II 110th CONGRESS 2d Session S. 2812 IN THE SENATE OF THE UNITED STATES April 3, 2008 Mr. Conrad (for himself and Ms. Stabenow) introduced the following bill; which was read twice and referred to the Committee on Finance A BILL To amend title XVIII of the Social Security Act to improve the provision of telehealth services under the Medicare program.

1.

Short title; table of contents

(a)

Short title

This Act may be cited as the Medicare Telehealth Improvement Act of 2008. (b)

Table of contents

The table of contents of this Act is as follows: Sec. 1. Short title; table of contents. Sec. 2. Increase in number of types of originating sites. Sec. 3. Expansion of practitioners eligible to furnish telehealth services. Sec. 4. Improvement of process for updating the list of telehealth services.

2.

Increase in number of types of originating sites

(a)

Increase

Section 1834(m)(4)(C)(ii) of the Social Security Act (42 U.S.C. 1395m(m)(4)(C)(ii)) is amended by adding at the end the following new subclauses: (VI)A skilled nursing facility (as defined in section 1819(a)). (VII)A renal dialysis facility. (VIII)A community mental health center (as defined in section 1861(ff)(3)(B)), a qualified community program described in 1913(b)(1) of the Public Health Service Act, and a county mental health clinic. (IX)Any other site that has a telecommunications system. . (b)

No facility fee for certain originating sites

Section 1834(m)(2) of the Social Security Act (42 U.S.C. 1395m(m)(2)) is amended— (1)in subparagraph (B), in the matter preceding clause (i), by striking With respect and inserting Subject to subparagraph (D), with respect; and (2)by adding at the end the following new subparagraph: (D)

No facility fee for certain originating sites

(i)

In general

No facility fee shall be paid to an originating site described in paragraph (4)(C)(ii)(IX). (ii)

No change in payment to distant site

Clause (i) shall not be construed to affect the payment to a distant site under subparagraph (A). . (c)

Effective date

The amendments made by this section shall apply to services furnished on or after the date that is 90 days after the date of enactment of this Act.

3.

Expansion of practitioners eligible to furnish telehealth services

(a)

In general

Section 1834(m) of the Social Security Act (42 U.S.C. 1395m(m)) is amended— (1)in paragraph (1), by striking (as defined in section 1861(r)) or a practitioner (described in section 1842(b)(18)(C)) and inserting or a practitioner; and (2)in paragraph (4), by striking subparagraph (E) and inserting the following new subparagraph: (E)

Practitioner

The term practitioner means— (i)a practitioner described in section 1842(b)(18)(C); (ii)a physical therapist (as described in section 1861(p)); (iii)an occupational therapist (as so described); (iv)a qualified speech-language pathologist (as defined in section 1861(ll)(3)(A)); (v)a qualified audiologist (as defined in section 1861(ll)(3)(B)); (vi)a certified provider (as described in section 1861(qq)(2)(A)); and (vii)any other individual or entity determined appropriate by the Secretary. . (b)

Effective date

The amendments made by subsection (a) shall apply to services furnished on or after the date that is 90 days after the date of enactment of this Act.

4.

Improvement of process for updating the list of telehealth services

(a)

In general

Section 1834(m)(4)(F)(ii) of the Social Security Act (42 U.S.C. 1395m(m)(4)(F)(ii)) is amended by adding at the end the following sentences: Such process shall require the Secretary to take into account the recommendations of the Telehealth Advisory Committee (as established under section 4(b) of the Medicare Telehealth Improvement Act of 2008) when adding or deleting services (and HCPCS codes). If the Secretary does not implement a recommendation of the Telehealth Advisory Committee, the Secretary shall publish in the Federal Register a statement regarding the reason such recommendation was not implemented.. (b)

Telehealth Advisory Committee

(1)

Establishment

On and after the date that is 6 months after the date of enactment of this Act, the Secretary of Health and Human Services (in this subsection referred to as the Secretary) shall have in place a Telehealth Advisory Committee (in this subsection referred to as the Advisory Committee) to make recommendations to the Secretary on the appropriate addition or deletion of services (and HCPCS codes) to those specified in paragraph (4)(F)(i) of section 1834(m) of the Social Security Act (42 U.S.C. 1395m(m)) for authorized payment under paragraph (1) of such section. (2)

Membership; terms

(A)

Membership

(i)

In general

The Advisory Committee shall be composed of 7 members, to be appointed by the Secretary, of whom— (I)five shall be practicing physicians; and (II)two shall be practicing non-physician health care providers. (ii)

Requirements for appointing members

In appointing members of the Advisory Committee, the Secretary shall— (I)ensure that each member has prior experience with the practice of telemedicine or telehealth; (II)give preference to individuals who are currently providing telemedicine or telehealth services; (III)ensure that the membership of the Advisory Committee represents a balance of specialties and geographic regions; and (IV)take into account the recommendations of stakeholders. (B)

Terms

The members of the Advisory Committee shall serve for such term as the Secretary may specify. (3)

Meetings

The Advisory Committee shall meet twice per year and at such other times as the Advisory Committee may provide. (4)

Permanent committee

Section 14 of the Federal Advisory Committee Act (5 U.S.C. App.) shall not apply to the Advisory Committee. (5)

Waiver of Administrative Limitation

The Secretary shall establish the Advisory Committee notwithstanding any limitation that may apply to the number of advisory committees that may be established (within the Department of Health and Human Services or otherwise).