Safe Testing at Residence Telehealth Act of 2021
Bill: H.R.318 | Sponsor: Rep. Schweikert, David (R-AZ)
Policy area: Health

Summary:
Safe Testing at Residence Telehealth Act of 2021
This bill provides for Medicare payment of certain at-home diagnostic tests and telehealth assessments that are provided in relation to COVID-19 (i.e., coronavirus disease 2019).
Specifically, during the public health emergency, the bill requires Medicare payment of diagnostic tests for respiratory conditions other than COVID-19 (e.g., influenza) that are used to finalize a COVID-19 diagnosis and of COVID-19 blood tests that are ordered via telehealth, as well as for related telehealth assessments, regardless of whether the practitioner who orders the test is the one who furnishes it and regardless of the location of the practitioner.
The bill requires practitioners to report specified demographic data with respect to such tests and services in order to receive payment, and prohibits payment for in-person tests that were already ordered via telehealth.

To amend title XVIII to provide coverage and payment for certain tests 
 and assistive telehealth consultations during the COVID-19 emergency 
                    period, 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 ``Safe Testing at Residence Telehealth 
Act of 2021''.

SEC. 2. COVERAGE AND PAYMENT FOR CERTAIN TESTS AND ASSISTIVE TELEHEALTH 
              CONSULTATIONS DURING THE COVID-19 EMERGENCY PERIOD.

