451 
sites located in a high-need health profes-
sional shortage area (as designated pursu-
ant to section 332(a)(1)(A) of the Public 
Health 
Service 
Act 
(42 
U.S.C. 
254e(a)(1)(A))). 
‘‘(B) 
RESTRICTIONS
DESCRIBED.—For 
purposes of this paragraph, restrictions applica-
ble to payment for telehealth services under 
paragraph (1) are— 
‘‘(i) requirements relating to qualifica-
tions for an originating site under para-
graph (4)(C)(ii); 
‘‘(ii) any geographic limitations under 
paragraph (4)(C)(i) (other than applicable 
State law requirements, including State li-
censure requirements); 
‘‘(iii) any limitation on the type of 
technology used to furnish telehealth serv-
ices; 
‘‘(iv) any limitation on the type of 
provider of services or supplier who may 
furnish telehealth services (other than the 
requirement that the provider of services 
or supplier is enrolled under this title); 
VerDate Sep 11 2014 
02:46 Aug 17, 2022
Jkt 029200
PO 00000
Frm 00451
Fmt 6652
Sfmt 6201
E:\BILLS\H8588.IH
H8588
pbinns on DSKJLVW7X2PROD with $$_JOB
452 
‘‘(v) any limitation on specific services 
designated as telehealth services pursuant 
to this subsection (provided the Secretary 
determines that such services are clinically 
appropriate to furnish remotely); or 
‘‘(vi) any other limitation relating to 
the furnishing of telehealth services under 
this title identified by the Secretary. 
‘‘(C) PUBLIC
COMMENT.—The Secretary 
shall establish a process by which stakeholders 
may (on at least an annual basis) provide public 
comment for waivers under this paragraph. 
‘‘(D) PERIODIC
REVIEW
OF
WAIVERS.— 
The Secretary shall periodically, but not more 
often than every 3 years, reassess each waiver 
under this paragraph to determine whether the 
waiver continues to meet the conditions applica-
ble under subparagraph (A).’’. 
(b) POSTING OF INFORMATION.—Not later than 2 
years after the date on which a waiver under section 
1834(m)(8) of the Social Security Act, as added by sub-
section (a), first becomes effective, and at least biennially 
thereafter, the Secretary of Health and Human Services 
shall post on the internet website of the Centers for Medi-
care & Medicaid Services— 
VerDate Sep 11 2014 
02:46 Aug 17, 2022
Jkt 029200
PO 00000
Frm 00452
Fmt 6652
Sfmt 6201
E:\BILLS\H8588.IH
H8588
pbinns on DSKJLVW7X2PROD with $$_JOB
453 
(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. 433. EXPANDING THE USE OF TELEHEALTH FOR MEN-
TAL HEALTH SERVICES. 
(a) IN GENERAL.—Section 1834(m) of the Social Se-
curity Act (42 U.S.C. 1395m(m)), as amended by the pre-
ceding sections, is amended— 
(1) in paragraph (4)(C)(i), by striking ‘‘and 
(8)’’ and inserting ‘‘(8), and (9)’’; and 
(2) by adding at the end the following: 
‘‘(9) TREATMENT OF MENTAL HEALTH SERV-
ICES FURNISHED THROUGH TELEHEALTH.—The ge-
ographic 
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 
mental health services (as determined by the Sec-
retary) furnished on or after January 1, 2023, to an 
eligible telehealth individual at an originating site 
VerDate Sep 11 2014 
02:46 Aug 17, 2022
Jkt 029200
PO 00000
Frm 00453
Fmt 6652
Sfmt 6201
E:\BILLS\H8588.IH
H8588
pbinns on DSKJLVW7X2PROD with $$_JOB
454 
described in paragraph (4)(C)(ii) (other than an 
originating site described in subclause (IX) of such 
paragraph).’’. 
(b) INCLUSION OF THE HOME AS AN ORIGINATING 
SITE.—Section 1834(m)(4)(C)(ii)(X) of such Act (42 
U.S.C. 1395m(m)(4)(C)(ii)(X)) is amended by striking 
‘‘paragraph (7)’’ and inserting ‘‘paragraphs (7) and (9)’’. 
(c) ADDITIONAL SERVICES.—As part of the imple-
mentation of the amendments made by this section, the 
Secretary of Health and Human Services shall consider 
whether additional services should be added to the services 
specified in paragraph (4)(F)(i) of section 1834(m) of 
such Act (42 U.S.C. 1395m) for authorized payment 
under paragraph (1) of such section. 
SEC. 434. USE OF TELEHEALTH IN EMERGENCY MEDICAL 
CARE. 
