I 
111TH CONGRESS 
1ST SESSION H. R. 2068 
To improve the provision of telehealth services under the Medicare Program, 
to provide grants for the development of telehealth networks, and for 
other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
APRIL 23, 2009 
Mr. THOMPSON of California (for himself, Mr. STUPAK, Mr. TERRY, and Mr. 
SAM JOHNSON of Texas) introduced the following bill; which was referred 
to the Committee on Energy and Commerce, and in addition to the Com-
mittee 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 improve the provision of telehealth services under the 
Medicare Program, to provide grants for the development 
of telehealth networks, 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 
‘‘Medicare Telehealth Enhancement Act of 2009’’. 
(b) TABLE OF CONTENTS.—The table of contents of 
this Act is as follows: 
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Sec. 1. Short title; table of contents. 
TITLE I—MEDICARE PROGRAM 
Sec. 101. Expansion and improvement of telehealth services. 
Sec. 102. Increase in number of types of originating sites; clarification. 
Sec. 103. Expansion of eligible telehealth providers and credentialing of tele-
medicine practitioners. 
Sec. 104. Access to telehealth services in the home. 
Sec. 105. Coverage of home health remote patient management services for 
chronic health conditions. 
Sec. 106. Sense of Congress on the use of remote patient management services. 
Sec. 107. Telehealth Advisory Committee. 
TITLE II—HRSA GRANT PROGRAM 
Sec. 201. Grant program for the development of telehealth networks. 
Sec. 202. Reauthorization of telehealth network and telehealth resource centers 
grant programs. 
TITLE I—MEDICARE PROGRAM 
SEC. 101. EXPANSION AND IMPROVEMENT OF TELEHEALTH 
SERVICES. 
(a) EXPANDING ACCESS TO TELEHEALTH SERVICES 
TO ALL AREAS.—Section 1834(m)(4)(C)(i) of the Social 
Security Act (42 U.S.C. 1395m(m)(4)(C)(i)) is amended 
in paragraph (4)(C)(i) by striking ‘‘and only if such site 
is located’’ and all that follows and inserting ‘‘without re-
gard to the geographic area within the United States 
where the site is located.’’. 
(b) EXPANSION OF USE OF STORE-AND-FORWARD 
TECHNOLOGY.—The 
second 
sentence 
of 
section 
1834(m)(1) of such Act (42 U.S.C. 1395m(m)(1)) is 
amended by inserting ‘‘and any telehealth program that 
has been the recipient of any Federal support from the 
Centers for Medicare & Medicaid Services, the Indian 
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Health Service, or the Health Services and Resources Ad-
ministration’’ after ‘‘Alaska or Hawaii’’. 
(c) EFFECTIVE DATE.—The amendments made by 
this section shall apply to services furnished on or after 
January 1, 2010. 
SEC. 102. INCREASE IN NUMBER OF TYPES OF ORIGI-
NATING SITES; CLARIFICATION. 
(a) INCREASE.—Paragraph (4)(C)(ii) of section 
1834(m) of the Social Security Act (42 U.S.C. 1395m(m)) 
is amended by adding at the end the following new sub-
clause: 
‘‘(IX) A renal dialysis facility.’’ 
(b) CLARIFICATION OF INTENT OF THE TERM ORIGI-
NATING SITE.—Such section is further amended by add-
ing at the end the following new paragraph: 
‘‘(5) CONSTRUCTION.—In applying the term 
‘originating site’ under this subsection, the Secretary 
shall apply the term only for the purpose of deter-
mining whether a site is eligible to receive a facility 
fee. Nothing in the application of such term under 
this subsection shall be construed as affecting the 
ability of an eligible practitioner to submit claims for 
telehealth services that are provided to other sites 
that have telehealth systems and capabilities.’’. 
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(c) EFFECTIVE DATE.—The amendments made by 
this section shall apply to services furnished on or after 
January 1, 2010. 
