehealth services under— 
(i) in the case of the report submitted 
by the Medicare Payment Advisory Com-
mission, the Medicare program; and 
(ii) in the case of the report submitted 
by the Medicaid and CHIP Payment and 
Access Commission, the Medicaid and Chil-
dren’s Health Insurance programs; 
during the emergency period described in sub-
section (a)(1); and 
(B) what is known about any increased 
risk in increased fraudulent activity, including 
the types of fraudulent activity, that could be 
associated with the expansion of access to such 
services under such programs during such pe-
riod. 
(2) RECOMMENDATIONS.—The reports sub-
mitted under paragraph (1) shall include rec-
ommendations, as appropriate, on— 
(A) potential improvements to telehealth 
services, and expansions of such services, under 
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the programs described in paragraph (1)(A); 
and 
(B) possible approaches to addressing any 
fraudulent activity described in paragraph 
(1)(B). 
Æ 
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