Advancing Telehealth Beyond COVID–19 Act of 2021

Bill: 117-hr-4040
Sponsor: full_name: Rep. Cheney, Liz [R-WY-At Large]
Introduced: 2021-06-22
Policy area: Health
Subjects: Drug, alcohol, tobacco use

Fraud offenses and financial crimes

Health care coverage and access

Health facilities and institutions

Health personnel

Health technology, devices, supplies

Internet and video services

Internet, web applications, social media

Medicare

Mental health

Rural conditions and development

Sound recording
Latest action: action_date: 2022-07-28
text: Received in the Senate and Read twice and referred to the Committee on Finance.

Summaries:
action_date: 2021-06-22
action_desc: Introduced in House
text: <p><b>Advancing Telehealth Beyond COVID-19 Act of 2021</b></p> <p>This bill makes permanent several telehealth flexibilities under Medicare that were initially authorized during the public health emergency relating to COVID-19. </p> <p>Specifically, the bill permanently allows (1) federally qualified health centers and rural health clinics to serve as the distant site (i.e., the location of the health care practitioner); (2) beneficiaries to receive telehealth services at any site, regardless of type or location; (3) any type of practitioner to furnish telehealth services, subject to approval by the Centers for Medicare &amp; Medicaid Services; and (4) audio-only evaluation and management and behavioral health services.</p>

action_date: 2022-07-27
action_desc: Passed House
text: <p><b>Advancing Telehealth Beyond COVID-19 Act of </b><b>2022</b></p> <p> <p>This bill modifies the extension of certain Medicare telehealth flexibilities after the end of the COVID-19 public health emergency.</p> <p>Specifically, the bill provides that certain flexibilities continue to apply until December 31, 2024, if the emergency period ends before that date. The bill allows </p> <ul> <li>beneficiaries to continue to receive telehealth services at any site, regardless of type or location (e.g., the beneficiary's home); </li> <li>occupational therapists, physical therapists, speech-language pathologists, and audiologists to continue to furnish telehealth services;</li> <li> federally qualified health centers and rural health clinics to continue to serve as the distant site (i.e., the location of the health care practitioner);</li> <li>evaluation and management and behavioral health services to continue to be provided via audio-only technology; and</li> <li>hospice physicians and nurse practitioners to continue to complete certain requirements relating to patient recertifications via telehealth.</li> </ul> <p>The bill also delays implementation of certain in-person evaluation requirements for mental health telehealth services until January 1, 2025, or the first day after the end of the emergency period, whichever is later. </p>

tv_txt: I 117th CONGRESS 1st Session H. R. 4040 IN THE HOUSE OF REPRESENTATIVES June 22, 2021 Ms. Cheney (for herself and Mrs. Dingell ) introduced the following bill; which was referred to the Committee on Energy and Commerce , and in addition to the Committee on Ways and Means , for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned A BILL To amend title XVIII of the Social Security Act to extend telehealth flexibilities under the Medicare program, and for other purposes.

