[Congressional Bills 111th Congress]
[From the U.S. Government Publishing Office]
[S. 2741 Introduced in Senate (IS)]
111th CONGRESS
1st Session
S. 2741
To establish telehealth pilot projects, expand access to stroke
telehealth services under the Medicare program, improve access to
``store-and-forward'' telehealth services in facilities of the Indian
Health Service and federally qualified health centers, reimburse
facilities of the Indian Health Service as originating sites, establish
regulations to consider credentialing and privileging standards for
originating sites with respect to receiving telehealth services, and
for other purposes.
_______________________________________________________________________
IN THE SENATE OF THE UNITED STATES
November 5, 2009
Mr. Udall of New Mexico introduced the following bill; which was read
twice and referred to the Committee on Finance
_______________________________________________________________________
A BILL
To establish telehealth pilot projects, expand access to stroke
telehealth services under the Medicare program, improve access to
``store-and-forward'' telehealth services in facilities of the Indian
Health Service and federally qualified health centers, reimburse
facilities of the Indian Health Service as originating sites, establish
regulations to consider credentialing and privileging standards for
originating sites with respect to receiving telehealth services, 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 ``Rural Telemedicine Enhancing
Community Health (TECH) Act of 2009''.
SEC. 2. TELEHEALTH PILOT PROJECTS.
(a) In General.--The Secretary of Health and Human Services
(referred to in this section as the ``Secretary'') shall establish 3-
year telehealth pilot projects for the purpose of analyzing the
clinical outcomes and cost effectiveness associated with telehealth
services in a variety of geographic areas. The Secretary shall provide
evaluation and treatment services to entities participating in the
pilot projects.
(b) Eligible Entities.--
(1) In general.--The Secretary shall select eligible
entities to participate in the pilot projects under this
section.
(2) Priority.--In selecting eligible entities to
participate in the pilot projects under this section, the
Secretary shall give priority to such entities located in
medically underserved areas and facilities of the Indian Health
Service.
(c) Evaluation.--The Secretary shall, through the pilot projects,
evaluate--
(1) the effective and economic delivery of care in treating
behavioral health issues (including post-traumatic stress
disorder) with the use of telehealth services in medically
underserved and tribal areas, including collaborative uses of
health professionals, integration of the range of telehealth
and other technologies, and exploration of appropriate
reimbursement methods for third party payers;
(2) the effectiveness of improving the capacity of non-
medical providers and non-specialized medical providers to
provide health services for chronic complex diseases in
medically underserved and tribal areas; and
(3) the effectiveness of using telehealth services to
provide acute stroke evaluation and treatment, occupational
therapy, physical therapy, and speech language pathology
services to treat cerebrovascular disease in medically
underserved and tribal areas.
(d) Report.--Not later than 3 years after the pilot projects are
established under subsection (a), the Secretary shall submit to
Congress a report describing the outcomes of such pilot projects and
providing recommendations for expanding the use of telehealth services.
(e) Expansion of Project.--If the Secretary determines that the
pilot projects under this section enhance outcomes for patients and
reduce expenditures for participating entities, the Secretary may
initiate similar projects for additional medical conditions and
geographic areas.
(f) Authorization of Appropriations.--To carry out this section,
there is authorized to be appropriated $13,500,000 for fiscal years
2011 through 2014.
SEC. 3. EXPANDING ACCESS TO STROKE TELEHEALTH SERVICES.
(a) Expansion of Originating Sites for Stroke Telehealth
Services.--Section 1834(m)(4) of the Social Security Act (42 U.S.C.