SEC. 103. EXPANSION OF ELIGIBLE TELEHEALTH PRO-
VIDERS AND CREDENTIALING OF TELEMEDI-
CINE PRACTITIONERS. 
(a) EXPANSION OF ELIGIBLE TELEHEALTH PRO-
VIDERS.—Section 1834(m)(1) of the Social Security Act 
(42 U.S.C. 1395m(m)(1)) is amended— 
(1) in paragraph (1)— 
(A) by striking ‘‘or a practitioner’’ and in-
serting ‘‘, a practitioner’’; 
(B) by inserting ‘‘, or other telehealth pro-
vider’’ after ‘‘1842(b)(18)(C))’’; and 
(C) by striking ‘‘or practitioner’’ and in-
serting ‘‘, practitioner, or provider’’; 
(2) in paragraphs (2), (3)(A), and (4), by strik-
ing ‘‘or practitioner’’ and inserting ‘‘, practitioner, 
or other telehealth provider’’ each place it appears; 
(3) in paragraph (4), by adding at the end the 
following new subparagraph: 
‘‘(G) TELEHEALTH PROVIDER.—The term 
‘telehealth provider’ means any supplier or pro-
vider of services (other than a physician or 
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practitioner) that is eligible to provide other 
health services under this title.’’. 
(b) 
CREDENTIALING
TELEMEDICINE
PRACTI-
TIONERS.—Section 1834(m) of such Act is amended by 
adding at the end the following new paragraph: 
‘‘(5) HOSPITAL CREDENTIALING OF TELEMEDI-
CINE PRACTITIONERS.—A telemedicine practitioner 
that is credentialed by a hospital in compliance with 
the Joint Commission Standards for Telemedicine 
shall be considered in compliance with Medicare con-
dition 
of 
participation 
and 
reimbursement 
credentialing requirements for telemedicine serv-
ices.’’. 
SEC. 104. ACCESS TO TELEHEALTH SERVICES IN THE 
HOME. 
(a) IN GENERAL.—Section 1895 of the Social Secu-
rity Act (42 U.S.C. 1395fff(e)) is amended by adding at 
the end the following new subsection: 
‘‘(f) COVERAGE OF TELEHEALTH SERVICES.— 
‘‘(1) IN GENERAL.—The Secretary shall include 
telehealth services that are furnished via a tele-
communication system by a home health agency to 
an individual receiving home health services under 
section 1814(a)(2)(C) or 1835(a)(2)(A) as a home 
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health visit for purposes of eligibility and payment 
under this title if the telehealth services— 
‘‘(A) are ordered as part of a plan of care 
certified by a physician pursuant to section 
1814(a)(2)(C) or 1835(a)(2)(A); 
‘‘(B) do not substitute for in-person home 
health services ordered as part of a plan of care 
certified by a physician pursuant to such re-
spective section; and 
‘‘(C) are considered the equivalent of a 
visit under criteria developed by the Secretary 
under paragraph (3). 
‘‘(2) PHYSICIAN
CERTIFICATION.—Nothing in 
this section shall be construed as waiving the re-
quirement for a physician certification under section 
1814(a)(2)(C) or 1835(a)(2)(A) for the payment for 
home health services, whether or not furnished via 
a telecommunication system. 
‘‘(3) CRITERIA FOR VISIT EQUIVALENCY.— 
‘‘(A) STANDARDS.—The Secretary shall es-
tablish standards and qualifications for catego-
rizing and coding under HCPCS codes tele-
health services under this subsection as equiva-
lent to an in-person visit for purposes of eligi-
bility and payment for home health services 
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under this title. In establishing the standards 
and qualifications, the Secretary may distin-
guish between varying modes and modalities of 
telehealth services and shall consider— 
‘‘(i) the nature and amount of service 
time involved; and 
‘‘(ii) the functions of the telecommuni-
cations. 
‘‘(B) LIMITATION.—A telecommunication 
that consists solely of a telephone audio con-
versation, facsimile, electronic text mail, or con-
sultation between two health care practitioners 
is not considered a visit under this subsection. 
