[Congressional Bills 114th Congress]
[From the U.S. Government Publishing Office]
[H.R. 691 Introduced in House (IH)]

114th CONGRESS
  1st Session
                                H. R. 691

   To promote the provision of telehealth by establishing a Federal 
            standard for telehealth, and for other purposes.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                            February 3, 2015

    Ms. Matsui (for herself and Mr. Johnson of Ohio) introduced the 
   following bill; which was referred to the Committee on Energy and 
                                Commerce

_______________________________________________________________________

                                 A BILL


 
   To promote the provision of telehealth by establishing a Federal 
            standard for telehealth, 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 ``Telehealth Modernization Act of 
2015''.

SEC. 2. FINDINGS.

    Congress finds the following:
            (1) Telehealth technologies can transform health care 
        delivery by improving access to quality care by removing 
        traditional barriers to health care delivery such as distance, 
        mobility, and time constraints.
            (2) Telehealth is a mode of delivering health care 
        utilizing information and communication technologies to enable 
        the diagnosis, consultation, treatment, and care management of 
        patients by health care providers.
            (3) The use of information and telecommunication 
        technologies to deliver health care has the potential to reduce 
        costs, improve quality, change conditions of practice, and 
        improve access to health care, particularly in rural and 
        medically underserved areas.
            (4) A lack of primary care providers, specialty providers, 
        and transportation continues to be a significant barrier to 
        access to health care in medically underserved rural and urban 
        areas.
            (5) Parts of the Nation have difficulty attracting and 
        retaining health care professionals, as well as supporting 
        local health facilities to provide a continuum of health care.
            (6) Many health care providers in medically underserved 
        areas are isolated from mentors, colleagues, and the 
        information resources necessary to support them personally and 
        professionally.
            (7) A patchwork of State regulatory environments poses 
        legal and regulatory hurdles that are inhibiting the 
        proliferation of private-sector telehealth innovations and have 
        created significant uncertainty for the telehealth community.
            (8) As of June 2013, 40 out of 50 States have introduced 
        legislation addressing telehealth policy, with wide variations 
        in how telehealth is defined.
            (9) To help clarify this uncertainty and provide States 
        with appropriate guidance, Congress should provide a workable 
        Federal definition of telehealth that ensures the highest 
        common denominator of care while facilitating future 
        innovation.
            (10) The fundamental health care provider-patient 
        relationship cannot only be preserved through a Federal 
        definition of telehealth, but also can be established, 
        augmented, and enhanced through the use of telehealth.

SEC. 3. FEDERAL STANDARD FOR TELEHEALTH.

    (a) In General.--If a State authorizes a health care professional 
to deliver health care to an individual, the State should also 
authorize the health care professional to deliver such health care to 
such individual through telehealth, subject to the conditions specified 
in subsection (b).
    (b) Conditions.--The following are conditions for the delivery of 
health care through telehealth by a health care professional to an 
individual that States should consider adopting:
            (1) Accessibility and review of medical history.--The 
        health care professional should have access to the medical 
        history of the individual, and should review such medical 
        history with the individual, to the same extent that the health 
        care professional would have access to such medical history and 
        would review such medical history if delivering the health care 
        in person.
            (2) Identification of underlying conditions and 
        contraindications.--To the extent practicable, the health care 
        professional should attempt to identify the conditions 
        underlying the symptoms, if any, reported by the individual 
        before such professional provides any diagnosis or treatment to 
        the individual. In the case that the health care professional 
        recommends a treatment to the individual, the health care 
        professional should review with the individual the 
        contraindications to the recommended treatment.
            (3) Diagnosis.--Subject to the professional discretion of 
        the health care professional, such professional should have a 
        conversation with the individual adequate to establish any 
        diagnosis rendered.
            (4) Document evaluation, medical records, and provision of 
        medical information.--The health care professional should 
        document the evaluation and treatment delivered to the 
        individual, if any, for the purpose of generating a medical 
        record of the encounter. At the option of the individual, the 
        health care professional should--
                    (A) provide the individual with medical 
                information, in standard medical record format, about 
                such evaluation and treatment; and
                    (B) send any documentation concerning such 
                evaluation and treatment to one or more selected health 
                care professionals responsible for the care of the 
                individual.
            (5) Transparency regarding professional credentials.--At 
        the option of the individual, the health care professional 
        should provide to the individual, in electronic and paper 
        format, information regarding the health care education, 
        certification, and credentials of the health care professional.
            (6) No assurance concerning items or services.--The health 
        care professional should offer no assurance to the individual 
        that any item or service, including a prescription, will be 
        issued or provided--
                    (A) in exchange for the payment of the consultation 
                fee charged by the health care professional; or
                    (B) solely in response to the individual completing 
                a form or questionnaire.
            (7) Prescription requirements.--Any prescription issued by 
        the health care professional as part of the health care 
        delivered to the individual should meet the following 
        requirements:
                    (A) The prescription is issued for a legitimate 
                medical purpose in the usual course of professional 
                practice.
                    (B) The prescription is issued by a health care 
                professional who has obtained a medical history and 
                conducted an evaluation of the individual to whom such 
                prescription is issued adequate to establish a 
                diagnosis.
                    (C) The prescription is not for a drug or substance 
                in schedule II, III, or IV of section 202(c) of the 
                Controlled Substances Act (21 U.S.C. 812(c)).
                    (D) The prescription is filled by an appropriately 
                licensed dispensing entity.
    (c) Construction.--Nothing in this section shall be construed to--
            (1) change the application of the HIPAA privacy regulation 
        (as defined in section 1180(b)(3) of the Social Security Act 
        (42 U.S.C. 1320d-9(b)(3))) with respect to a health care 
        professional's provision of telehealth; or
            (2) affect the standard of care for medical or clinical 
        appropriateness as established by State law or policy.
    (d) Definitions.--For purposes of this section:
            (1) Telehealth.--The term ``telehealth'' means, with 
        respect to health care that a health care professional is 
        authorized to deliver to an individual in person under State 
        law, such health care delivered by such health care 
        professional to such individual not in person, from any 
        location to any other location, and by means of real-time 
        video, secure chat or secure email, or integrated telephony.
            (2) Health care professional.--The term ``health care 
        professional'' means, with respect to health care, a physician 
        or practitioner who is authorized under law to deliver such 
        health care in person.
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