[Congressional Bills 118th Congress]
[From the U.S. Government Publishing Office]
[H.R. 4189 Introduced in House (IH)]

<DOC>






118th CONGRESS
  1st Session
                                H. R. 4189

  To amend title XVIII of the Social Security Act to expand access to 
              telehealth services, and for other purposes.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                             June 15, 2023

 Mr. Thompson of California (for himself, Ms. Matsui, Mr. Schweikert, 
   and Mr. Johnson of Ohio) 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 expand access to 
              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; TABLE OF CONTENTS.

    (a) Short Title.--This Act may be cited as the ``Creating 
Opportunities Now for Necessary and Effective Care Technologies for 
Health Act of 2023'' or the ``CONNECT for Health Act of 2023''.
    (b) Table of Contents.--The table of contents of this Act is as 
follows:

Sec. 1. Short title; table of contents.
Sec. 2. Findings and sense of Congress.
           TITLE I--REMOVING BARRIERS TO TELEHEALTH COVERAGE

Sec. 101. Removing geographic requirements for telehealth services.
Sec. 102. Expanding originating sites.
Sec. 103. Expanding authority for practitioners eligible to furnish 
                            telehealth services.
Sec. 104. Improvements to the process for adding telehealth services.
Sec. 105. Federally qualified health centers and rural health clinics.
Sec. 106. Native American health facilities.
Sec. 107. Repeal of six-month in-person visit requirement for 
                            telemental health services.
Sec. 108. Waiver of telehealth requirements during public health 
                            emergencies.
Sec. 109. Use of telehealth in recertification for hospice care.
                      TITLE II--PROGRAM INTEGRITY

Sec. 201. Clarification for fraud and abuse laws regarding technologies 
                            provided to beneficiaries.
Sec. 202. Additional resources for telehealth oversight.
Sec. 203. Addressing significant outlier billing patterns for 
                            telehealth services.
TITLE III--BENEFICIARY AND PROVIDER SUPPORTS, QUALITY OF CARE, AND DATA

Sec. 301. Beneficiary engagement on telehealth.
Sec. 302. Provider supports on telehealth.
Sec. 303. Ensuring the inclusion of telehealth in measuring quality of 
                            care.
Sec. 304. Posting of information on telehealth services.

SEC. 2. FINDINGS AND SENSE OF CONGRESS.

    (a) Findings.--Congress finds the following:
            (1) The use of technology in health care and coverage of 
        telehealth services are rapidly evolving.
            (2) Research has found that telehealth services can expand 
        access to care, improve the quality of care, and reduce 
        spending.
            (3) In 2021, 91 percent of patients receiving telehealth 
        services were satisfied with their experiences.
            (4) Health care workforce shortages are a significant 
        problem in many areas and for many types of health care 
        clinicians.
            (5) Telehealth increases access to care in areas with 
        workforce shortages and for individuals who live far away from 
        health care facilities, have limited mobility or 
        transportation, or have other barriers to accessing care.
            (6) The use of health technologies can strengthen the 
        expertise of the health care workforce, including by connecting 
        clinicians to specialty consultations.
            (7) Prior to the COVID-19 pandemic, the utilization of 
        telehealth services in the Medicare program under title XVIII 
        of the Social Security Act (42 U.S.C. 1395 et seq.) was low, 
        accounting for 0.1 percent of Medicare Part B visits in 2019.
            (8) Telehealth now represents a critical component of care 
        delivery. As of February 2023, 15 percent of Medicare fee-for-
        service beneficiaries have had a telehealth service in the past 
        quarter.
            (9) Long-term certainty about coverage of telehealth 
        services under the Medicare program is necessary to fully 
        realize the benefits of telehealth.
    (b) Sense of Congress.--It is the sense of Congress that--
            (1) health care providers can furnish safe, effective, and 
        high-quality health care services through telehealth;
            (2) the Secretary of Health and Human Services should 
        promptly take all necessary measures to ensure that providers 
        and beneficiaries can continue to furnish and utilize, 
        respectively, telehealth services in the Medicare program, 
        including modifying, as appropriate, the definition of 
        ``interactive telecommunications system'' in regulations and 
        program instruction under the Medicare program to ensure that 
        providers can utilize all appropriate means and types of 
        technology, including audio-visual, audio-only, and other types 
        of technologies, to furnish telehealth services; and
            (3) barriers to the use of telehealth should be removed.

           TITLE I--REMOVING BARRIERS TO TELEHEALTH COVERAGE

SEC. 101. REMOVING GEOGRAPHIC REQUIREMENTS FOR TELEHEALTH SERVICES.

    Section 1834(m)(4)(C) of the Social Security Act (42 U.S.C. 
1395m(m)(4)(C)) is amended--
            (1) in clause (i), in the matter preceding subclause (I), 
        by striking ``clause (iii)'' and inserting ``clauses (iii) and 
        (iv)''; and
            (2) by adding at the end the following new clause:
                            ``(iv) Removal of geographic 
                        requirements.--The geographic requirements 
                        described in clause (i) shall not apply with 
                        respect to telehealth services furnished on or 
                        after January 1, 2025.''.

SEC. 102. EXPANDING ORIGINATING SITES.

    (a) Expanding the Home as an Originating Site.--Section 
1834(m)(4)(C)(ii)(X) of the Social Security Act (42 U.S.C. 
1395m(m)(4)(C)(ii)(X)) is amended to read as follows:
                                    ``(X)(aa) Prior to January 1, 2025, 
                                the home of an individual but only for 
                                purposes of section 1881(b)(3)(B) or 
                                telehealth services described in 
                                paragraph (7).
                                    ``(bb) On or after January 1, 2025, 
                                the home of an individual. For purposes 
                                of the preceding sentence, the home of 
                                an individual includes temporary 
                                lodging and, in the case where, for 
                                privacy or other personal reasons, an 
                                individual chooses to travel a short 
                                distance from the home for the 
                                furnishing of a telehealth service, 
                                includes such location, as described in 
                                the final rule entitled `Medicare 
                                Program; CY 2022 Payment Policies Under 
                                the Physician Fee Schedule and Other 
                                Changes to Part B Payment Policies; 
                                Medicare Shared Savings Program 
                                Requirements; Provider Enrollment 
                                Regulation Updates; and Provider and 
                                Supplier Prepayment and Post-Payment 
                                Medical Review Requirements' published 
                                in the Federal Register on November 19, 
                                2021 (86 Fed. Reg. 64996), or a 
                                successor regulation.''.
    (b) Allowing Additional 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:
                                    ``(XII) