[Congressional Bills 104th Congress]
[From the U.S. Government Publishing Office]
[H.R. 851 Introduced in House (IH)]







104th CONGRESS
  1st Session
                                H. R. 851

To direct the Secretary of Health and Human Services to establish pilot 
 projects to investigate the effectiveness of the use of rural health 
 care provider telemedicine networks to provide coverage of physician 
     consultative services under part B of the medicare program to 
                  individuals residing in rural areas.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                            February 7, 1995

 Mrs. Lincoln (for herself, Mr. Richardson, and Mr. Dickey) introduced 
  the following bill; which was referred to the Committee on 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 direct the Secretary of Health and Human Services to establish pilot 
 projects to investigate the effectiveness of the use of rural health 
 care provider telemedicine networks to provide coverage of physician 
     consultative services under part B of the medicare program to 
                  individuals residing in rural areas.

    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 ``Rural Telemedicine Act of 1995''.

SEC. 2. ESTABLISHMENT OF PROJECT.

    (a) In General.--The Secretary of Health and Human Services 
(hereafter referred to as the ``Secretary'') shall establish not more 
than 10 pilot projects not later than 9 months after the date of 
enactment of this Act to investigate over a 3-year period the 
effectiveness of the use of rural health care provider telemedicine 
networks to provide coverage of physician consultative services under 
part B of the medicare program to individuals residing in rural areas.
    (b) Networks Defined.--In this Act, the term ``rural health care 
provider telemedicine network'' (hereafter referred to as a 
``network'') means a network of providers that meets the following 
requirements:
            (1) The network serves physicians, clinics, and other 
        nontertiary care providers in a rural area who have entered 
        into agreements with a multispecialty tertiary care provider 
        (without regard to whether or not such tertiary care provider 
        is in the rural area) regarding patient referral and transfer, 
        the use of joint communications systems, and the provision of 
        emergency and nonemergency transportation among the network 
        members.
            (2) The area in which the network operates is a rural area 
        designated as a health professional shortage area (under 
        section 332(a) of the Public Health Service Act) or is an 
        underserved rural area in accordance with such other criteria 
        as the Secretary may specify.

SEC. 3. MEDICARE PAYMENT FOR PARTICIPANTS.

    (a) In General.--Under the projects established under this Act, the 
Secretary shall make payments from the Federal Supplementary Medical 
Insurance Trust Fund under part B of title XVIII of the Social Security 
Act in accordance with the methodology described in subsection (b) for 
physicians' services consisting of a professional consultation with an 
individual or entity furnishing a service for which payment may be made 
under such part to a medicare beneficiary in a rural area, 
notwithstanding that the individual providing the professional 
consultation is not at the same location as the individual furnishing 
the service to the medicine beneficiary.
    (b) Methodology for Determining Amount of Payments.--Taking into 
account the amount of funds available for payments under the project, 
the Secretary shall establish a methodology for determining the amount 
of payments made under subsection (a), and shall include in the 
methodology a method for making payment for reasonable costs incurred 
in the usage of signal transmission facilities suitable for the conduct 
of physician consultative services.
    (c) Payment for Nonphysician Providers.--Payments may be made under 
subsection (a) for any service described in such paragraph, without 
regard to whether or not the individual furnishing such service is a 
physician.

SEC. 4. ELIGIBILITY OF NETWORKS.

    (a) In General.--A network is eligible to participate in a pilot 
project under this Act if--
            (1) the network submits to the Secretary (at such time and 
        in such form as the Secretary may require) an application 
        containing such information and assurances as the Secretary may 
        require; and
            (2) the network agrees to submit to the Secretary such 
        information as the Secretary may require to determine the 
        amount of payments described in section 3(b), to prepare 
        reports under section 6, and to otherwise carry out the 
        project.
    (b) Rural Area Defined.--In this Act, the term ``rural area'' has 
the meaning given such term in section 1886(d)(2)(D) of the Social 
Security Act.

SEC. 5. CRITERIA FOR SELECTING PARTICIPANTS.

    (a) Technology Applied.--In selecting among eligible networks for 
participation in pilot projects under this Act, the Secretary shall 
give priority to networks that provide for consultations between 
patients and medical specialists involving transmission of detailed 
data on the patient in a manner that serves as a reasonable substitute 
for inperson interaction between the patients and the specialists.
    (b) Permitting Existing Networks To Participate.--Nothing in this 
Act may be construed to prohibit the Secretary from selecting a network 
operating at the time of the establishment of the pilot projects from 
participating in the project.

SEC. 6. REPORTS.

    (a) Interim Report on Participating Sites.--Not later than 24 
months after the Secretary first makes payment under subsection (b) for 
services under a pilot project, the Secretary shall submit a report to 
Congress describing the projects and the networks participating in the 
projects under this section, including a description of the amounts 
expended and the number of patients served under the projects.
    (b) Final.--Not later than 1 year after the termination of the 
projects, the Secretary shall submit a final report to Congress 
describing the operation of the projects and containing--
            (1) the Secretary's analysis of the projects' cost-
        effectiveness and success in promoting the access of providers 
        of health care services in rural areas to consultation services 
        of specialist physicians;
            (2) the Secretary's analysis of the impact of the projects 
        on the ability of patients to obtain a higher quality and 
        greater range of care; and
            (3) such recommendations as the Secretary considers 
        appropriate for changes in the medicare program relating to 
        telemedicine, including estimates of the costs associated with 
        any such changes.

SEC. 7. AUTHORIZATION OF APPROPRIATIONS.

    There are authorized to be appropriated from the Federal 
Supplementary Medical Insurance Trust Fund under section 1841 of the 
Social Security Act a total of $51,000,000 for carrying out the 
demonstration project under this Act. Of such amount, not more than 
$1,000,000 may be used for administrative purposes, including preparing 
and submitting reports under section 6.
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