‘‘(1) is provided not more frequently than on an 
annual basis to an individual who has been diag-
nosed with diabetes; 
‘‘(2) meets technical standards set forth by the 
Secretary (which shall be determined in consultation 
with industry and practitioner groups with expertise 
in ophthalmic photography, telemedicine, or related 
fields); and 
‘‘(3) is furnished via a telecommunications sys-
tem by a physician (as defined in subsection (r)), a 
practitioner (described in section 1842(b)(18)(C) of 
this title), or a non-physician technician deemed to 
be qualified by the Secretary under the regulations 
promulgated pursuant to this Act, to an eligible pa-
tient enrolled under this part, notwithstanding that 
the individual physician or practitioner providing the 
service is not at the same location as the bene-
ficiary.’’. 
(b) PAYMENT NOTWITHSTANDING LIMITATION ON 
STORE AND FORWARD TECHNOLOGY.—Notwithstanding 
any limitations to the contrary that are set forth in section 
1834(m)(1) of the Social Security Act (42 U.S.C. 
1395m(m)(1)), the amendments made by subsection (a) 
shall be applicable to remote assessments of diabetic ret-
inopathy that are furnished through the use of store-and-
forward technologies that provide for the asynchronous 
transmission of health care information in single or multi-
media formats. 
(c) INTERIM PAYMENT PENDING PUBLICATION OF 
FINAL RULE.—For the period beginning 30 days after the 
date of the enactment of this Act and ending on the date 
the Secretary of Health and Human Services publishes a 
final regulation to carry out section 1861(s)(1)(W) of the 
Social Security Act, as added by subsection (a), the Sec-
retary shall provide for payment of retinopathy assess-
ments furnished under such section during such period, 
and assign such temporary HCPCS code as is necessary 
to provide for such payment. 
(d) STUDY ON REIMBURSEMENT FOR REMOTE AS-
SESSMENTS OF DIABETIC RETINOPATHY.—(1) Not later 
than 1 year after the date of the enactment of this Act, 
the Secretary of Health and Human Services shall conduct 
a study on the costs incurred by health care providers to 
provide remote assessment of diabetic retinopathy serv-
ices, including an analysis of—
(A) per-patient cost, and 
(B) start-up and administrative costs. 
(2) Not later than 2 years after the date of the enact-
ment of this Act, the Secretary shall submit a report to
Congress on the study conducted under paragraph (1) and 
shall include recommendations as respect to—
(A) the adequacy of reimbursements for remote 
assessment of diabetic retinopathy under the medi-
care program; and 
(B) whether the study under paragraph (1) 
should be repeated, and if so, how frequently. 
(e) EFFECTIVE DATE.—The amendments made by 
subsection (a) shall apply to assessments performed on or 
after the date that is 30 days after the date of the enact-
ment of this Act. 
SEC. 4 MEDICAID COVERAGE OF REMOTE ASSESSMENT OF 
DIABETIC RETINOPATHY. 
(a) REQUIREMENT.—Section 1905(a)(13) of the So-
cial Security Act (42 U.S.C. 1396d(a)(13)) is amended by 
inserting ‘‘remote assessment of diabetic retinopathy (as 
defined in section 1861(s)(1)(ww)),’’ after ‘‘including’’. 
(b) EFFECTIVE DATE.—The amendments made by 
subsection (a) shall apply to assessments performed on or 
after the date of the enactment of this Act. 
(c) STATE COMPLIANCE.—In the case of a State plan 
for medical assistance under title XIX of the Social Secu-
rity Act which the Secretary of Health and Human Serv-
ices determines requires State legislation (other than legis-
lation authorizing or appropriating funds) in order for the
plan to meet the additional requirement imposed by the 
amendments made by subsection (a), the State plan shall 
not be regarded as failing to comply with the requirements 
of such title solely on the basis of its failure to meet this 
additional requirement before the first day of the first cal-
endar quarter beginning after the close of the first regular 
session of the State legislature that begins after the date 
of the enactment of this Act. For purposes of the previous 
sentence, in the case of a State that has a 2-year legisla-
tive session, each year of such session shall be deemed to 
be a separate regular session of the State legislature. 
SEC. 5. MOBILE DIABETIC RETINOPATHY SCREENING 
PILOT PROGRAM. 
Title III of the Public Health Service Act (42 U.S.C. 
241 et seq.) is amended—
(1) by moving section 317R so that it follows 
section 317Q; and 
(2) by inserting after section 317R (as so 
moved) the following: 
‘‘SEC. 317S. MOBILE DIABETIC RETINOPATHY SCREENING 
PILOT PROGRAM. 
