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<bill bill-stage="Introduced-in-House" dms-id="H9298DFE320814A4C8960FD1DF82EAF83" public-private="public" key="H" bill-type="olc"><metadata xmlns:dc="http://purl.org/dc/elements/1.1/">
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<dc:title>116 HR 341 IH: Ensuring Telehealth Expansion Act of 2021</dc:title>
<dc:publisher>U.S. House of Representatives</dc:publisher>
<dc:date>2021-01-15</dc:date>
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<dc:language>EN</dc:language>
<dc:rights>Pursuant to Title 17 Section 105 of the United States Code, this file is not subject to copyright protection and is in the public domain.</dc:rights>
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<distribution-code display="yes">I</distribution-code><congress display="yes">117th CONGRESS</congress><session display="yes">1st Session</session><legis-num display="yes">H. R. 341</legis-num><current-chamber>IN THE HOUSE OF REPRESENTATIVES</current-chamber><action display="yes"><action-date date="20210115">January 15, 2021</action-date><action-desc><sponsor name-id="W000816">Mr. Williams of Texas</sponsor> introduced the following bill; which was referred to the <committee-name committee-id="HWM00">Committee on Ways and Means</committee-name>, and in addition to the Committee on <committee-name committee-id="HIF00">Energy and Commerce</committee-name>, 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</action-desc></action><legis-type>A BILL</legis-type><official-title display="yes">To make permanent certain telehealth flexibilities established in response to COVID–19.</official-title></form><legis-body id="HEBA6EEED00C64CDAB0C021A60CEC02F2" style="OLC"><section id="H8EC71F5918D6498FA7221AA526AB526B" section-type="section-one"><enum>1.</enum><header>Short title</header><text display-inline="no-display-inline">This Act may be cited as the <quote><short-title>Ensuring Telehealth Expansion Act of 2021</short-title></quote>.</text></section><section id="H15E4043DC48F4173B7CF16C55D88D14C" section-type="subsequent-section"><enum>2.</enum><header>Making permanent certain telehealth flexibilities established in response to COVID–19</header><subsection id="H9E1AB7AA33D54A1D8EB266BB8501CB63"><enum>(a)</enum><header>Exemption for telehealth services</header><paragraph id="H8377A07F212A40C2833D09B5986CAC48"><enum>(1)</enum><header>In general</header><text display-inline="yes-display-inline">Subparagraph (E) of <external-xref legal-doc="usc" parsable-cite="usc/26/223">section 223(c)(2)</external-xref> of the Internal Revenue Code of 1986 is amended by striking <quote>In the case of plan years beginning on or before December 31, 2021, a plan</quote> and inserting <quote>A plan</quote>. </text></paragraph><paragraph id="HF483D7005523449F9F2D71AD2CB91453"><enum>(2)</enum><header>Certain coverage disregarded</header><text display-inline="yes-display-inline">Clause (ii) of <external-xref legal-doc="usc" parsable-cite="usc/26/223">section 223(c)(1)(B)</external-xref> of the Internal Revenue Code of 1986 is amended by striking <quote>(in the case of plan years beginning on or before December 31, 2021)</quote>.</text></paragraph></subsection><subsection id="H1C4C2D3107FF4726AC0341176BDCB004"><enum>(b)</enum><header>Increasing Medicare telehealth flexibilities</header><text display-inline="yes-display-inline">Section 1834(m) of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1395m">42 U.S.C. 1395m(m)</external-xref>) is amended by adding at the end the following new paragraph:</text><quoted-block style="OLC" id="HCFB722F96CFF41A9B3E186D4CE8E60CA" display-inline="no-display-inline"><paragraph id="H84F4E63608F348248415C8AE1372058B"><enum>(9)</enum><header>Waiver authority</header><text display-inline="yes-display-inline">The Secretary may waive any requirement of this subsection if determined appropriate by the Secretary.</text></paragraph><after-quoted-block>.