1395m(m)(4)) is amended--
(1) in subparagraph (C)--
(A) in clause (i), in the matter preceding
subclause (I), by striking ``The term'' and inserting
``Subject to clause (iii), the term''; and
(B) by adding at the end the following new clause:
``(iii) Expansion of originating sites for
stroke telehealth services.--In the case of
stroke telehealth services, the term
`originating site' means any site described in
clause (ii) at which the eligible telehealth
individual is located at the time the service
is furnished via a telecommunications system,
regardless of where the site is located.''; and
(2) by adding at the end the following new subparagraph:
``(G) Stroke telehealth services.--The term `stroke
telehealth services' means a telehealth service used
for the evaluation or treatment of individuals with
acute stroke, occupational therapy, physical therapy,
and speech language pathology services furnished
subsequent to a stroke, and stroke prevention and
education services.''.
(b) Effective Date.--The amendments made by subsection (a) shall
apply to telehealth services furnished on or after the date that is 6
months after the date of enactment of this Act.
SEC. 4. IMPROVING ACCESS TO TELEHEALTH SERVICES AT IHS FACILITIES AND
FQHCS.
(a) Inclusion of IHS Facilities as Originating Sites.--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
subclause:
``(IX) A facility of the Indian
Health Service, whether operated by
such Service or by an Indian tribe or
tribal organization (as those terms are
defined in section 4 of the Indian
Health Care Improvement Act).''.
(b) Access to Store-and-Forward and Videoconferencing
Technologies.--
(1) In general.--Section 1834(m)(1) of such Act (42 U.S.C.
1395m(m)(1)) is amended by adding at the end the following
sentence: ``For purposes of the first sentence, in the case of
telehealth services described in subclause (I) of paragraph
(4)(F)(iii) that are furnished by a facility of the Indian
Health Service (whether operated by such Service or by an
Indian tribe or tribal organization (as those terms are defined
in section 4 of the Indian Health Care Improvement Act)) or a
federally qualified health center (as defined in section
1861(aa)(4)), the term `telecommunications system' includes
store-and-forward technologies described in the preceding
sentence and, in the case of telehealth services described in
subclause (II) of such paragraph that are furnished by such a
facility or federally qualified health center, such term
includes videoconferencing technologies.''
(2) Conforming amendment.--Section 1834(m)(4)(F) of such
Act (42 U.S.C. 1395m(m)(4)(F)) is amended by adding at the end
the following new clauses:
``(iii) Telehealth services described.--For
purposes of paragraph (1):
``(I) The telehealth services
described in this subclause include
consultations related to neurosurgery,
neurology, cardiology, dermatology,
pediatric specialty, and orthopedic (as
specified by the Secretary).
``(II) The telehealth services
described in this subclause are
services related to hepatitis and other
chronic conditions and behavioral
health services (as specified by the
Secretary).''.
(c) Effective Date.--The amendments made by this section shall
apply to telehealth services furnished on or after the date that is 6
months after the date of enactment of this Act.
SEC. 5. IMPROVING CREDENTIALING AND PRIVILEGING STANDARDS FOR
TELEHEALTH SERVICES.
Section 1834(m) of the Social Security Act (42 U.S.C. 1395m(m)) is
amended by adding at the end the following new paragraph:
``(5) Establishment of remote credentialing and privileging
standards.--
``(A) In general.--Not later than 2 years after the
date of the enactment of this paragraph, the Secretary
shall establish reasonable regulations for considering
the remote credentialing and privileging standards
applicable to telehealth services, including
interpretative services, for originating sites under
this subsection. Such regulations shall allow an
originating site to accept, and not duplicate, the
credentialing and privileging processes and decisions
made by another site.
``(B) Clarification regarding acceptance of
processes and decisions prior to enactment of
regulations.--During the period beginning on such date
of enactment and ending on the effective date of the
regulations under subparagraph (A), the Secretary shall
not take any punitive action under any rule or
regulation against an originating site on the basis of
that site's acceptance, for purposes of receiving
telehealth services (including interpretive services),
the credentialing and privileging processes and
decisions made by another site that is accredited by a
national accreditation body recognized by the Secretary
under section 1865(a)(1) if the site accepting such
credentialing and privileging processes is also so
accredited and complies with the applicable
requirements for such acceptance.''.
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