(a) IN GENERAL.—Section 1834(m) of the Social Se-
curity Act (42 U.S.C. 1395m(m)), as amended by the pre-
ceding sections, is amended— 
(1) in paragraph (4)(C)(i), by striking ‘‘and 
(9)’’ and inserting ‘‘(9), and (10)’’; and 
(2) by adding at the end the following: 
‘‘(10) TREATMENT
OF
EMERGENCY
MEDICAL 
CARE
FURNISHED
THROUGH
TELEHEALTH.—The 
geographic requirements described in paragraph 
VerDate Sep 11 2014 
02:46 Aug 17, 2022
Jkt 029200
PO 00000
Frm 00454
Fmt 6652
Sfmt 6201
E:\BILLS\H8588.IH
H8588
pbinns on DSKJLVW7X2PROD with $$_JOB
455 
(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, 
2023, 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— 
(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 
VerDate Sep 11 2014 
02:46 Aug 17, 2022
Jkt 029200
PO 00000
Frm 00455
Fmt 6652
Sfmt 6201
E:\BILLS\H8588.IH
H8588
pbinns on DSKJLVW7X2PROD with $$_JOB
456 
(2) provide clarification on what requests to 
add telehealth services under such process should in-
clude. 
SEC. 436. RURAL HEALTH CLINICS AND FEDERALLY QUALI-
FIED HEALTH CENTERS. 
(a) EXPANSION
OF ORIGINATING SITES.—Section 
1834(m)(4)(C) of the Social Security Act (42 U.S.C. 
1395m(m)(4)(C)), as amended by the preceding sections, 
is amended— 
(1) in clause (i), by striking ‘‘and (10)’’ and in-
serting ‘‘and (10), and subject to clause (iii),’’; and 
(2) by adding at the end the following new 
clause: 
‘‘(iii) RURAL
HEALTH
CLINICS
AND 
FEDERALLY
QUALIFIED
HEALTH
CEN-
TERS.—The term ‘originating site’ shall 
also include any Federally qualified health 
center and any rural health clinic (as such 
terms are defined in section 1861(aa)) at 
which the eligible telehealth individual is 
located at the time the service is furnished 
via a telecommunications system, whether 
or not the individual is located in an area 
described in clause (i), insofar as such 
sites are not otherwise included in the defi-
VerDate Sep 11 2014 
02:46 Aug 17, 2022
Jkt 029200
PO 00000
Frm 00456
Fmt 6652
Sfmt 6201
E:\BILLS\H8588.IH
H8588
pbinns on DSKJLVW7X2PROD with $$_JOB
457 
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 
(B) by striking ‘‘such physician or practi-
tioner’’ and inserting ‘‘such physician, practi-
tioner, Federally qualified health center, or 
rural health clinic’’; and 
VerDate Sep 11 2014 
02:46 Aug 17, 2022
Jkt 029200
PO 00000
Frm 00457
Fmt 6652
Sfmt 6201
E:\BILLS\H8588.IH
H8588
pbinns on DSKJLVW7X2PROD with $$_JOB
458 
(3) in paragraph (4)— 
(A) in subparagraph (A), by inserting 
‘‘and includes a Federally qualified health cen-
ter or rural health clinic that furnishes a tele-
health service to an eligible individual’’ before 
the period at the end; and 
(B) in subparagraph (F), by adding at the 
end the following new clause: 
‘‘(iii) INCLUSION OF RURAL HEALTH 
CLINIC SERVICES AND FEDERALLY QUALI-
FIED
HEALTH
CENTER
SERVICES
FUR-
NISHED
USING
TELEHEALTH.—For pur-
poses of this subparagraph, the term ‘tele-
health services’ includes a rural health 
clinic service or Federally qualified health 
center service that is furnished using tele-
health to the extent that payment codes 
corresponding to services identified by the 
Secretary under clause (i) or (ii) are listed 
on the corresponding claim for such rural 
health clinic service or Federally qualified 
health center service.’’. 
(c) EFFECTIVE DATE.—The amendments made by 
this section shall apply to services furnished on or after 
January 1, 2023. 
VerDate Sep 11 2014 
02:46 Aug 17, 2022
Jkt 029200
PO 00000
Frm 00458
Fmt 6652
Sfmt 6201
E:\BILLS\H8588.IH
H8588
pbinns on DSKJLVW7X2PROD with $$_JOB
459 
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-
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 
VerDate Sep 11 2014 
02:46 Aug 17, 2022
Jkt 029200
PO 00000
Frm 00459
Fmt 6652
Sfmt 6201
E:\BILLS\H8588.IH
H8588
pbinns on DSKJLVW7X2PROD with $$_JOB
460 
Act (42 U.S.C. 1395m(m)(2)(B)(i)) is amended, in the 
matter preceding subclause (I), by inserting ‘‘(other than 
an originating site that is only described in clause (iv) of 
paragraph (4)(C), and does not meet the requirement for 
an originating site under clause (i) of such paragraph)’’ 
after ‘‘the originating site’’. 
