[Congressional Bills 117th Congress]
[From the U.S. Government Publishing Office]
[H.R. 4437 Introduced in House (IH)]

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117th CONGRESS
  1st Session
                                H. R. 4437

    To amend title XVIII of the Social Security Act to provide for 
   permanent payments for telehealth services furnished by Federally 
 qualified health centers and rural health clinics under the Medicare 
                                program.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                             July 16, 2021

    Mr. Thompson of Pennsylvania (for himself and Mr. Butterfield) 
 introduced the following bill; which was referred to the Committee on 
   Energy and Commerce, and in addition to the Committee on Ways and 
 Means, 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

_______________________________________________________________________

                                 A BILL


 
    To amend title XVIII of the Social Security Act to provide for 
   permanent payments for telehealth services furnished by Federally 
 qualified health centers and rural health clinics under the Medicare 
                                program.

    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 ``Helping Ensure Access to Local 
TeleHealth Act of 2021'' or the ``HEALTH Act of 2021''.

SEC. 2. PROVIDING FOR PERMANENT COST-RELATED PAYMENTS FOR TELEHEALTH 
              SERVICES FURNISHED BY FEDERALLY QUALIFIED HEALTH CENTERS 
              AND RURAL HEALTH CLINICS UNDER THE MEDICARE PROGRAM AND 
              PERMANENTLY REMOVING ORIGINATING SITE FACILITY AND 
              LOCATION REQUIREMENTS FOR DISTANT SITE TELEHEALTH 
              SERVICES FURNISHED BY SUCH CENTERS AND SUCH CLINICS.

    (a) Coverage of Audio-Only Telehealth Services.--
            (1) In general.--Section 1834(m)(4) of the Social Security 
        Act (42 U.S.C. 1395m(m)(4)) is amended by adding at the end the 
        following new subparagraph:
                    ``(G) Telecommunications system.--Except as 
                provided in paragraph (1), the term `telecommunications 
                system' means a two-way, real-time interactive 
                communications system, whether by audiovisual or audio-
                only communications.''.
            (2) Required implementation steps.--Not later than 60 days 
        after the date of the enactment of this Act, the Secretary of 
        Health and Human Services shall--
                    (A) revise section 410.78(a)(3) of title 42, Code 
                of Federal Regulations (or a successor regulation) to 
                define the term ``interactive telecommunications 
                system'' in accordance with the amendment made by 
                paragraph (1); and
                    (B) revise section 405.2463 of such title (or a 
                successor regulation) to provide that, for purposes of 
                distant site telehealth services furnished by Federally 
                qualified health centers and rural health clinics under 
                section 1834(m)(8) of the Social Security Act (42 
                U.S.C. 1395m(m)(8)), a visit includes any two-way, 
                real-time interactive communication between an 
                individual and the distant site Federally qualified 
                health center provider or rural health clinic, whether 
                by audiovisual or audio-only communication.
    (b) Permanent Telehealth Payments.--Section 1834(m)(8) of the 
Social Security Act (42 U.S.C. 1395m(m)(8)) is amended--
            (1) in the header, by striking ``during emergency period'';
            (2) in subparagraph (A), in the matter preceding clause 
        (i), by striking ``During the emergency period described in 
        section 1135(g)(1)(B)'' and inserting ``With respect to 
        telehealth services furnished on or after the date of the 
        beginning of the emergency period described in section 
        1135(g)(1)(B)''; and
            (3) by striking subparagraph (B) and inserting the 
        following new subparagraph:
                    ``(B) Payment.--
                            ``(i) In general.--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 facility (as 
                        applicable) for purposes of paragraph (1) or 
                        (3), respectively, 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), respectively.
                            ``(ii) Treatment of costs for fqhc pps 
                        calculations and rhc air calculations.--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.''.
    (c) Elimination of Originating Site Requirements for Telehealth 
Services Furnished by FQHCs or RHCs.--
            (1) In general.--Section 1834(m) of the Social Security Act 
        (42 U.S.C. 1395m(m)), as amended by subsection (b), is further 
        amended--
                    (A) in paragraph (4)(C)(i), by striking ``and (7)'' 
                and inserting ``(7), and (8)''; and
                    (B) in paragraph (8), by adding at the end the 
                following new subparagraph:
                    ``(C) Nonapplication of originating site 
                requirements.--The geographic and site requirements 
                described in paragraph (4)(C) shall not apply with 
                respect to telehealth services furnished by a Federally 
                qualified health center or a rural health clinic 
                serving as a distant site.''.
            (2) Special payment rule for originating sites with respect 
        to telehealth services furnished by an fqhc or rhc.--Section 
        1834(m)(2)(B) of the Social Security Act (42 U.S.C. 
        1395m(m)(2)(B)) is amended--
                    (A) in clause (i), by striking ``clause (ii)'' and 
                inserting ``clauses (ii) and (iii)''; and
                    (B) by adding at the end the following new clause:
                            ``(iii) Special rule for telehealth 
                        services furnished by fqhcs and rhcs.--No 
                        facility fee shall be paid under this 
                        subparagraph to an originating site with 
                        respect to telehealth services furnished by a 
                        Federally qualified health center or rural 
                        health clinic serving as a distant site unless 
                        such originating site is a site described in 
                        any of subclauses (I) through (IX) or (XI) of 
                        paragraph (4)(C)(ii).''.
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