‘‘(4) TELEHEALTH SERVICE.— 
‘‘(A) DEFINITION.—For purposes of this 
subsection, the term ‘telehealth service’ means 
technology-based professional consultations, pa-
tient monitoring, patient training services, clin-
ical observation, assessment, or treatment, and 
any additional services that utilize technologies 
specified by the Secretary as HCPCS codes de-
veloped under paragraph (3). 
‘‘(B) UPDATE
OF
HCPCS
CODES.—The 
Secretary shall establish a process for the up-
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dating, not less frequently than annually, of 
HCPCS codes for telehealth services. 
‘‘(5) CONDITIONS
FOR
PAYMENT
AND
COV-
ERAGE.—Nothing in this subsection shall be con-
strued as waiving any condition of payment under 
sections 1814(a)(2)(C) or 1835(a)(2)(A) or exclu-
sion of coverage under section 1862(a)(1). 
‘‘(6) COST REPORTING.—Notwithstanding any 
provision to the contrary, the Secretary shall provide 
that the costs of telehealth services under this sub-
section shall be reported as a reimbursable cost cen-
ter on any cost report submitted by a home health 
agency to the Secretary.’’. 
(b) EFFECTIVE DATE.— 
(1) The amendment made by subsection (a) 
shall apply to telehealth services furnished on or 
after October 1, 2010. The Secretary of Health and 
Human Services shall develop and implement cri-
teria and standards under section 1895(f)(3) of the 
Social Security Act, as amended by subsection (a), 
by no later than July 1, 2010. 
(2) In the event that the Secretary has not 
complied with these deadlines, beginning October 1, 
2010, a home health visit for purpose of eligibility 
and payment under title XVIII of the Social Secu-
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rity Act shall include telehealth services under sec-
tion 1895(f) of such Act with the aggregate of tele-
communication encounters in a 24-hour period con-
sidered the equivalent of one in-person visit. 
SEC. 105. COVERAGE OF HOME HEALTH REMOTE PATIENT 
MANAGEMENT 
SERVICES 
FOR 
CHRONIC 
HEALTH CONDITIONS. 
(a) MEDICARE COVERAGE.— 
(1) IN
GENERAL.—Section 1861(s)(2) of the 
Social Security Act (42 U.S.C. 1395x(s)(2)) is 
amended— 
(A) in subparagraph (DD), by striking 
‘‘and’’ at the end; 
(B) in subparagraph (EE), by adding 
‘‘and’’ at the end; and 
(C) by inserting after subparagraph (EE) 
the following new subparagraph: 
‘‘(FF) home health remote patient management 
services (as defined in subsection (hhh));’’. 
(2) SERVICES
DESCRIBED.—Section 1861 of 
such Act (42 U.S.C. 1395x) is amended by adding 
at the end the following new subsection: 
‘‘(hhh) HOME HEALTH REMOTE PATIENT MANAGE-
MENT SERVICES FOR CHRONIC HEALTH CONDITIONS.— 
(1) The term ‘remote patient management services’ means 
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the remote monitoring, evaluation, and management of an 
individual with a covered chronic health condition (as de-
fined in paragraph (2)) through the utilization of a system 
of technology that allows a remote interface to collect and 
transmit clinical data between the individual and a home 
health agency, in accordance with a plan of care estab-
lished by a physician, for the purposes of clinical review 
or response by the home health agency. Such term, with 
respect to an individual, does not include any remote mon-
itoring, evaluation, or management of the individual if 
such remote monitoring, evaluation, or management, re-
spectively, is included as a home health visit under section 
1895(f) for purposes of payment under this title. 
‘‘(2) For purposes of paragraph (1), the term ‘cov-
ered chronic health condition’ means any chronic health 
condition specified by the Secretary.’’. 