1. Short title This Act may be cited as the Advancing Telehealth Beyond COVID–19 Act of 2021 . 2. Extending Medicare telehealth flexibilities (a) Expanding access to telehealth services (1) In general Section 1834(m)(4)(C) of the Social Security Act ( 42 U.S.C. 1395m(m)(4)(C) ) is amended by adding at the end the following new clause: (iii) Expanding access to telehealth services With respect to telehealth services furnished beginning on the first day after the end 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, including the home of an individual. . (2) Conforming amendments Such section is amended— (A) in paragraph (2)(B)— (i) in clause (i), in the matter preceding subclause (I), by striking clause (ii) and inserting clauses (ii) and (iii) ; and (ii) by adding at the end the following new clause: (iii) No facility fee for new sites With respect to telehealth services furnished on or after the date of enactment of this clause, a facility fee shall only be paid under this subparagraph to an originating site that is described in paragraph (4)(C)(ii) (other than subclause (X) of such paragraph). . (B) in paragraph (4)(C)— (i) in clause (i), in the matter preceding subclause (I), by inserting and clause (iii) after and (7) ; and (ii) in clause (ii)(X), by inserting prior to the first day after the end of the emergency period described in section 1135(g)(1)(B) before the period; (C) in paragraph (5), by inserting and prior to the first day after the end of the emergency period described in section 1135(g)(1)(B) after January 1, 2019, ; (D) in paragraph (6)(A), by inserting and prior to the first day after the end of the emergency period described in section 1135(g)(1)(B), after January 1, 2019, ; and (E) in paragraph (7), by inserting and prior to the first day after the end of the emergency period described in section 1135(g)(1)(B), after July 1, 2019, . (b) Expanding practitioners eligible To furnish telehealth services Section 1834(m) of the Social Security Act ( 42 U.S.C. 1395m(m) ) is amended— (1) in paragraph (1), by striking (described in section 1842(b)(18)(C)) and inserting (defined in paragraph (4)(E)) ; and (2) in paragraph (4)(E)— (A) by striking practitioner .—The term and inserting “ practitioner .— (A) In general Subject to subparagraph (B), the term ; and (B) by adding at the end the following new subparagraph: (B) Expansion The Secretary, after consulting with stakeholders regarding services that are clinically appropriate, may expand the types of practitioners who may furnish telehealth services to include any health care professional that is eligible to bill the program under this title for their professional services. . (c) Allowing for the furnishing of audio-only telehealth services Section 1834(m)(4) of the Social Security Act ( 42 U.S.C. 1395m(m)(4) ) is amended by adding at the end the following new subparagraph: (G) Telecommunications system (i) In general The term telecommunications system includes, in the case of a specified telehealth service (as defined in clause (ii)) furnished to an individual, a communications system consisting only of audio capabilities. (ii) Specified telehealth service defined The term specified telehealth service means a telehealth service consisting of— (I) evaluation and management services; (II) mental and behavioral health services; (III) substance use disorder services; or (IV) any other service specified by the Secretary. Such term does not include communication of lab results from a physician or practitioner to an individual via a telecommunications system unless such communication involves a diagnosis of such individual based on such results or the prescription, or modification of a prescription, of a drug based on such results. . 3. Making permanent the ability of federally qualified health centers and rural health clinics to furnish telehealth services under the Medicare program Section 1834(m)(8) of the Social Security Act ( 42 U.S.C. 1395m(m)(8) ) is amended— (1) in the header, by striking during emergency period ; (2) in subparagraph (A), in the matter preceding clause (i), by striking During and inserting Beginning on the first day of ; and (3) in subparagraph (B)(i), by striking during such emergency period . 4. 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 subparagraph: (K) the provision of technologies (as defined by the Secretary) on or after the date of the enactment of this subparagraph, by a provider 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 solicitation; and (ii) the provision of the technologies meets any other requirements set forth in regulations promulgated by the Secretary. .

tv_txt: IIB 117th CONGRESS 2d Session H. R. 4040 IN THE SENATE OF THE UNITED STATES July 28, 2022 Received; read twice and referred to the Committee on Finance AN ACT To amend title XVIII of the Social Security Act to extend telehealth flexibilities under the Medicare program, and for other purposes.