</after-quoted-block></quoted-block></subsection><subsection id="H4B3984B361784E3897C001EBE94702E5"><enum>(c)</enum><header>Enhancing Medicare telehealth services for federally qualified health centers and rural health clinics; Eliminating special payment rule for such services</header><paragraph id="HF708825AEEDB4684A4BC59BCA9D6B2B5"><enum>(1)</enum><header>In general</header><text display-inline="yes-display-inline">Paragraph (8) of section 1834(m) of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1395m">42 U.S.C. 1395m(m)</external-xref>) is amended to read as follows:</text><quoted-block style="OLC" id="H7C423CCC11D6468BA26E34C90925B8A9" display-inline="no-display-inline"><paragraph id="HA128CFDAF0AC474DA12C332124ABA348"><enum>(8)</enum><header>Enhancing telehealth services for federally qualified health centers and rural health clinics</header><subparagraph id="HBB94870531AC45C591D506135167E54E"><enum>(A)</enum><header>In general</header><text>With respect to services furnished on or after the first day of the emergency period described in section 1135(g)(1)(B), the Secretary shall pay for telehealth services that are furnished via a telecommunications system by a Federally qualified health center or a rural health clinic to an eligible telehealth individual enrolled under this part notwithstanding that the Federally qualified health center or rural clinic providing the telehealth service is not at the same location as the beneficiary.</text></subparagraph><subparagraph id="H8FAD941D7C9643C08981A0B22BE6C124"><enum>(B)</enum><header>Payment</header><clause id="H9539D69176BD4977BBF548497B731FA6"><enum>(i)</enum><header>In general</header><text display-inline="yes-display-inline">A telehealth service furnished by a rural health clinic or a Federally qualified health center serving as a distant site to an individual shall be deemed to be so furnished to such individual as an outpatient of such clinic or center (as applicable) for purposes of section 1861(aa) and payable as a rural health clinic service or Federally qualified health center service (as applicable) under section 1833(a)(3) or under the prospective payment system established under section 1834(o) (as applicable).</text></clause><clause id="HBBB1A18BC92F472D9A729AB27171E618"><enum>(ii)</enum><header>Treatment of costs for FQHC PPS calculations and RHC AIR calculations</header><text display-inline="yes-display-inline">Costs associated with the delivery of telehealth services by a Federally qualified health center or rural health clinic serving as a distant site pursuant to this paragraph shall be considered allowable costs for purposes of the prospective payment system established under section 1834(o) and any payment methodologies developed under section 1833(a)(3), as applicable.</text></clause></subparagraph><subparagraph id="HDE6E2C375D9A4404A6655360CBED291C"><enum>(C)</enum><header>Definitions</header><text display-inline="yes-display-inline">For purposes of this subsection—</text><clause id="HA45F48FEB5A54255BD2842E06CA66606"><enum>(i)</enum><text>the term <term>distant site</term> includes a Federally qualified health center or rural health clinic that furnishes a telehealth service to an eligible telehealth individual; and</text></clause><clause id="HB3172700065747AB969AF32D0D6BDA08"><enum>(ii)</enum><text>the term <term>telehealth services</term> includes a rural health clinic service or Federally qualified health center service that is furnished using telehealth to the extent that payment codes corresponding to services identified by the Secretary under clause (i) or (ii) of paragraph (4)(F) are listed on the corresponding claim for such rural health clinic service or Federally qualified health center service.</text></clause></subparagraph></paragraph><after-quoted-block>.</after-quoted-block></quoted-block></paragraph><paragraph id="H7EA1ED1015574995B4363F6CB66EE764"><enum>(2)</enum><header>Conforming amendment</header><text display-inline="yes-display-inline">Section 1834(m)(2)(A) of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1395m">42 U.S.C. 1395m(m)(2)(A)</external-xref>) is amended by striking <quote>Subject to paragraph (8), the</quote> and inserting <quote>The</quote>. </text></paragraph><paragraph id="HF0BC212D16F74D5BB4A1871EB0C8F07F"><enum>(3)</enum><header>Effective date</header><text>The amendments made by this subsection shall take effect as if included in the enactment of the CARES Act (<external-xref legal-doc="public-law" parsable-cite="pl/116/136">Public Law 116–136</external-xref>).