(b) PAYMENT.— 
(1) IN GENERAL.—Section 1834 of such Act 
(42 U.S.C. 1395l) is amended by adding at the end 
the following new subsection: 
‘‘(n) HOME HEALTH REMOTE PATIENT MANAGE-
MENT SERVICES.— 
‘‘(1) IN GENERAL.—The Secretary shall estab-
lish a fee schedule for home health remote patient 
management 
services 
(as 
defined 
in 
section 
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1861(hhh)) for which payment is made under this 
part. The fee schedule shall be designed in a manner 
so that, on an annual basis, the aggregate payment 
amounts under this title for such services approxi-
mates 50 percent of the savings amount described in 
paragraph (2) for such year. 
‘‘(2) SAVINGS DESCRIBED.— 
‘‘(A) IN GENERAL.—For purposes of para-
graph (1), the savings amount described in this 
paragraph for a year is the amount (if any), as 
estimated by the Secretary before the beginning 
of the year, by which— 
‘‘(i) the product described in subpara-
graph (B) for the year, exceeds 
‘‘(ii) the total payments under this 
part and part A for items and services fur-
nished to individuals receiving home health 
remote patient management services at any 
time during the year. 
‘‘(B) PRODUCT DESCRIBED.—The product 
described in this subparagraph for a year is the 
product of— 
‘‘(i) the average per capita total pay-
ments under this part and part A for items 
and services furnished during the year to 
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individuals not described in subparagraph 
(A)(ii), adjusted to remove case mix dif-
ferences between such individuals not de-
scribed in such subparagraph and the indi-
viduals described in such subparagraph; 
and 
‘‘(ii) the number of individuals under 
subparagraph (A)(ii) for the year. 
‘‘(3) LIMITATION.—In no case may payments 
under this subsection result in the aggregate expend-
itures under this title (including payments under 
this subsection) exceeding the amount that the Sec-
retary estimates would have been expended if cov-
erage under this title for home health patient man-
agement services was not provided. 
‘‘(4) CLARIFICATION.—Payments under the fee 
schedule under this subsection, with respect to an 
individual, shall be in addition to any other pay-
ments that a home health agency would otherwise 
receive under this title for items and services fur-
nished to such individual and shall have no effect on 
the amount of such other payments. 
‘‘(5) PAYMENT
TRANSFER.—There shall be 
transferred from the Federal Hospital Insurance 
Trust Fund under section 1817 to the Federal Sup-
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plementary Medical Insurance Trust Fund under 
section 1841 each year an amount equivalent to the 
product of— 
‘‘(A) expenditures under this subsection 
for the year, and 
‘‘(B) the ratio of the portion of the savings 
described in paragraph (2) for the year that are 
attributable to part A, to the total savings de-
scribed in such paragraph for the year.’’. 
(2) 
CONFORMING
AMENDMENT.—Section 
1833(a)(1) of such Act (42 U.S.C. 1395l(1)) is 
amended— 
(A) by striking ‘‘and (W)’’ and inserting 
‘‘(W)’’; and 
(B) by inserting before the semicolon at 
the end the following: ‘‘, (X) with respect to 
home health remote patient management serv-
ices (as defined in section 1861(hhh)), the 
amounts paid shall be the amount determined 
under the fee schedule established under section 
1834(n)’’. 
(c) EXPANSION
OF HOME HEALTH REMOTE PA-
TIENT MANAGEMENT SERVICES COVERAGE
TO ADDI-
TIONAL CHRONIC HEALTH CONDITIONS.—The Secretary 
of Health and Human Services is authorized to carry out 
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pilot projects for purposes of determining the extent to 
which the coverage under title XVIII of the Social Security 
Act of home health remote patient management services 
(as defined in paragraph (1) of section 1861(hhh) of such 
Act, as added by subsection (a)) should be extended to 
individuals with chronic health conditions other than those 
initially specified by the Secretary under paragraph (2) 
of such section. 
(d) EFFECTIVE DATE.—The amendments made by 
subsections (a), (b), and (c) shall apply to services fur-
nished on or after January 1, 2010. 
SEC. 106. SENSE OF CONGRESS ON THE USE OF REMOTE 
PATIENT MANAGEMENT SERVICES. 