1. Short title This Act may be cited as the Advancing Telehealth Beyond COVID–19 Act of 2022 . 2. Removing geographic requirements and expanding originating sites for telehealth services Section 1834(m) of the Social Security Act ( 42 U.S.C. 1395m(m) ) is amended— (1) in paragraph (2)(B)(iii)— (A) by striking With and inserting In the case that the emergency period described in section 1135(g)(1)(B) ends before December 31, 2024, with ; and (B) by striking that are furnished during the 151-day period beginning on the first day after the end of the emergency period described in section 1135(g)(1)(B) and inserting that are furnished during the period beginning on the first day after the end of such emergency period and ending December 31, 2024 ; and (2) in paragraph (4)(C)(iii)— (A) by striking With and inserting In the case that the emergency period described in section 1135(g)(1)(B) ends before December 31, 2024, with ; and (B) by striking that are furnished during the 151-day period beginning on the first day after the end of the emergency period described in section 1135(g)(1)(B) and inserting that are furnished during the period beginning on the first day after the end of such emergency period and ending on December 31, 2024 . 3. Expanding practitioners eligible to furnish telehealth services Section 1834(m)(4)(E) of the Social Security Act ( 42 U.S.C. 1395m(m)(4)(E) ) is amended by striking and, for the 151-day period beginning on the first day after the end of the emergency period described in section 1135(g)(1)(B) and inserting and, in the case that the emergency period described in section 1135(g)(1)(B) ends before December 31, 2024, for the period beginning on the first day after the end of such emergency period and ending on December 31, 2024 . 4. Extending telehealth services for federally qualified health centers and rural health clinics Section 1834(m)(8)(A) of the Social Security Act ( 42 U.S.C. 1395m(m)(8)(A) ) is amended by striking during the 151-day period beginning on the first day after the end of such emergency period and inserting in the case that such emergency period ends before December 31, 2024, during the period beginning on the first day after the end of such emergency period and ending on December 31, 2024 . 5. Delaying the in-person requirements under medicare for mental health services furnished through telehealth and telecommunications technology (a) Delay in requirements for mental health services furnished through telehealth Section 1834(m)(7)(B)(i) of the Social Security Act ( 42 U.S.C. 1395m(m)(7)(B)(i) ) is amended, in the matter preceding subclause (I), by striking on or after the day that is the 152nd day after the end of the period at the end of the emergency sentence described in section 1135(g)(1)(B)) and inserting on or after January 1, 2025 (or, if later, the first day after the end of the emergency period described in section 1135(g)(1)(B)) . (b) Mental health visits furnished by rural health clinics Section 1834(y) of the Social Security Act ( 42 U.S.C. 1395m(y) ) is amended— (1) in the heading, by striking to hospice patients ; and (2) in paragraph (2), by striking prior to the day that is the 152nd day after the end of the emergency period described in section 1135(g)(1)(B)) and inserting prior to January 1, 2025 (or, if later, the first day after the end of the emergency period described in section 1135(g)(1)(B)) . (c) Mental health visits furnished by federally qualified health centers Section 1834(o)(4) of the Social Security Act ( 42 U.S.C. 1395m(o)(4) is amended— (1) in the heading, by striking to hospice patients ; and (2) in subparagraph (B), by striking prior to the day that is the 152nd day after the end of the emergency period described in section 1135(g)(1)(B)) and inserting prior to January 1, 2025 (or, if later, the first day after the end of the emergency period described in section 1135(g)(1)(B)) . 6. Allowing for the furnishing of audio-only telehealth services Section 1834(m)(9) of the Social Security Act ( 42 U.S.C. 1395m(m)(9) ) is amended by striking The Secretary shall continue to provide coverage and payment under this part for telehealth services identified in paragraph (4)(F)(i) as of the date of the enactment of this paragraph that are furnished via an audio-only telecommunications system during the 151-day period beginning on the first day after the end of the emergency period described in section 1135(g)(1)(B) and inserting In the case that the emergency period described in section 1135(g)(1)(B) ends before December 31, 2024, the Secretary shall continue to provide coverage and payment under this part for telehealth services identified in paragraph (4)(F)(i) that are furnished via an audio-only communications system during the period beginning on the first day after the end of such emergency period and ending on December 31, 2024 . 7. Use of telehealth to conduct face-to-face encounter prior to recertification of eligibility for hospice care during emergency period 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 and during the 151-day period beginning on the first day after the end of such emergency period and inserting and, in the case that such emergency period ends before December 31, 2024, during the period beginning on the first day after the end of such emergency period described in such section 1135(g)(1)(B) and ending on December 31, 2024 . 8. Funding from medicare improvement fund Section 1898(b)(1) of the Social Security Act ( 42 U.S.C. 1395jjj(b)(1) ) is amended by striking $7,500,000,000 and inserting $5,153,000,000 . 9. Program instruction authority Notwithstanding any other provision of law, the Secretary of Health and Human Services may implement the provisions of, including amendments made by, sections 2 through 7 through program instruction or otherwise. 10. Determination of budgetary effects The budgetary effects of this Act, for the purpose of complying with the Statutory Pay-As-You-Go Act of 2010, shall be determined by reference to the latest statement titled Budgetary Effects of PAYGO Legislation for this Act, submitted for printing in the Congressional Record by the Chairman of the House Budget Committee, provided that such statement has been submitted prior to the vote on passage.

Passed the House of Representatives July 27, 2022. Cheryl L. Johnson, Clerk.

tv_txt: I 117th CONGRESS 2d Session H. R. 4040 IN THE HOUSE OF REPRESENTATIVES AN ACT To amend title XVIII of the Social Security Act to extend telehealth flexibilities under the Medicare program, and for other purposes.

