1.This Act may be cited as the
Rural Telemedicine Enhancing Community
Health (TECH) Act of 2009
.
2.Telehealth pilot
projects
(a)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)
(1)The Secretary shall select eligible entities to
participate in the pilot projects under this section.
(2)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)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)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)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 appropriationsTo carry out this section, there is authorized
to be appropriated $13,500,000 for fiscal years 2011 through 2014.
3.Expanding access
to stroke telehealth services
(a)Expansion of
originating sites for stroke telehealth servicesSection
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 servicesIn 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 servicesThe 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)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.
4.Improving access
to telehealth services at IHS facilities and FQHCs
(a)Inclusion of
IHS facilities as originating sitesSection 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)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)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 describedFor 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)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.
5.Improving
credentialing and privileging standards for telehealth servicesSection 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)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
regulationsDuring 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.
.