I 
117TH CONGRESS 
1ST SESSION H. R. 2903 
To amend title XVIII of the Social Security Act to expand access to telehealth 
services, and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
APRIL 28, 2021 
Mr. THOMPSON of California (for himself, Mr. SCHWEIKERT, Mr. JOHNSON 
of Ohio, Ms. MATSUI, and Mr. WELCH) 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 subse-
quently 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 (CONNECT) for Health Act of 2021’’ 
or the ‘‘CONNECT for Health Act of 2021’’. 
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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. Findings and sense of Congress. 
TITLE I—REMOVING BARRIERS TO TELEHEALTH COVERAGE 
Sec. 101. Expanding the use of telehealth through the waiver of requirements. 
Sec. 102. Removing geographic requirements for telehealth services. 
Sec. 103. Expanding originating sites. 
Sec. 104. Use of telehealth in emergency medical care. 
Sec. 105. Improvements to the process for adding telehealth services. 
Sec. 106. Federally qualified health centers and rural health clinics. 
Sec. 107. Native American health facilities. 
Sec. 108. Waiver of telehealth requirements during public health emergencies. 
Sec. 109. Use of telehealth in recertification for hospice care. 
TITLE II—PROGRAM INTEGRITY 
Sec. 201. Clarification for fraud and abuse laws regarding technologies pro-
vided to beneficiaries. 
Sec. 202. Additional resources for telehealth oversight. 
Sec. 203. Provider and beneficiary education on telehealth. 
TITLE III—DATA AND TESTING OF MODELS 
Sec. 301. Study on telehealth utilization during the COVID–19 pandemic. 
Sec. 302. Analysis of telehealth waivers in alternative payment models. 
Sec. 303. Model to allow additional health professionals to furnish telehealth 
services. 
Sec. 304. Testing of models to examine the use of telehealth under the Medi-
care program. 
SEC. 2. FINDINGS AND SENSE OF CONGRESS. 
(a) FINDINGS.—Congress finds the following: 
(1) The use of technology in health care and 
coverage of telehealth services are rapidly evolving. 
(2) Research has found that telehealth services 
can expand access to care, improve the quality of 
care, and reduce spending, and that patients receiv-
ing telehealth services are satisfied with their experi-
ences. 
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(3) Health care workforce shortages are a sig-
nificant problem in many areas and for many types 
of health care clinicians. 
(4) Telehealth increases access to care in areas 
with workforce shortages and for individuals who 
live far away from health care facilities, have limited 
mobility or transportation, or have other barriers to 
accessing care. 
(5) The use of health technologies can strength-
en the expertise of the health care workforce, includ-
ing by connecting clinicians to specialty consulta-
tions. 
(6) Prior to the COVID–19 pandemic, the utili-
zation of telehealth services in the Medicare program 
under title XVIII of the Social Security Act (42 
U.S.C. 1395 et seq.) was low, with only 0.25 percent 
of Medicare fee-for-service beneficiaries utilizing tele-
health services in 2016. 
(7) The COVID–19 pandemic demonstrated ad-
ditional benefits of telehealth, including reducing in-
fection risk of patients and health care professionals 
and conserving space in health care facilities, and 
the Centers for Disease Control and Prevention rec-
ommended that telehealth services should be opti-
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mized, when available and appropriate, during the 
pandemic. 
(8) Long-term certainty about coverage of tele-
health services under the Medicare program is nec-
essary to fully realize the benefits of telehealth. 
(b) SENSE OF CONGRESS.—It is the sense of Con-
gress that— 
(1) health care providers can furnish safe, effec-
tive, and high-quality health care services through 
telehealth; 
(2) the Secretary of Health and Human Serv-
ices should promptly take all necessary measures to 
ensure that providers and beneficiaries can continue 
to furnish and utilize, respectively, telehealth serv-
ices in the Medicare program during and after the 
conclusion of the COVID–19 pandemic, including 
modifying, as appropriate, the definition of ‘‘inter-
active telecommunications system’’ in regulations 
and program instruction under the Medicare pro-
gram to ensure that providers can utilize all appro-
priate means and types of technology, including 
audio-visual, audio-only, and other types of tech-
nologies, to furnish telehealth services; and 
(3) barriers to the use of telehealth should be 
removed. 
