540 
‘‘(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, 
2021, to an eligible telehealth individual at an origi-
nating site described in subclause (II), (V), or (VII) 
of paragraph (4)(C)(ii).’’. 
(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. 
SEC. 435. IMPROVEMENTS TO THE PROCESS FOR ADDING 
TELEHEALTH SERVICES. 
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 review— 
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(1) implement revisions to the process so that 
the criteria to add services prioritizes, as appro-
priate, improved access to care through telehealth 
services; and 
(2) provide clarification on what requests to 
add telehealth services under such process should in-
clude. 
SEC. 436. RURAL HEALTH CLINICS AND FEDERALLY QUALI-
FIED HEALTH CENTERS. 
(a) EXPANSION
OF ORIGINATING SITES.—Section 
1834(m)(4)(C) of the Social Security Act (42 U.S.C. 
1395m(m)(4)(C)), as amended by the preceding sections, 
is amended— 
(1) in clause (i), by striking ‘‘and (10)’’ and in-
serting ‘‘and (10), and subject to clause (iii),’’; and 
(2) by adding at the end the following new 
clause: 
‘‘(iii) RURAL
HEALTH
CLINICS
AND 
FEDERALLY
QUALIFIED
HEALTH
CEN-
TERS.—The term ‘originating site’ shall 
also include any Federally qualified health 
center and any rural health clinic (as such 
terms are defined in section 1861(aa)) at 
which the eligible telehealth individual is 
located at the time the service is furnished 
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via a telecommunications system, whether 
or not the individual is located in an area 
described in clause (i), insofar as such 
sites are not otherwise included in the defi-
nition of originating site under such 
clause, subject to applicable State law re-
quirements, including State licensure re-
quirements.’’. 
(b) 
EXPANSION
OF
DISTANT
SITES.—Section 
1834(m) of the Social Security Act (42 U.S.C. 1395m(m)) 
is amended— 
(1) in the first sentence of paragraph (1)— 
(A) by striking ‘‘or a practitioner (de-
scribed in section 1842(b)(18)(C))’’ and insert-
ing ‘‘, a practitioner (described in section 
1842(b)(18)(C)), a Federally qualified health 
center, or a rural health clinic’’; and 
(B) by striking ‘‘or practitioner’’ and in-
serting ‘‘, practitioner, Federally qualified 
health center, or rural health clinic’’; 
(2) in paragraph (2)(A)— 
(A) by inserting ‘‘or to a Federally quali-
fied health center or rural health clinic that 
serves as a distant site’’ after ‘‘a distant site’’; 
and 
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(B) by striking ‘‘such physician or practi-
tioner’’ and inserting ‘‘such physician, practi-
tioner, Federally qualified health center, or 
rural health clinic’’; and 
(3) in paragraph (4)— 
(A) in subparagraph (A), by inserting 
‘‘and includes a Federally qualified health cen-
ter or rural health clinic that furnishes a tele-
health service to an eligible individual’’ before 
the period at the end; and 
(B) in subparagraph (F), by adding at the 
end the following new clause: 
‘‘(iii) INCLUSION OF RURAL HEALTH 
CLINIC SERVICES AND FEDERALLY QUALI-
FIED
HEALTH
CENTER
SERVICES
FUR-
NISHED
USING
TELEHEALTH.—For pur-
poses of this subparagraph, the term ‘tele-
health services’ includes a rural health 
clinic service or Federally qualified health 
center service that is furnished using tele-
health to the extent that payment codes 
corresponding to services identified by the 
Secretary under clause (i) or (ii) are listed 
on the corresponding claim for such rural 
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health clinic service or Federally qualified 
health center service.’’. 
(c) EFFECTIVE DATE.—The amendments made by 
this section shall apply to services furnished on or after 
January 1, 2021. 
SEC. 437. 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 the preceding sections, is amended— 
(1) in clause (i), by striking ‘‘clause (iii)’’ and 
inserting ‘‘clauses (iii) and (iv)’’; and 
(2) by adding at the end the following new 
clause: 
‘‘(iv) NATIVE AMERICAN HEALTH FA-
CILITIES.—The originating site require-
ments 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 defined in section 4 of the In-
dian Health Care Improvement Act (25 
U.S.C. 1603)) or a tribal organization (as 
that term is defined in section 4 of the In-
dian Self-Determination and Education 
Assistance Act (25 U.S.C. 5304)), or a fa-
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cility of the Native Hawaiian health care 
systems authorized under the Native Ha-
waiian Health Care Improvement Act (42 
U.S.C. 11701 et seq.).’’. 
