Ensuring Telehealth Expansion Act of 2021
Bill: H.R.341 | Sponsor: Rep. Williams, Roger (R-TX)
Policy area: Health

Summary:
Ensuring Telehealth Expansion Act of 2021
This bill makes permanent several telehealth flexibilities that were initially authorized during the public health emergency relating to COVID-19 (i.e., coronavirus disease 2019), particularly with respect to Medicare coverage of telehealth services.
For example, the bill permanently allows federally qualified health centers and rural health clinics to serve as the distant site (i.e., the location of the health care practitioner) for telehealth services under Medicare. Payment must be made in the same manner as for non-telehealth services, rather than in accordance with a separate methodology determined by the Centers for Medicare & Medicaid Services (CMS). The bill also permanently allows beneficiaries to receive Medicare telehealth services at any site, regardless of type or location, and grants the CMS general authority to waive any other requirements as it deems appropriate.

To make permanent certain telehealth flexibilities established in 
                         response to COVID-19.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Ensuring Telehealth Expansion Act of 
2021''.

SEC. 2. MAKING PERMANENT CERTAIN TELEHEALTH FLEXIBILITIES ESTABLISHED 
              IN RESPONSE TO COVID-19.

    (a) Exemption for Telehealth Services.--
            (1) In general.--Subparagraph (E) of section 223(c)(2) of 
        the Internal Revenue Code of 1986 is amended by striking ``In 
        the case of plan years beginning on or before December 31, 
        2021, a plan'' and inserting ``A plan''.
            (2) Certain coverage disregarded.--Clause (ii) of section 
        223(c)(1)(B) of the Internal Revenue Code of 1986 is amended by 
        striking ``(in the case of plan years beginning on or before 
        December 31, 2021)''.
    (b) Increasing Medicare Telehealth Flexibilities.--Section 1834(m) 
of the Social Security Act (42 U.S.C. 1395m(m)) is amended by adding at 
the end the following new paragraph:
            ``(9) Waiver authority.--The Secretary may waive any 
        requirement of this subsection if determined appropriate by the 
        Secretary.''.
    (c) Enhancing Medicare Telehealth Services for Federally Qualified 
Health Centers and Rural Health Clinics; Eliminating Special Payment 
Rule for Such Services.--
            (1) In general.--Paragraph (8) of section 1834(m) of the 
        Social Security Act (42 U.S.C. 1395m(m)) is amended to read as 
        follows:
            ``(8) Enhancing telehealth services for federally qualified 
        health centers and rural health clinics.--
                    ``(A) In general.--With respect to services 
                furnished on or after the first day of the emergency 
                period described in section 1135(g)(1)(B), the 
                Secretary shall pay for telehealth services that are 
                furnished via a telecommunications system by a 
                Federally qualified health center or a rural health 
                clinic to an eligible telehealth individual enrolled 
                under this part notwithstanding that the Federally 
                qualified health center or rural clinic providing the 
                telehealth service is not at the same location as the 
                beneficiary.
                    ``(B) Payment.--
                            ``(i) In general.--A telehealth service 
                        furnished by a rural health clinic or a 
                        Federally qualified health center serving as a 
                        distant site to an individual shall be deemed 
                        to be so furnished to such individual as an 
                        outpatient of such clinic or center (as 
                        applicable) for purposes of section 1861(aa) 
                        and payable as a rural health clinic service or 
                        Federally qualified health center service (as 
                        applicable) under section 1833(a)(3) or under 
                        the prospective payment system established 
                        under section 1834(o) (as applicable).
                            ``(ii) Treatment of costs for fqhc pps 
                        calculations and rhc air calculations.--Costs 
                        associated with the delivery of telehealth 
                        services by a Federally qualified health center 
                        or rural health clinic serving as a distant 
                        site pursuant to this paragraph shall be 
                        considered allowable costs for purposes of the 
                        prospective payment system established under 
                        section 1834(o) and any payment methodologies 
                        developed under section 1833(a)(3), as 
                        applicable.
                    ``(C) Definitions.--For purposes of this 
                subsection--
                            ``(i) the term `distant site' includes a 
                        Federally qualified health center or rural 
                        health clinic that furnishes a telehealth 
                        service to an eligible telehealth individual; 
                        and
                            ``(ii) the term `telehealth services' 
                        includes a rural health clinic service or 
                        Federally qualified health center service that 
                        is furnished using telehealth to the extent 
                        that payment codes corresponding to services 
                        identified by the Secretary under clause (i) or 
                        (ii) of paragraph (4)(F) are listed on the 
                        corresponding claim for such rural health 
                        clinic service or Federally qualified health 
                        center service.''.
            (2) Conforming amendment.--Section 1834(m)(2)(A) of the 
        Social Security Act (42 U.S.C. 1395m(m)(2)(A)) is amended by 
        striking ``Subject to paragraph (8), the'' and inserting 
        ``The''.
            (3) Effective date.--The amendments made by this subsection 
        shall take effect as if included in the enactment of the CARES 
        Act (Public Law 116-136).
    (d) Waiver of Requirements for Face-to-Face Visits Between Home 
Dialysis Patients and Physicians.--Section 1881(b)(3)(B)(iii) of the 
Social Security Act (42 U.S.C. 1395rr(b)(3)(B)(iii)) is amended by 
striking ``during the emergency period described in section 
1135(g)(1)(B)'' and inserting ``during any period beginning on or after 
the first day of the emergency period described in section 
1135(g)(1)(B)''.
    (e) Use of Telehealth To Conduct Face-to-Face Encounter Prior to 
Recertification of Eligibility for Hospice Care.--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 striking ``during the emergency 
period described in section 1135(g)(1)(B)'' and inserting ``during any 
period beginning on or after the first day of the emergency period 
described in section 1135(g)(1)(B)''.
    (f) Encouraging Use of Telecommunications Systems for Home Health 
Services.--Section 3707 of the CARES Act (Public Law 116-136) is 
amended by striking ``during the emergency period described in section 
1135(g)(1)(B) of such Act (42 U.S.C. 1320b-5(g)(1)(B))'' and inserting 
``on or after the first day of the emergency period described in 
section 1135(g)(1)(B) of such Act (42 U.S.C. 1320b-5(g)(1)(B))''.

SEC. 3. NONAPPLICATION OF ORIGINATING SITE REQUIREMENTS WITH RESPECT TO 
              TELEHEALTH SERVICES UNDER MEDICARE PROGRAM.

    Section 1834(m)(4)(C) of the Social Security Act (42 U.S.C. 
1395m(m)(4)(C)) is amended--
            (1) in clause (i), by inserting before ``paragraphs (5), 
        (6), and (7)'' the following: ``clause (iii) and''; and
            (2) by adding at the end the following new clause:
                            ``(iii) Nonapplication of originating site 
                        requirements.--Beginning on the first day of 
                        the emergency period described in section 
                        1135(g)(1)(B), the term `originating site' 
                        means any site at which the eligible telehealth 
                        individual is located at the time the service 
                        is furnished via a telecommunications 
                        system.''.

SEC. 4. REPORT BY COMPTROLLER GENERAL.

    Not later than 5 years after the date of the enactment of this Act, 
the Comptroller General of the United States shall submit to Congress a 
report on the successes and limitations of implementing the statutory 
provisions amended by sections 2 and 3, including--
            (1) details of any savings or costs to the Federal 
        Government that are attributable to the implementation of such 
        provisions; and
            (2) an analysis of how the implementation of such 
        provisions have impacted rural hospitals.
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