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TITLE I—REMOVING BARRIERS 
TO TELEHEALTH COVERAGE 
SEC. 101. EXPANDING THE USE OF TELEHEALTH THROUGH 
THE WAIVER OF REQUIREMENTS. 
(a) IN GENERAL.—Section 1834(m) of the Social Se-
curity Act (42 U.S.C. 1395m(m)) is amended— 
(1) in paragraph (4)(C)(i), by striking ‘‘and 
(7)’’ and inserting ‘‘(7), and (9)’’; and 
(2) by adding at the end the following: 
‘‘(9) AUTHORITY
TO
WAIVE
REQUIREMENTS 
AND LIMITATIONS.— 
‘‘(A) IN
GENERAL.—Notwithstanding the 
preceding provisions of this subsection, in the 
case of telehealth services furnished on or after 
January 1, 2022, the Secretary may waive any 
requirement described in subparagraph (B) that 
is applicable to payment for telehealth services 
under this subsection, but only if the Secretary 
determines that such waiver would not ad-
versely impact quality of care. 
‘‘(B) REQUIREMENTS
DESCRIBED.—For 
purposes of this paragraph, requirements appli-
cable to payment for telehealth services under 
this subsection are— 
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‘‘(i) requirements relating to qualifica-
tions for an originating site under para-
graph (4)(C)(ii); 
‘‘(ii) 
any 
geographic 
requirement 
under paragraph (4)(C)(i) (other than ap-
plicable State law requirements, including 
State licensure requirements); 
‘‘(iii) any limitation on the type of 
technology used to furnish telehealth serv-
ices; 
‘‘(iv) any limitation on the types of 
practitioners who are eligible to furnish 
telehealth services (other than the require-
ment that the practitioner is enrolled 
under this title); 
‘‘(v) any limitation on specific services 
designated as telehealth services pursuant 
to this subsection (provided the Secretary 
determines that such services are clinically 
appropriate to furnish remotely); or 
‘‘(vi) any other limitation relating to 
the furnishing of telehealth services under 
this title identified by the Secretary. 
‘‘(C) WAIVER IMPLEMENTATION.—In im-
plementing a waiver under this paragraph, the 
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Secretary may establish parameters, as appro-
priate, for telehealth services under such waiv-
er, including with respect to payment of a facil-
ity fee for originating sites and beneficiary and 
program integrity protections. 
‘‘(D) PUBLIC
COMMENT.—The Secretary 
shall establish a process by which stakeholders 
may (on at least an annual basis) provide public 
comment on waivers under this paragraph. 
‘‘(E) PERIODIC
REVIEW
OF
WAIVERS.— 
The Secretary shall periodically, but not more 
often than every 3 years, reassess each waiver 
under this paragraph to determine whether the 
waiver continues to meet the quality of care 
condition applicable under subparagraph (A). 
The Secretary shall terminate any waiver that 
does not continue to meet such condition.’’. 
(b) POSTING OF INFORMATION.—Not later than 2 
years after the date on which a waiver under section 
1834(m)(9) of the Social Security Act, as added by sub-
section (a), first becomes effective, and at least every 2 
years thereafter, the Secretary of Health and Human 
Services shall post on the internet website of the Centers 
for Medicare & Medicaid Services— 
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(1) the number of Medicare beneficiaries receiv-
ing telehealth services by reason of each waiver 
under such section; 
(2) the impact of such waivers on expenditures 
and utilization under title XVIII of the Social Secu-
rity Act (42 U.S.C. 1395 et seq.); and 
(3) other outcomes, as determined appropriate 
by the Secretary. 
SEC. 102. REMOVING GEOGRAPHIC REQUIREMENTS FOR 
TELEHEALTH SERVICES. 
Section 1834(m)(4)(C) of the Social Security Act (42 
U.S.C. 1395m(m)(4)(C)), as amended by section 101, is 
amended— 
(1) in clause (i), in the matter preceding sub-
clause (I), by inserting ‘‘and clause (iii)’’ after ‘‘and 
(9)’’; and 
(2) by adding at the end the following new 
clause: 
‘‘(iii) REMOVAL OF GEOGRAPHIC RE-
QUIREMENTS.—The 
geographic 
require-
ments described in clause (i) shall not 
apply with respect to telehealth services 
furnished on or after the date of the enact-
ment of this clause.’’. 
