I
104TH CONGRESS
1ST SESSION
H. R. 851
To direct the Secretary of Health and Human Services to establish pilot
projects to investigate the effectiveness of the use of rural health care
provider telemedicine networks to provide coverage of physician consult-
ative services under part B of the medicare program to individuals
residing in rural areas.
IN THE HOUSE OF REPRESENTATIVES
FEBRUARY 7, 1995
Mrs. LINCOLN (for herself, Mr. RICHARDSON, and Mr. DICKEY) introduced
the following bill; which was referred to the Committee on 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 consider-
ation of such provisions as fall within the jurisdiction of the committee
concerned
A BILL
To direct the Secretary of Health and Human Services to
establish pilot projects to investigate the effectiveness
of the use of rural health care provider telemedicine
networks to provide coverage of physician consultative
services under part B of the medicare program to indi-
viduals residing in rural areas.
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 ‘‘Rural Telemedicine
Act of 1995’’.
SEC. 2. ESTABLISHMENT OF PROJECT.
(a) IN GENERAL.—The Secretary of Health and
Human Services (hereafter referred to as the ‘‘Secretary’’)
shall establish not more than 10 pilot projects not later
than 9 months after the date of enactment of this Act
to investigate over a 3-year period the effectiveness of the
use of rural health care provider telemedicine networks to
provide coverage of physician consultative services under
part B of the medicare program to individuals residing
in rural areas.
(b) NETWORKS DEFINED.—In this Act, the term
‘‘rural health care provider telemedicine network’’ (here-
after referred to as a ‘‘network’’) means a network of pro-
viders that meets the following requirements:
(1) The network serves physicians, clinics, and
other nontertiary care providers in a rural area who
have entered into agreements with a multispecialty
tertiary care provider (without regard to whether or
not such tertiary care provider is in the rural area)
regarding patient referral and transfer, the use of
joint communications systems, and the provision of
emergency and nonemergency transportation among
the network members.
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(2) The area in which the network operates is
a rural area designated as a health professional
shortage area (under section 332(a) of the Public
Health Service Act) or is an underserved rural area
in accordance with such other criteria as the Sec-
retary may specify.
SEC. 3. MEDICARE PAYMENT FOR PARTICIPANTS.
(a) IN GENERAL.—Under the projects established
under this Act, the Secretary shall make payments from
the Federal Supplementary Medical Insurance Trust
Fund under part B of title XVIII of the Social Security
Act in accordance with the methodology described in sub-
section (b) for physicians’ services consisting of a profes-
sional consultation with an individual or entity furnishing
a service for which payment may be made under such part
to a medicare beneficiary in a rural area, notwithstanding
that the individual providing the professional consultation
is not at the same location as the individual furnishing
the service to the medicine beneficiary.
(b) METHODOLOGY FOR DETERMINING AMOUNT OF
PAYMENTS.—Taking into account the amount of funds
available for payments under the project, the Secretary
shall establish a methodology for determining the amount
of payments made under subsection (a), and shall include
in the methodology a method for making payment for rea-
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sonable costs incurred in the usage of signal transmission
facilities suitable for the conduct of physician consultative
services.
(c) PAYMENT
FOR NONPHYSICIAN PROVIDERS.—
Payments may be made under subsection (a) for any serv-
ice described in such paragraph, without regard to wheth-
er or not the individual furnishing such service is a physi-
cian.
SEC. 4. ELIGIBILITY OF NETWORKS.
(a) IN GENERAL.—A network is eligible to partici-
pate in a pilot project under this Act if—
(1) the network submits to the Secretary (at
such time and in such form as the Secretary may re-
quire) an application containing such information
and assurances as the Secretary may require; and
(2) the network agrees to submit to the Sec-
retary such information as the Secretary may re-
quire to determine the amount of payments de-
scribed in section 3(b), to prepare reports under sec-
tion 6, and to otherwise carry out the project.
(b) RURAL AREA DEFINED.—In this Act, the term
‘‘rural area’’ has the meaning given such term in section
1886(d)(2)(D) of the Social Security Act.
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SEC. 5. CRITERIA FOR SELECTING PARTICIPANTS.
(a) TECHNOLOGY APPLIED.—In selecting among eli-
gible networks for participation in pilot projects under this
Act, the Secretary shall give priority to networks that pro-
vide for consultations between patients and medical spe-
cialists involving transmission of detailed data on the pa-
tient in a manner that serves as a reasonable substitute
for inperson interaction between the patients and the spe-
cialists.
(b) PERMITTING EXISTING NETWORKS TO PARTICI-
PATE.—Nothing in this Act may be construed to prohibit
the Secretary from selecting a network operating at the
time of the establishment of the pilot projects from partici-
pating in the project.
SEC. 6. REPORTS.
(a) INTERIM REPORT ON PARTICIPATING SITES.—
Not later than 24 months after the Secretary first makes
payment under subsection (b) for services under a pilot
project, the Secretary shall submit a report to Congress
describing the projects and the networks participating in
the projects under this section, including a description of
the amounts expended and the number of patients served
under the projects.
(b) FINAL.—Not later than 1 year after the termi-
nation of the projects, the Secretary shall submit a final