(a) FINDINGS.—Congress finds as follows: 
(1) Remote patient management services can 
make chronic disease management more effective 
and efficient for patients and for the health care sys-
tem. 
(2) By collecting, analyzing, and transmitting 
clinical health information to a health care provider, 
remote patient management services allow patients 
and providers to manage the medical condition of 
patients in a consistent and real time fashion. 
(3) Utilization of remote patient management 
services not only improves the quality of care given 
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to patients, it also reduces the need for frequent of-
fice appointments, costly emergency room visits, and 
unnecessary hospitalizations. 
(4) Management the medical condition or dis-
ease of a patient from the patient’s home reduces 
the need for face to face provider interactions. Use 
of remote patient management services minimizes 
unnecessary travel and missed work and provides 
particular value to patients residing in rural or un-
derserved communities who would otherwise face po-
tentially significant access barriers to receiving need-
ed care. 
(5) Among the areas in which remote patient 
management services are emerging in health care 
are the treatment of congestive heart failure, diabe-
tes, cardiac arrhythmia, epilepsy, and sleep apnea. 
Prompt transmission of clinical data on each of 
these conditions, to the health care provider or the 
patient as appropriate, is essential to providing time-
ly and appropriate therapeutic interventions which 
can then reduce expensive hospitalizations. 
(6) Despite these benefits, remote patient man-
agement services have failed to diffuse rapidly. A 
significant barrier to wider adoption is the relative 
lack of payment mechanisms in fee for service Medi-
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care to reimburse for remote, non face to face pa-
tient management. 
(7) Elimination of this barrier to new remote 
patient management services should be encouraged 
by requiring reimbursement under the Medicare pro-
gram for providers’ time spent analyzing and re-
sponding to patient data transmitted by remote 
technologies. 
(8) Reimbursement under the Medicare pro-
gram for health care providers’ time spent analyzing 
and responding to data transmitted to providers by 
remote technologies should be made on a separate 
basis and should not be combined with payments for 
others services (also referred to as ‘‘bundled pay-
ments’’). 
(9) Payment codes used for reporting and bill-
ing for payment for providers’ remote patient man-
agement services should be revised or adjusted, as 
appropriate, to encourage the application of such 
services for other medical conditions. 
(b) SENSE OF CONGRESS.—It is the sense of the 
Congress that— 
(1) remote patient management services are in-
tegral to improvement in the delivery, care, and effi-
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ciency of health care services furnished in the 
United States; and 
(2) the Administrator of the Centers for Medi-
care & Medicaid Services should be encouraged to— 
(A) expand the types of medical conditions 
for which the use of remote patient manage-
ment services are reimbursed under the Medi-
care program; 
(B) provide for separate, non-bundled pay-
ment under the Medicare program for remote 
patient management services; and 
(C) create, revise and adjust, as appro-
priate, codes for the accurate reporting and bill-
ing for payment for remote patient manage-
ment services. 
SEC. 107. TELEHEALTH ADVISORY COMMITTEE. 
(a) IN GENERAL.—Section 1834(m)(4)(F)(ii) of the 
Social Security Act (42 U.S.C. 1395m(m)(4)(F)(ii)) is 
amended by adding at the end the following sentences: 
‘‘Such process shall require the Secretary to take into ac-
count the recommendations of the Telehealth Advisory 
Committee (as established under section 107(b) of the 
Medicare Telehealth Enhancement Act of 2009) when 
adding or deleting services (and HCPCS codes) and in es-
tablishing policies of the Centers for Medicare & Medicaid 
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Services regarding the delivery of telehealth services. If 
the Secretary does not implement a recommendation of 
the Telehealth Advisory Committee, the Secretary shall 
publish in the Federal Register a statement regarding the 
reason such recommendation was not implemented.’’. 