‘‘(a) IN GENERAL.—
‘‘(1) ESTABLISHMENT.—The Secretary shall es-
tablish a grant program, to be known as the ‘‘Mobile 
Diabetic Retinopathy Screening Pilot Program’’, to
make grants to 5 eligible entities for the purpose of 
establishing mobile diabetic retinopathy screening 
programs. 
‘‘(2) USE OF FUNDS.—The Secretary may not 
make a grant to an eligible entity under this section 
unless the entity agrees to use the grant to carry out 
a project consisting of the design, demonstration, 
and implementation of a mobile diabetic retinopathy 
screening program. 
‘‘(3) MAXIMUM AMOUNT.—The Secretary may 
not make any grant under this section in an amount 
that is greater than $1,000,000 for any year. 
‘‘(4) SOLICITATION
OF
APPLICATIONS.—Not 
later than 90 days after the date on which amounts 
are first made available to carry out this section, the 
Secretary shall publish a notice of solicitation for ap-
plications for grants under this section that specifies 
the information to be included in each application. 
‘‘(5) APPLICATIONS.—To seek a grant under 
this section, an eligible entity shall submit an appli-
cation to the Secretary at such time, in such form, 
and containing such information as the Secretary 
may require.
‘‘(6) PRIORITY.—In making grants under this 
section, the Secretary shall give priority to any ap-
plicant that—
‘‘(A) has experience in evaluating diabetic 
retinopathy using telecommunications equip-
ment, including store and forward technologies; 
and 
‘‘(B) proposes to serve rural, impoverished, 
minority, and remote populations. 
‘‘(7) 
CONGRESSIONAL
NOTIFICATION.—The 
Secretary may not make a grant under this section 
unless, not less than 3 days before making the 
grant, the Secretary provides notification of the 
grant to the appropriate committees of the Congress. 
‘‘(b) EVALUATION AND REPORT.—
‘‘(1) EVALUATION.—Not later than 3 years 
after making the first grant under this section, the 
Secretary shall convene an advisory committee for 
the purposes of conducting an evaluation of the Mo-
bile Diabetic Retinopathy Screening Pilot Program. 
In conducting the evaluation, the advisory committee 
shall determine—
‘‘(A) whether the Program has been effec-
tive in increasing early detection of diabetic ret-
inopathy, whether preventative measures taken
upon such detection have been effective in de-
creasing the prevalence and severity of diabetic 
retinopathy, and whether these findings war-
rant continued or expanded support of the Pro-
gram; and 
‘‘(B) whether the program may serve as a 
useful model for similar screening programs to 
detect complications associated with diabetes, 
high blood pressure, high cholesterol, and other 
chronic conditions. 
‘‘(2) REPORT.—Not later than 42 months after 
making the first grant under this section, the Sec-
retary shall submit a report to the appropriate com-
mittees of the Congress containing the results of the 
advisory committee’s evaluation. 
‘‘(c) DEFINITIONS.—In this section: 
‘‘(1) ADVISORY COMMITTEE.—The term ‘advi-
sory committee’ means the advisory committee con-
vened under subsection (b). 
‘‘(2) ELIGIBLE ENTITY.—The term ‘eligible en-
tity’ means—
‘‘(A) a hospital (as defined in section 
1861(e) of the Social Security Act (42 U.S.C. 
1395x(e))); or
‘‘(B) a State, an institution of higher edu-
cation, a local government, a tribal government, 
a nonprofit health organization, or a community 
health center receiving assistance under section 
330. 
‘‘(3) MOBILE DIABETIC RETINOPATHY SCREEN-
ING PROGRAM.—The term ‘mobile diabetic retinop-
athy screening program’ means any program—
‘‘(A) that offers remote assessment of dia-
betic retinopathy as described in Section 
1861(s)(1) of the Social Security Act (42 
U.S.C. 1395x); 
‘‘(B) whose patients primarily reside in 
rural, underserved, and remote areas; and 
‘‘(C) that is mobile (as determined by the 
Secretary). 
‘‘(4) PROGRAM.—The term ‘Program’ means 
the Mobile Diabetic Retinopathy Screening Pilot 
Program established under this section. 
‘‘(d) AUTHORIZATION OF APPROPRIATIONS.—
‘‘(1) IN GENERAL.—There is authorized to be 
appropriated to carry out this section (except for 
subsection (b)) $5,000,000 for each of fiscal years 
2005 through 2009.
‘‘(2) EVALUATION
AND
REPORT.—There are 
authorized to be appropriated to carry out sub-
section (b) such sums as may be necessary.’’.
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