</text></paragraph></subsection><subsection id="H7FA2B690AB374444BCCA81405C6B861D"><enum>(d)</enum><header>Waiver of requirements for face-to-Face visits between home dialysis patients and physicians</header><text display-inline="yes-display-inline">Section 1881(b)(3)(B)(iii) of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1395rr">42 U.S.C. 1395rr(b)(3)(B)(iii)</external-xref>) is amended by striking <quote>during the emergency period described in section 1135(g)(1)(B)</quote> and inserting <quote>during any period beginning on or after the first day of the emergency period described in section 1135(g)(1)(B)</quote>. </text></subsection><subsection id="H1B83BAFC792B4641A73AD47441A5D725"><enum>(e)</enum><header>Use of telehealth To conduct face-to-Face encounter prior to recertification of eligibility for hospice care</header><text display-inline="yes-display-inline">Section 1814(a)(7)(D)(i)(II) of the Social Security Act (42 U.S.C. 1395f(a)(7(D)(i)(II)) is amended by striking <quote>during the emergency period described in section 1135(g)(1)(B)</quote> and inserting <quote>during any period beginning on or after the first day of the emergency period described in section 1135(g)(1)(B)</quote>.</text></subsection><subsection id="HA4C835C760E44D7DB2682B1B4445F39F"><enum>(f)</enum><header>Encouraging use of telecommunications systems for home health services</header><text>Section 3707 of the CARES Act (<external-xref legal-doc="public-law" parsable-cite="pl/116/136">Public Law 116–136</external-xref>) is amended by striking <quote>during the emergency period described in section 1135(g)(1)(B) of such Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1320b-5">42 U.S.C. 1320b–5(g)(1)(B)</external-xref>)</quote> and inserting <quote>on or after the first day of the emergency period described in section 1135(g)(1)(B) of such Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1320b-5">42 U.S.C. 1320b–5(g)(1)(B)</external-xref>)</quote>.</text></subsection></section><section id="HD29E8DA9AFF647639F33ECFF8B093CD1"><enum>3.</enum><header>Nonapplication of originating site requirements with respect to telehealth services under Medicare program</header><text display-inline="no-display-inline">Section 1834(m)(4)(C) of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1395m">42 U.S.C. 1395m(m)(4)(C)</external-xref>) is amended—</text><paragraph id="H7146770C428C4895A85969000FC9202A"><enum>(1)</enum><text>in clause (i), by inserting before <quote>paragraphs (5), (6), and (7)</quote> the following: <quote>clause (iii) and</quote>; and</text></paragraph><paragraph id="HEAA824BC9EEC46FEA1B2E24878087E3A"><enum>(2)</enum><text>by adding at the end the following new clause:</text><quoted-block style="OLC" id="H57BAD28DFF6D407A877B107762D886D5" display-inline="no-display-inline"><clause id="H73231F6201C0415895A5CDF32A490BFB"><enum>(iii)</enum><header>Nonapplication of originating site requirements</header><text display-inline="yes-display-inline">Beginning on the first day of the emergency period described in section 1135(g)(1)(B), the term <term>originating site</term> means any site at which the eligible telehealth individual is located at the time the service is furnished via a telecommunications system.</text></clause><after-quoted-block>.</after-quoted-block></quoted-block></paragraph></section><section id="H8D96C849779E4C469257C5E0B55A6D88"><enum>4.</enum><header>Report by Comptroller General</header><text display-inline="no-display-inline">Not later than 5 years after the date of the enactment of this Act, the Comptroller General of the United States shall submit to Congress a report on the successes and limitations of implementing the statutory provisions amended by sections 2 and 3, including—</text><paragraph id="HC8A6A5E53D5146FAA9EC7FD61A1EB299"><enum>(1)</enum><text>details of any savings or costs to the Federal Government that are attributable to the implementation of such provisions; and</text></paragraph><paragraph id="HC750E6CE4C5F4AFCAE34E24A859D2785"><enum>(2)</enum><text>an analysis of how the implementation of such provisions have impacted rural hospitals.</text></paragraph></section></legis-body></bill> 