(b) TELEHEALTH ADVISORY COMMITTEE.— 
(1) ESTABLISHMENT.—On and after the date 
that is 6 months after the date of enactment of this 
Act, the Secretary of Health and Human Services 
(in this subsection referred to as the ‘‘Secretary’’) 
shall have in place a Telehealth Advisory Committee 
(in this subsection referred to as the ‘‘Advisory 
Committee’’) to make recommendations to the Sec-
retary on— 
(A) policies of the Centers for Medicare & 
Medicaid Services regarding the delivery of tele-
health services; and 
(B) the appropriate addition or deletion of 
services (and HCPCS codes) to those specified 
in paragraph (4)(F)(i) of section 1834(m) of 
the Social Security Act (42 U.S.C. 1395m(m)) 
for authorized payment under paragraph (1) of 
such section. 
(2) MEMBERSHIP; TERMS.— 
(A) MEMBERSHIP.— 
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(i) IN GENERAL.—The Advisory Com-
mittee shall be composed of 9 members, to 
be appointed by the Secretary, of whom— 
(I) five shall be practicing physi-
cians; 
(II) two shall be practicing non- 
physician health care providers; and 
(III) two shall be administrators 
of telehealth programs. 
(ii) REQUIREMENTS FOR APPOINTING 
MEMBERS.—In appointing members of the 
Advisory Committee, the Secretary shall— 
(I) ensure that each member has 
prior experience with the practice of 
telemedicine or telehealth; 
(II) give preference to individuals 
who are currently providing telemedi-
cine or telehealth services or who are 
involved in telemedicine or telehealth 
programs; 
(III) ensure that the membership 
of the Advisory Committee represents 
a balance of specialties and geo-
graphic regions; and 
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(IV) take into account the rec-
ommendations of stakeholders. 
(B) TERMS.—The members of the Advi-
sory Committee shall serve for such term as the 
Secretary may specify. 
(C) CONFLICTS OF INTEREST.—An advi-
sory committee member may not participate 
with respect to a particular matter considered 
in an advisory committee meeting if such mem-
ber (or an immediate family member of such 
member) has a financial interest that could be 
affected by the advice given to the Secretary 
with respect to such matter. 
(3) MEETINGS.—The Advisory Committee shall 
meet twice per year and at such other times as the 
Advisory Committee may provide. 
(4) PERMANENT
COMMITTEE.—Section 14 of 
the Federal Advisory Committee Act (5 U.S.C. 
App.) shall not apply to the Advisory Committee. 
(5) WAIVER
OF
ADMINISTRATIVE
LIMITA-
TION.—The Secretary shall establish the Advisory 
Committee notwithstanding any limitation that may 
apply to the number of advisory committees that 
may be established (within the Department of 
Health and Human Services or otherwise). 
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TITLE II—HRSA GRANT 
PROGRAM 
SEC. 201. GRANT PROGRAM FOR THE DEVELOPMENT OF 
TELEHEALTH NETWORKS. 
(a) IN GENERAL.—The Secretary of Health and 
Human Services (in this section referred to as the ‘‘Sec-
retary’’), acting through the Director of the Office for the 
Advancement of Telehealth (of the Health Resources and 
Services Administration), shall make grants to eligible en-
tities (as described in subsection (b)(2)) for the purpose 
of expanding access to health care services for individuals 
in rural areas, frontier areas, and urban medically under-
served areas through the use of telehealth. 
(b) ELIGIBLE ENTITIES.— 
(1) APPLICATION.—To be eligible to receive a 
grant under this section, an eligible entity described 
in paragraph (2) shall, in consultation with the 
State office of rural health or other appropriate 
State entity, prepare and submit to the Secretary an 
application, at such time, in such manner, and con-
taining such information as the Secretary may re-
quire, including the following: 
(A) A description of the anticipated need 
for the grant. 
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(B) A description of the activities which 
the entity intends to carry out using amounts 
provided under the grant. 
(C) A plan for continuing the project after 
Federal support under this section is ended. 
(D) A description of the manner in which 
the activities funded under the grant will meet 
health care needs of underserved rural popu-
lations within the State. 