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SEC. 103. EXPANDING ORIGINATING SITES. 
(a) EXPANDING
THE HOME
AS
AN ORIGINATING 
SITE.—Section 1834(m)(4)(C)(ii)(X) of the Social Secu-
rity Act (42 U.S.C. 1395m(m)(4)(C)(ii)(X)) is amended 
to read as follows: 
‘‘(X)(aa) Prior to the date of en-
actment of the CONNECT for Health 
Act of 2021, the home of an indi-
vidual but only for purposes of section 
1881(b)(3)(B) or telehealth services 
described in paragraph (7). 
‘‘(bb) On or after such date of 
enactment, the home of an indi-
vidual.’’. 
(b) ALLOWING ADDITIONAL ORIGINATING SITES.— 
Section 1834(m)(4)(C)(ii) of the Social Security Act (42 
U.S.C. 1395m(m)(4)(C)(ii)) is amended by adding at the 
end the following new subclause: 
‘‘(XII) Any other site determined 
appropriate by the Secretary at which 
an eligible telehealth individual is lo-
cated at the time a telehealth service 
is furnished via a telecommunications 
system.’’. 
(c) PARAMETERS FOR NEW ORIGINATING SITES.— 
Section 1834(m)(4)(C) of the Social Security Act (42 
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U.S.C. 1395m(m)(4)(C)), as amended by section 102, is 
amended by adding at the end the following new clause: 
‘‘(iv) 
REQUIREMENTS
FOR
NEW 
SITES.— 
‘‘(I) IN
GENERAL.—The Sec-
retary may establish requirements for 
the furnishing of telehealth services at 
sites described in clause (ii)(XII) to 
provide for beneficiary and program 
integrity protections. 
‘‘(II) CLARIFICATION.—Nothing 
in this clause shall be construed to 
preclude the Secretary from estab-
lishing requirements for other origi-
nating sites described in clause (ii)’’. 
(d) NO ORIGINATING SITE FACILITY FEE FOR NEW 
SITES.—Section 1834(m)(2)(B)(ii) of the Social Security 
Act (42 U.S.C. 1395m(m)(2)(B)(ii)) is amended— 
(1) in the heading, by striking ‘‘IF ORIGINATING 
SITE IS THE HOME’’ and inserting ‘‘FOR CERTAIN 
SITES’’; and 
(2) by striking ‘‘paragraph (4)(C)(ii)(X)’’ and 
inserting ‘‘subclause (X) or (XII) of paragraph 
(4)(C)’’. 
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SEC. 104. USE OF TELEHEALTH IN EMERGENCY MEDICAL 
CARE. 
(a) IN GENERAL.—Section 1834(m) of the Social Se-
curity Act (42 U.S.C. 1395m(m)), as amended by sections 
101 and 102, is amended— 
(1) in paragraph (4)(C)(i), by striking ‘‘and 
(9)’’ and inserting ‘‘(9), and (10)’’; and 
(2) by adding at the end the following: 
‘‘(10) TREATMENT
OF
EMERGENCY
MEDICAL 
CARE
FURNISHED
THROUGH
TELEHEALTH.—The 
geographic requirements described in paragraph 
(4)(C)(i) (other than applicable State law require-
ments, including State licensure requirements) shall 
not apply with respect to telehealth services that are 
services for emergency medical care (as determined 
by the Secretary) furnished on or after January 1, 
2022, to an eligible telehealth individual.’’. 
(b) ADDITIONAL SERVICES.—As part of the imple-
mentation of the amendments made by this section, the 
Secretary of Health and Human Services shall consider 
whether additional services should be added to the services 
specified in paragraph (4)(F)(i) of section 1834(m) of 
such Act (42 U.S.C. 1395m)) for authorized payment 
under paragraph (1) of such section. 
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SEC. 105. IMPROVEMENTS TO THE PROCESS FOR ADDING 
TELEHEALTH SERVICES. 