(c) EFFECTIVE DATE.—The amendments made by 
this section shall apply to services furnished on or after 
January 1, 2023. 
SEC. 438. WAIVER OF TELEHEALTH RESTRICTIONS DURING 
NATIONAL EMERGENCIES. 
Section 1135(b) of the Social Security Act (42 U.S.C. 
1320b–5(b)) is amended— 
(1) in paragraph (6), by striking ‘‘and’’ after 
the semicolon; 
(2) in paragraph (7), by striking the period at 
the end and inserting ‘‘; and’’; and 
(3) by adding at the end the following: 
‘‘(8) requirements for payment for telehealth 
services under section 1834(m).’’. 
SEC. 439. USE OF TELEHEALTH IN RECERTIFICATION FOR 
HOSPICE CARE. 
(a) IN GENERAL.—Section 1814(a)(7)(D)(i) of the 
Social Security Act (42 U.S.C. 1395f(a)(7)(D)(i)) is 
amended by inserting ‘‘(including through use of tele-
VerDate Sep 11 2014 
02:46 Aug 17, 2022
Jkt 029200
PO 00000
Frm 00460
Fmt 6652
Sfmt 6201
E:\BILLS\H8588.IH
H8588
pbinns on DSKJLVW7X2PROD with $$_JOB
461 
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. 
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 
VerDate Sep 11 2014 
02:46 Aug 17, 2022
Jkt 029200
PO 00000
Frm 00461
Fmt 6652
Sfmt 6201
E:\BILLS\H8588.IH
H8588
pbinns on DSKJLVW7X2PROD with $$_JOB
462 
(3) by adding at the end the following new sub-
paragraph: 
‘‘(K) the provision of technologies (as de-
fined by the Secretary) on or after the date of 
the enactment of this subparagraph, by a pro-
vider of services or supplier (as such terms are 
defined for purposes of title XVIII) directly to 
an individual who is entitled to benefits under 
part A of title XVIII, enrolled under part B of 
such title, or both, for the purpose of furnishing 
telehealth services, remote patient monitoring 
services, or other services furnished through the 
use of technology (as defined by the Secretary), 
if— 
‘‘(i) the technologies are not offered 
as part of any advertisement or solicita-
tion; and 
‘‘(ii) the provision of the technologies 
meets any other requirements set forth in 
regulations 
promulgated 
by 
the 
Sec-
retary.’’. 
SEC. 441. STUDY AND REPORT ON INCREASING ACCESS TO 
TELEHEALTH SERVICES IN THE HOME. 
(a) MEDPAC STUDY.—The Medicare Payment Advi-
sory Commission (in this section referred to as the ‘‘Com-
VerDate Sep 11 2014 
02:46 Aug 17, 2022
Jkt 029200
PO 00000
Frm 00462
Fmt 6652
Sfmt 6201
E:\BILLS\H8588.IH
H8588
pbinns on DSKJLVW7X2PROD with $$_JOB
463 
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. 
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),’’. 
VerDate Sep 11 2014 
02:46 Aug 17, 2022
Jkt 029200
PO 00000
Frm 00463
Fmt 6652
Sfmt 6201
E:\BILLS\H8588.IH
H8588
pbinns on DSKJLVW7X2PROD with $$_JOB
464 
SEC. 443. MODEL TO ALLOW ADDITIONAL HEALTH PROFES-
SIONALS TO FURNISH TELEHEALTH SERV-
ICES. 
Section 1115A(b)(2)(B) of the Social Security Act 
(42 U.S.C. 1315a(b)(2)(B)) is amended by adding at the 
end the following new clause: 
‘‘(xxviii) Allowing health professionals 
who are not otherwise eligible under sec-
tion 1834(m) to furnish telehealth services 
to furnish such services.’’. 
SEC. 444. TESTING OF MODELS TO EXAMINE THE USE OF 
TELEHEALTH UNDER THE MEDICARE PRO-
GRAM. 
Section 1115A(b)(2) of the Social Security Act (42 
U.S.C. 1315a(b)(2)) is amended by adding at the end the 
following new subparagraph: 
‘‘(D) TESTING MODELS TO EXAMINE USE 
OF TELEHEALTH UNDER MEDICARE.—The Sec-
retary shall consider testing under this sub-
section models to examine the use of telehealth 
under title XVIII.’’. 
Æ 
VerDate Sep 11 2014 
02:46 Aug 17, 2022
Jkt 029200
PO 00000
Frm 00464
Fmt 6652
Sfmt 6301
E:\BILLS\H8588.IH
H8588
pbinns on DSKJLVW7X2PROD with $$_JOB