(E) A description of how the local commu-
nity or region to be served by the network or 
proposed network will be involved in the devel-
opment and ongoing operations of the network. 
(F) The source and amount of non-Federal 
funds the entity would pledge for the project. 
(G) A showing of the long-term viability of 
the project and evidence of health care provider 
commitment to the network. 
The application should demonstrate the manner in 
which the project will promote the integration of 
telehealth in the community so as to avoid redun-
dancy of technology and achieve economies of scale. 
(2) ELIGIBLE ENTITIES.— 
(A) IN GENERAL.—An eligible entity de-
scribed in this paragraph is a hospital or other 
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health care provider in a health care network of 
community-based health care providers that in-
cludes at least— 
(i) two of the organizations described 
in subparagraph (B); and 
(ii) one of the institutions and entities 
described in subparagraph (C), 
if the institution or entity is able to dem-
onstrate use of the network for purposes of 
education or economic development (as required 
by the Secretary). 
(B) ORGANIZATIONS DESCRIBED.—The or-
ganizations described in this subparagraph are 
the following: 
(i) Community or migrant health cen-
ters. 
(ii) Local health departments. 
(iii) Nonprofit hospitals. 
(iv) Private practice health profes-
sionals, including community and rural 
health clinics. 
(v) Other publicly funded health or so-
cial services agencies. 
(vi) Skilled nursing facilities. 
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(vii) County mental health and other 
publicly funded mental health facilities. 
(viii) Providers of home health serv-
ices. 
(ix) Renal dialysis facilities. 
(C) INSTITUTIONS
AND
ENTITIES
DE-
SCRIBED.—The institutions and entities de-
scribed in this subparagraph are the following: 
(i) A public school. 
(ii) A public library. 
(iii) A university or college. 
(iv) A local government entity. 
(v) A local health entity. 
(vi) A health-related nonprofit founda-
tion. 
(vii) An academic health center. 
An eligible entity may include for-profit entities so 
long as the recipient of the grant is a not-for-profit 
entity. 
(c) PREFERENCE.—The Secretary shall establish pro-
cedures to prioritize financial assistance under this section 
based upon the following considerations: 
(1) The applicant is a health care provider in 
a health care network or a health care provider that 
proposes to form such a network that furnishes or 
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proposes to furnish services in a medically under-
served area, health professional shortage area, or 
mental health professional shortage area. 
(2) The applicant is able to demonstrate broad 
geographic coverage in the rural or medically under-
served areas of the State, or States in which the ap-
plicant is located. 
(3) The applicant proposes to use Federal 
funds to develop plans for, or to establish, telehealth 
systems that will link rural hospitals and rural 
health care providers to other hospitals, health care 
providers, and patients. 
(4) The applicant will use the amounts provided 
for a range of health care applications and to pro-
mote greater efficiency in the use of health care re-
sources. 
(5) The applicant is able to demonstrate the 
long-term viability of projects through cost participa-
tion (cash or in-kind). 
(6) The applicant is able to demonstrate finan-
cial, institutional, and community support for the 
long-term viability of the network. 
(7) The applicant is able to provide a detailed 
plan for coordinating system use by eligible entities 
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so that health care services are given a priority over 
non-clinical uses. 
(d) MAXIMUM AMOUNT OF ASSISTANCE TO INDI-
VIDUAL RECIPIENTS.—The Secretary shall establish, by 
regulation, the terms and conditions of the grant and the 
maximum amount of a grant award to be made available 
to an individual recipient for each fiscal year under this 
section. The Secretary shall cause to have published in the 
Federal Register or the ‘‘HRSA Preview’’ notice of the 
terms and conditions of a grant under this section and 
the maximum amount of such a grant for a fiscal year. 
(e) USE OF AMOUNTS.—The recipient of a grant 
under this section may use sums received under such 
grant for the acquisition of telehealth equipment and 
modifications or improvements of telecommunications fa-
cilities including the following: 
(1) The development and acquisition through 
lease or purchase of computer hardware and soft-
ware, audio and video equipment, computer network 
equipment, interactive equipment, data terminal 
equipment, and other facilities and equipment that 
would further the purposes of this section. 