(a) REVIEW.—The Secretary shall undertake a review 
of 
the 
process 
established 
pursuant 
to 
section 
1834(m)(4)(F)(ii) of the Social Security Act (42 U.S.C. 
1395m(m)(4)(F)(ii)), and based on the results of such re-
view— 
(1) implement revisions to the process so that 
the criteria to add services prioritizes, as appro-
priate, improved access to care through clinically ap-
propriate telehealth services; and 
(2) provide clarification on what requests to 
add telehealth services under such process should in-
clude. 
(b) TEMPORARY COVERAGE
OF CERTAIN TELE-
HEALTH SERVICES.—Section 1834(m)(4)(F) of the Social 
Security Act (42 U.S.C. 1395m(m)(4)(F)) is amended by 
adding at the end the following new clause: 
‘‘(iii) TEMPORARY COVERAGE OF CER-
TAIN
TELEHEALTH
SERVICES.—The Sec-
retary may add services with a reasonable 
potential likelihood of clinical benefit and 
improved access to care when furnished via 
a telecommunications system (as deter-
mined by the Secretary) on a temporary 
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basis to those specified in clause (i) for au-
thorized payment under paragraph (1).’’. 
SEC. 106. FEDERALLY QUALIFIED HEALTH CENTERS AND 
RURAL HEALTH CLINICS. 
Section 1834(m) of the Social Security Act (42 
U.S.C. 1395m(m)), as amended by sections 101, 102, and 
104, is amended— 
(1) in paragraph (4)(C)(i), in the matter pre-
ceding subclause (I), by inserting ‘‘, (8)’’ after 
‘‘(7)’’; and 
(2) in paragraph (8)— 
(A) in the paragraph heading by inserting 
‘‘AND AFTER’’ after ‘‘DURING ’’; 
(B) in subparagraph (A)— 
(i) in the matter preceding clause (i), 
by inserting ‘‘and after such emergency pe-
riod’’ after ‘‘1135(g)(1)(B)’’; 
(ii) in clause (ii), by striking ‘‘and’’ at 
the end; 
(iii) by redesignating clause (iii) as 
clause (iv); and 
(iv) by inserting after clause (ii) the 
following new clause: 
‘‘(iii) the geographic requirements de-
scribed in paragraph (4)(C)(i) shall not 
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apply with respect to such a telehealth 
service; and’’; 
(C) by striking subparagraph (B) and in-
serting the following: 
‘‘(B) PAYMENT.— 
‘‘(i) IN GENERAL.—A telehealth serv-
ice furnished by a Federally qualified 
health center or a rural health clinic to an 
individual pursuant to this paragraph on 
or after the date of the enactment of this 
subparagraph shall be deemed to be so fur-
nished to such individual as an outpatient 
of such clinic or facility (as applicable) for 
purposes of paragraph (1) or (3), respec-
tively, of section 1861(aa) and payable as 
a Federally qualified health center service 
or rural health clinic service (as applicable) 
under the prospective payment system es-
tablished under section 1834(o) or under 
section 1833(a)(3), respectively. 
‘‘(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 
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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.’’. 
SEC. 107. NATIVE AMERICAN HEALTH FACILITIES. 
(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 sections 101, 102, and 103, is amended— 
(1) in clause (i), by striking ‘‘clause (iii)’’ and 
inserting ‘‘clauses (iii) and (v)’’; and 
(2) by adding at the end the following new 
clause: 
‘‘(v) NATIVE AMERICAN HEALTH FA-
CILITIES.—With respect to telehealth serv-
ices furnished on or after January 1, 2022, 
the originating site requirements described 
in clauses (i) and (ii) shall not apply with 
respect to a facility of the Indian Health 
Service, whether operated by such Service, 
or by an Indian tribe (as that term is de-
fined in section 4 of the Indian Health 
Care Improvement Act (25 U.S.C. 1603)) 
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or a tribal organization (as that term is 
defined in section 4 of the Indian Self-De-
termination and Education Assistance Act 
(25 U.S.C. 5304)), or a facility of the Na-
tive Hawaiian health care systems author-
ized under the Native Hawaiian Health 
Care Improvement Act (42 U.S.C. 11701 
et seq.).’’. 