    (a) Coverage and Payment Rule.--
            (1) In general.--Section 1834(m) of the Social Security Act 
        (42 U.S.C. 1395m(m)) is amended by adding at the end of the 
        following new paragraph:
            ``(9) Coverage and payment for certain tests and assistive 
        telehealth consultations during covid-19 emergency period.--
                    ``(A) In general.--During the emergency period 
                described in section 1135(g)(1)(B), the Secretary shall 
                pay for a test described in subparagraph (C) that is 
                ordered and an assistive telehealth consultation that 
                is furnished via a telecommunications system by a 
                physician or practitioner to an eligible telehealth 
                individual enrolled under this part notwithstanding 
                that the individual physician or practitioner ordering 
                the test did not furnish the test or that the 
                individual physician or practitioner providing the 
                assistive telehealth consultation is not at the same 
                location as the beneficiary.
                    ``(B) Payment amount.--During the emergency period 
                described in section 1135(g)(1)(B), the Secretary shall 
                pay to a physician or practitioner located at a distant 
                site that--
                            ``(i) orders a test described in 
                        subparagraph (C) to an eligible telehealth 
                        individual an amount equal to the amount that 
                        such physician or practitioner would have been 
                        paid for a diagnostic laboratory test under 
                        section 1833(h); and
                            ``(ii) furnishes an assistive telehealth 
                        consultation to an eligible telehealth 
                        individual an amount equal to the amount that a 
                        physician or practitioner would have been paid 
                        for such telehealth service under paragraph 
                        (2).
                    ``(C) Tests described.--For purposes of 
                subparagraphs (A) and (B), a test described in this 
                subparagraph is a medical device (as defined in section 
                201(h) of the Federal Food, Drug, and Cosmetic Act) or 
                is a test approved under an emergency use authorization 
                under section 564 of such Act and is either--
                            ``(i) a diagnostic laboratory test for the 
                        diagnosis of influenza or a similar respiratory 
                        condition that is required to obtain a final 
                        diagnosis of COVID-19 for an individual when 
                        such test is ordered by a physician or 
                        practitioner in conjunction with a COVID-19 
                        diagnostic laboratory test for purposes of 
                        discounting a diagnosis of influenza or a 
                        related diagnosis for such individual; or
                            ``(ii) a serology test for COVID-19.
                    ``(D) Other matters relating to documentation and 
                claims review.--The requirements of paragraphs (2) and 
                (3) of section 410.32(d) of title 42, Code of Federal 
                Regulations (as in effect on the date of the enactment 
                of this paragraph), relating to documentation and 
                claims review, respectively, shall apply to a test 
                described in subparagraph (C) and an assistive 
                telehealth consultation.
                    ``(E) Demographic data.--To be eligible for 
                reimbursement under this paragraph, each claim for 
                reimbursement shall include, with respect to such an 
                eligible telehealth individual, the following 
                demographic data:
                            ``(i) Age.
                            ``(ii) Race and ethnicity.
                            ``(iii) Gender.
                            ``(iv) An affirmative or negative statement 
                        of the existence of any chronic condition.
                            ``(v) Any other information the Secretary 
                        determines appropriate.
                    ``(F) Assistive telehealth consultation.--In this 
                paragraph, the term `assistive telehealth consultation' 
                means a telehealth service (as defined in paragraph 
                (4)(F)) that is--
                            ``(i) an evaluation and management service;
                            ``(ii) an assessment of any evidence of 
                        systems which would make a diagnostic 
                        laboratory test necessary to be furnished in 
                        the home of an eligible telehealth individual;
                            ``(iii) the ordering of a diagnostic 
                        laboratory test;
                            ``(iv) an assessment of an individual 
                        succeeding the delivery of a diagnostic 
                        laboratory test;
                            ``(v) any assistance in the collection of a 
                        sample necessary for a diagnostic laboratory 
                        test and securing the sample for shipping;
                            ``(vi) the referral of an eligible 
                        telehealth individual to a physician or 
                        practitioner for in-person treatment; or
                            ``(vii) the review of a diagnostic 
                        laboratory test by a physician or 
                        practitioner.''.
            (2) Report.--
                    (A) In general.--During the period beginning 20 
                days after the date of the enactment of this Act and 
                ending on the last day of the emergency period, each 
                physician and practitioner, who furnishes a test or an 
                assistive telehealth consultation during such period, 
                shall, on a monthly basis during such period, submit to 
                the Administrator of the Centers for Medicare & 
                Medicaid Services and the appropriate State health 
                agency demographic data specified under section 
                1834(m)(9)(E) of the Social Security Act (42 U.S.C. 
                1395m(m)(9)(E)) with respect to individuals to whom 
                such test or consultation was so furnished (in 
                accordance with the HIPAA privacy regulation).
                    (B) Definitions.--In this paragraph:
                            (i) Assistive telehealth consultation.--The 
                        term ``assistive telehealth consultation'' has 
                        the meaning given such term in section 
                        1834(m)(9)(E) of the Social Security Act (42 
                        U.S.C. 1395m(m)(9)(F)).
                            (ii) Emergency period.--The term 
                        ``emergency period'' has the meaning as such 
                        term is described in section 1135(g)(1)(B) of 
                        the Social Security Act (42 U.S.C. 1320b-
                        5(g)(1)(B)).
                            (iii) HIPAA privacy regulation.--The term 
                        ``HIPAA privacy regulation'' has the meaning 
                        given such term in section 1180(b)(3) of the 
                        Social Security Act (42 U.S.C. 1320d-9(b)(3)).
                            (iv) Test.--The term ``test'' has the 
                        meaning as such term is described in section 
                        1834(m)(9)(C) of the Social Security Act (42 
                        U.S.C. 1395m(m)(9)(C)).
    .(b) No Payment for Certain In-Person Test After Telehealth Test 
During the COVID-19 Emergency Period.--
            (1) In general.--Section 1833(h) of the Social Security Act 
        (42 U.S.C. 1395l(h)) is amended--
                    (A) in paragraph (1)(A), by striking ``Subject to 
                section 1834(d)(1)'' and inserting ``Subject to section 
                1834(a)(1) and paragraph (10)''; and
                    (B) by adding at the end the following new 
                paragraph:
    ``(10) During the emergency period described in section 
1135(g)(1)(B), the Secretary may not make payment for a test described 
in section 1834(m)(9)(C) that is furnished in-person by a physician or 
practitioner to an individual if a physician or practitioner has 
previously ordered such a test via a telecommunications system pursuant 
to section 1834(m)(9)(A), unless the physician or practitioner 
determines such a test is medically necessary and appropriate (as 
determined by the Secretary).''.
            (2) Report.--Not later than 1 year after the termination of 
        the emergency period described in section 1135(g)(1)(B) of the 
        Social Security Act (42 U.S.C. 1320b-5(g)(1)(B)), the Inspector 
        General of the Department of Health and Human Services shall 
        review claims for payment for tests described in section 
        1834(m)(9)(C) of such Act (42 U.S.C. 1395m(m)(9)(C)) furnished 
        during such emergency period and submit to Congress a report on 
        any instances of waste, fraud, or abuse identified through such 
        review.
    (c) Conforming Amendments.--Section 1834(m) of the Social Security 
Act (42 U.S.C. 1395m(m)(4)(C)(ii)(X)), as amended by subsection (a), is 
further amended--
            (1) in paragraph (1), by striking ``Subject to paragraph 
        (8)'' and inserting ``Subject to paragraphs (8) and (9)'';
            (2) in paragraph (2), by striking ``Subject to paragraph 
        (8)'' and inserting ``Subject to paragraphs (8) and (9)''; and
            (3) in paragraph (4)(C)(ii)(X), by striking ``telehealth 
        services described in paragraph (7)'' and inserting 
        ``telehealth services described in paragraph (7) or (9)''.
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