(b) NO ORIGINATING SITE FACILITY FEE FOR NEW 
SITES.—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 (iv) of 
paragraph (4)(C), and does not meet the requirement for 
an originating site under clause (i) of such paragraph)’’ 
after ‘‘the originating site’’. 
(c) EFFECTIVE DATE.—The amendments made by 
this section shall apply to services furnished on or after 
January 1, 2021. 
SEC. 438. WAIVER OF TELEHEALTH RESTRICTIONS DURING 
NATIONAL EMERGENCIES. 
Section 1135(b) of the Social Security Act (42 U.S.C. 
1320b–5(b)) is amended— 
(1) in paragraph (6), by striking ‘‘and’’ after 
the semicolon; 
(2) in paragraph (7), by striking the period at 
the end and inserting ‘‘; and’’; and 
(3) by adding at the end the following: 
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‘‘(8) requirements for payment for telehealth 
services under section 1834(m).’’. 
SEC. 439. USE OF TELEHEALTH IN RECERTIFICATION FOR 
HOSPICE CARE. 
(a) IN GENERAL.—Section 1814(a)(7)(D)(i) of the 
Social Security Act (42 U.S.C. 1395f(a)(7)(D)(i)) is 
amended by inserting ‘‘(including through use of tele-
health, notwithstanding the requirements in section 
1834(m)(4)(C))’’ after ‘‘face-to-face encounter’’. 
(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— 
(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. 
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SEC. 440. 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 
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 
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‘‘(ii) the provision of the technologies 
meets any other requirements set forth in 
regulations 
promulgated 
by 
the 
Sec-
retary.’’. 
SEC. 441. STUDY AND REPORT ON INCREASING ACCESS TO 
TELEHEALTH SERVICES IN THE HOME. 
(a) MEDPAC STUDY.—The Medicare Payment Advi-
sory Commission (in this section referred to as the ‘‘Com-
mission’’) shall conduct a study on increasing access under 
the Medicare program under title XVIII of the Social Se-
curity Act (42 U.S.C. 1395 et seq.) to telehealth services 
in the home. Such study shall include an analysis of the 
following: 
(1) How different payers allow the home to be 
an originating site for telehealth services. 
(2) Particular types of telehealth services or 
subgroups of beneficiaries with respect to which al-
lowing the home to be an originating site under the 
Medicare program would be suitable. 
(b) REPORT.—Not later than 24 months after the 
date of the enactment of this Act, the Commission shall 
submit to Congress a report containing the results of the 
study conducted under subsection (a), together with rec-
ommendations for such legislation and administrative ac-
tion as the Commission determines appropriate. 
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SEC. 442. ANALYSIS OF TELEHEALTH WAIVERS IN ALTER-
NATIVE PAYMENT MODELS. 
The second sentence of section 1115A(g) of the So-
cial Security Act (42 U.S.C. 1315a(g)) is amended by in-
serting ‘‘an analysis of waivers under section (d)(1) re-
lated to telehealth and the impact on quality and spending 
under the applicable titles of such waivers,’’ after ‘‘sub-
section (c),’’. 
SEC. 443. MODEL TO ALLOW ADDITIONAL HEALTH PROFES-
SIONALS TO FURNISH TELEHEALTH SERV-
ICES. 
Section 1115A(b)(2)(B) of the Social Security Act 
(42 U.S.C. 1315a(b)(2)(B)) is amended by adding at the 
end the following new clause: 
‘‘(xxviii) Allowing health professionals 
who are not otherwise eligible under sec-
tion 1834(m) to furnish telehealth services 
to furnish such services.’’. 
SEC. 444. TESTING OF MODELS TO EXAMINE THE USE OF 
TELEHEALTH UNDER THE MEDICARE PRO-
GRAM. 
Section 1115A(b)(2) of the Social Security Act (42 
U.S.C. 1315a(b)(2)) is amended by adding at the end the 
following new subparagraph: 
‘‘(D) TESTING MODELS TO EXAMINE USE 
OF TELEHEALTH UNDER MEDICARE.—The Sec-
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retary shall consider testing under this sub-
section models to examine the use of telehealth 
under title XVIII.’’. 
Æ 
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