(b) NO ORIGINATING SITE FACILITY FEE FOR CER-
TAIN
NATIVE
AMERICAN
FACILITIES.—Section 
1834(m)(2)(B)(i) of the Social Security Act (42 U.S.C. 
1395m(m)(2)(B)(i)) is amended, in the matter preceding 
subclause (I), by inserting ‘‘(other than an originating site 
that is only described in clause (v) of paragraph (4)(C), 
and does not meet the requirement for an originating site 
under clauses (i) and (ii) of such paragraph)’’ after ‘‘the 
originating site’’. 
SEC. 108. WAIVER OF TELEHEALTH REQUIREMENTS DUR-
ING PUBLIC HEALTH EMERGENCIES. 
Section 1135(g)(1) of the Social Security Act (42 
U.S.C. 1320b–5(g)(1)) is amended— 
(1) in subparagraph (A), in the matter pre-
ceding clause (i), by striking ‘‘subparagraph (B)’’ 
and inserting ‘‘subparagraphs (B) and (C)’’; and 
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(2) by adding at the end the following new sub-
paragraph: 
‘‘(C) EXCEPTION FOR WAIVER OF TELE-
HEALTH
REQUIREMENTS
DURING
PUBLIC 
HEALTH EMERGENCIES.—For purposes of sub-
section (b)(8), in addition to the emergency pe-
riod described in subparagraph (B), an ‘emer-
gency area’ is a geographical area in which, and 
an ‘emergency period’ is the period during 
which, there exists a public health emergency 
declared by the Secretary pursuant to section 
319 of the Public Health Service Act.’’. 
SEC. 109. USE OF TELEHEALTH IN RECERTIFICATION FOR 
HOSPICE CARE. 
(a) IN GENERAL.—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 inserting ‘‘and after such emergency pe-
riod’’ after ‘‘1135(g)(1)(B)’’. 
(b) GAO REPORT.—Not later than 3 years after the 
date of enactment of this Act, the Comptroller General 
of the United States shall submit a report to Congress 
evaluating the impact of the amendment made by sub-
section (a) on— 
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(1) the number and percentage of beneficiaries 
recertified for the Medicare hospice benefit at 180 
days and for subsequent benefit periods; 
(2) the appropriateness for hospice care of the 
patients recertified through the use of telehealth; 
and 
(3) any other factors determined appropriate by 
the Comptroller General. 
TITLE II—PROGRAM INTEGRITY 
SEC. 201. CLARIFICATION FOR FRAUD AND ABUSE LAWS 
REGARDING 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 (I), by striking ‘‘; or’’ and 
inserting a semicolon; 
(2) in subparagraph (J), by striking the period 
at the end and inserting ‘‘; or’’; and 
(3) by adding at the end the following new sub-
paragraph: 
‘‘(K) the provision of technologies (as de-
fined by the Secretary) on or after the date of 
the enactment of this subparagraph, by a pro-
vider of services or supplier (as such terms are 
defined for purposes of title XVIII) directly to 
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an individual who is entitled to benefits under 
part A of title XVIII, enrolled under part B of 
such title, or both, for the purpose of furnishing 
telehealth services, remote patient monitoring 
services, or other services furnished through the 
use of technology (as defined by the Secretary), 
if— 
‘‘(i) the technologies are not offered 
as part of any advertisement or solicita-
tion; and 
‘‘(ii) the provision of the technologies 
meets any other requirements set forth in 
regulations 
promulgated 
by 
the 
Sec-
retary.’’. 
SEC. 202. ADDITIONAL RESOURCES FOR TELEHEALTH 
OVERSIGHT. 
In addition to amounts otherwise available, there are 
authorized to be appropriated to the Inspector General of 
the Department of Health and Human Services for each 
of fiscal years 2022 through 2026, out of any money in 
the Treasury not otherwise appropriated, $3,000,000, to 
remain available until expended, for purposes of con-
ducting audits, investigations, and other oversight and en-
forcement activities with respect to telehealth services, re-
mote patient monitoring services, or other services fur-
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