(2) The provision of technical assistance and in-
struction for the development and use of such pro-
gramming equipment or facilities. 
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(3) The development and acquisition of instruc-
tional programming. 
(4) Demonstration projects for teaching or 
training medical students, residents, and other 
health profession students in rural or medically un-
derserved training sites about the application of tele-
health. 
(5) The provision of telenursing services de-
signed to enhance care coordination and promote pa-
tient self-management skills. 
(6) The provision of services designed to pro-
mote patient understanding and adherence to na-
tional guidelines for common chronic diseases, such 
as congestive heart failure or diabetes. 
(7) Transmission costs, maintenance of equip-
ment, and compensation of specialists and referring 
health care providers, when no other form of reim-
bursement is available. 
(8) Development of projects to use telehealth to 
facilitate collaboration between health care providers. 
(9) Electronic archival of patient records. 
(10) Collection and analysis of usage statistics 
and data that can be used to document the cost-ef-
fectiveness of the telehealth services. 
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(11) Such other uses that are consistent with 
achieving the purposes of this section as approved by 
the Secretary. 
(f) PROHIBITED USES.—Sums received under a 
grant under this section may not be used for any of the 
following: 
(1) To acquire real property. 
(2) Expenditures to purchase or lease equip-
ment to the extent the expenditures would exceed 
more than 40 percent of the total grant funds. 
(3) To purchase or install transmission equip-
ment off the premises of the telehealth site and any 
transmission costs not directly related to the grant. 
(4) For construction, except that such funds 
may be expended for minor renovations relating to 
the installation of equipment. 
(5) Expenditures for indirect costs (as deter-
mined by the Secretary) to the extent the expendi-
tures would exceed more than 15 percent of the total 
grant. 
(g) ADMINISTRATION.— 
(1) NONDUPLICATION.—The Secretary shall en-
sure that facilities constructed using grants provided 
under this section do not duplicate adequately estab-
lished telehealth networks. 
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(2) COORDINATION WITH OTHER AGENCIES.— 
The Secretary shall coordinate, to the extent prac-
ticable, with other Federal and State agencies and 
not-for-profit organizations, operating similar grant 
programs to pool resources for funding meritorious 
proposals. 
(3) INFORMATIONAL EFFORTS.—The Secretary 
shall establish and implement procedures to carry 
out outreach activities to advise potential end users 
located in rural and medically underserved areas of 
each State about the program authorized by this 
section. 
(h) PROMPT IMPLEMENTATION.—The Secretary shall 
take such actions as are necessary to carry out the grant 
program as expeditiously as possible. 
(i) AUTHORIZATION
OF APPROPRIATIONS.—There 
are authorized to be appropriated to carry out this section 
$10,000,000 for fiscal year 2010, and such sums as may 
be necessary for each of the fiscal years 2011 through 
2014. 
SEC. 202. REAUTHORIZATION OF TELEHEALTH NETWORK 
AND 
TELEHEALTH 
RESOURCE 
CENTERS 
GRANT PROGRAMS. 
Subsection (s) of section 330I of the Public Health 
Service Act (42 U.S.C. 254c–14) is amended— 
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(1) in paragraph (1)— 
(A) by striking ‘‘and’’ before ‘‘such sums’’; 
and 
(B) by inserting ‘‘$10,000,000 for fiscal 
year 2010, and such sums as may be necessary 
for each of fiscal years 2011 through 2014’’ be-
fore the semicolon; and 
(2) in paragraph (2)— 
(A) by striking ‘‘and’’ before ‘‘such sums’’; 
and 
(B) by inserting ‘‘$10,000,000 for fiscal 
year 2010, and such sums as may be necessary 
for each of fiscal years 2011 through 2014’’ be-
fore the semicolon. 
Æ 
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