1. Short title This Act may be cited as the Advancing Telehealth Beyond COVID–19 Act of 2022 . 2. Removing geographic requirements and expanding originating sites for telehealth services Section 1834(m) of the Social Security Act ( 42 U.S.C. 1395m(m) ) is amended— (1) in paragraph (2)(B)(iii)— (A) by striking With and inserting In the case that the emergency period described in section 1135(g)(1)(B) ends before December 31, 2024, with ; and (B) by striking that are furnished during the 151-day period beginning on the first day after the end of the emergency period described in section 1135(g)(1)(B) and inserting that are furnished during the period beginning on the first day after the end of such emergency period and ending December 31, 2024 ; and (2) in paragraph (4)(C)(iii)— (A) by striking With and inserting In the case that the emergency period described in section 1135(g)(1)(B) ends before December 31, 2024, with ; and (B) by striking that are furnished during the 151-day period beginning on the first day after the end of the emergency period described in section 1135(g)(1)(B) and inserting that are furnished during the period beginning on the first day after the end of such emergency period and ending on December 31, 2024 . 3. Expanding practitioners eligible to furnish telehealth services Section 1834(m)(4)(E) of the Social Security Act ( 42 U.S.C. 1395m(m)(4)(E) ) is amended by striking and, for the 151-day period beginning on the first day after the end of the emergency period described in section 1135(g)(1)(B) and inserting and, in the case that the emergency period described in section 1135(g)(1)(B) ends before December 31, 2024, for the period beginning on the first day after the end of such emergency period and ending on December 31, 2024 . 4. Extending telehealth services for federally qualified health centers and rural health clinics Section 1834(m)(8)(A) of the Social Security Act ( 42 U.S.C. 1395m(m)(8)(A) ) is amended by striking during the 151-day period beginning on the first day after the end of such emergency period and inserting in the case that such emergency period ends before December 31, 2024, during the period beginning on the first day after the end of such emergency period and ending on December 31, 2024 . 5. Delaying the in-person requirements under medicare for mental health services furnished through telehealth and telecommunications technology (a) Delay in requirements for mental health services furnished through telehealth Section 1834(m)(7)(B)(i) of the Social Security Act ( 42 U.S.C. 1395m(m)(7)(B)(i) ) is amended, in the matter preceding subclause (I), by striking on or after the day that is the 152nd day after the end of the period at the end of the emergency sentence described in section 1135(g)(1)(B)) and inserting on or after January 1, 2025 (or, if later, the first day after the end of the emergency period described in section 1135(g)(1)(B)) . (b) Mental health visits furnished by rural health clinics Section 1834(y) of the Social Security Act ( 42 U.S.C. 1395m(y) ) is amended— (1) in the heading, by striking to hospice patients ; and (2) in paragraph (2), by striking prior to the day that is the 152nd day after the end of the emergency period described in section 1135(g)(1)(B)) and inserting prior to January 1, 2025 (or, if later, the first day after the end of the emergency period described in section 1135(g)(1)(B)) . (c) Mental health visits furnished by federally qualified health centers Section 1834(o)(4) of the Social Security Act ( 42 U.S.C. 1395m(o)(4) is amended— (1) in the heading, by striking to hospice patients ; and (2) in subparagraph (B), by striking prior to the day that is the 152nd day after the end of the emergency period described in section 1135(g)(1)(B)) and inserting prior to January 1, 2025 (or, if later, the first day after the end of the emergency period described in section 1135(g)(1)(B)) . 6. Allowing for the furnishing of audio-only telehealth services Section 1834(m)(9) of the Social Security Act ( 42 U.S.C. 1395m(m)(9) ) is amended by striking The Secretary shall continue to provide coverage and payment under this part for telehealth services identified in paragraph (4)(F)(i) as of the date of the enactment of this paragraph that are furnished via an audio-only telecommunications system during the 151-day period beginning on the first day after the end of the emergency period described in section 1135(g)(1)(B) and inserting In the case that the emergency period described in section 1135(g)(1)(B) ends before December 31, 2024, the Secretary shall continue to provide coverage and payment under this part for telehealth services identified in paragraph (4)(F)(i) that are furnished via an audio-only communications system during the period beginning on the first day after the end of such emergency period and ending on December 31, 2024 . 7. Use of telehealth to conduct face-to-face encounter prior to recertification of eligibility for hospice care during emergency period 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 and during the 151-day period beginning on the first day after the end of such emergency period and inserting and, in the case that such emergency period ends before December 31, 2024, during the period beginning on the first day after the end of such emergency period described in such section 1135(g)(1)(B) and ending on December 31, 2024 . 8. Funding from medicare improvement fund Section 1898(b)(1) of the Social Security Act ( 42 U.S.C. 1395jjj(b)(1) ) is amended by striking $7,500,000,000 and inserting $5,153,000,000 . 9. Program instruction authority Notwithstanding any other provision of law, the Secretary of Health and Human Services may implement the provisions of, including amendments made by, sections 2 through 7 through program instruction or otherwise. 10. Determination of budgetary effects The budgetary effects of this Act, for the purpose of complying with the Statutory Pay-As-You-Go Act of 2010, shall be determined by reference to the latest statement titled Budgetary Effects of PAYGO Legislation for this Act, submitted for printing in the Congressional Record by the Chairman of the House Budget Committee, provided that such statement has been submitted prior to the vote on passage.

Passed the House of Representatives July 27, 2022. Cheryl L. Johnson, Clerk.