TIKES Act
Bill: H.R.1397 | Sponsor: Rep. Blunt Rochester, Lisa (D-DE)
Policy area: Health

Summary:
Telehealth Improvement for Kids' Essential Services Act or the TIKES Act
This bill requires several agencies to promote and evaluate the use of telehealth under Medicaid and the Children's Health Insurance Program (CHIP).
Specifically, the bill requires (1) the Centers for Medicare & Medicaid Services to issue guidance to states on ways to increase access to telehealth; (2) the Medicaid and CHIP Payment and Access Commission to study the impact of telehealth on health care access, utilization, costs, and outcomes; and (3) the Government Accountability Office to evaluate federal interagency collaboration with respect to the provision of telehealth services to individuals under the age of 18.

To provide for strategies to increase access to telehealth under the 
Medicaid program and Children's Health Insurance Program, and for other 
                               purposes.

    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 ``Telehealth Improvement for Kids' 
Essential Services Act'' or the ``TIKES Act''.

SEC. 2. STRATEGIES TO INCREASE ACCESS TO TELEHEALTH UNDER MEDICAID AND 
              CHILDREN'S HEALTH INSURANCE PROGRAM.

    (a) Guidance.--Not later than 1 year after the date of the 
enactment of this Act, the Secretary of Health and Human Services shall 
issue and disseminate guidance to States to clarify strategies to 
overcome existing barriers and increase access to telehealth under the 
Medicaid program under title XIX of the Social Security Act (42 U.S.C. 
1396 et seq.) and the Children's Health Insurance Program under title 
XXI of such Act (42 U.S.C. 1397aa et seq.). Such guidance shall include 
technical assistance and best practices regarding--
            (1) telehealth delivery of covered services;
            (2) recommended voluntary billing codes, modifiers, and 
        place-of-service designations for telehealth and other virtual 
        health care services;
            (3) the simplification or alignment (including through 
        reciprocity) of provider licensing, credentialing, and 
        enrollment protocols with respect to telehealth across States, 
        State Medicaid plans under such title XIX, and Medicaid managed 
        care organizations, including during national public health 
        emergencies;
            (4) existing strategies States can use to integrate 
        telehealth and other virtual health care services into value-
        based health care models; and
            (5) examples of States that have used waivers under the 
        Medicaid program to test expanded access to telehealth, 
        including during the emergency period described in section 
        1135(g)(1)(B) of the Social Security Act (42 U.S.C. 1320b-
        5(g)(1)(B)).
    (b) Studies.--
            (1) Telehealth impact on health care access.--Not later 
        than 1 year after the date of the enactment of this Act, the 
        Medicaid and CHIP Payment and Access Commission shall conduct a 
        study, with respect to a minimum of 10 States across geographic 
        regions of the United States, and submit to Congress a report, 
        on the impact of telehealth on health care access, utilization, 
        cost, and outcomes, broken down by race, ethnicity, sex, age, 
        disability status, and zip code. Such report shall--
                    (A) evaluate cost, access, utilization, outcomes, 
                and patient experience data from across the health care 
                field, including States, Medicaid managed care 
                organizations, provider organizations, and other 
                organizations that provide or pay for telehealth under 
                the Medicaid program and Children's Health Insurance 
                Program;
                    (B) identify barriers and potential solutions to 
                provider entry and participation in telehealth that 
                States are experiencing, as well as barriers to 
                providing telehealth across State lines, including 
                during times of public health crisis or public health 
                emergency;
                    (C) determine the frequency at which out-of-State 
                telehealth is provided to patients enrolled in the 
                Medicaid program and the potential impact on access to 
                telehealth if State Medicaid policies were more 
                aligned; and
                    (D) identify and evaluate opportunities for more 
                alignment among such policies to promote access to 
                telehealth across all States, State Medicaid plans 
                under title XIX of the Social Security Act (42 U.S.C. 
                1396 et seq.), State child health plans under title XXI 
                of such Act (42 U.S.C. 1397aa et seq.), and Medicaid 
                managed care organizations, including the potential for 
                regional compacts or reciprocity agreements.
            (2) Federal agency telehealth collaboration.--Not later 
        than 1 year after the date of the enactment of this Act, the 
        Comptroller General of the United States shall conduct a study 
        and submit to Congress a report evaluating collaboration 
        between Federal agencies with respect to telehealth services 
        furnished under the Medicaid or CHIP program to individuals 
        under the age of 18, including such services furnished to such 
        individuals in early care and education settings. Such report 
        shall include recommendations on--
                    (A) opportunities for Federal agencies to improve 
                collaboration with respect to such telehealth services; 
                and
                    (B) opportunities for collaboration between Federal 
                agencies to expand telehealth access to such 
                individuals enrolled under the Medicaid or CHIP 
                program, including in early care and education 
                settings.
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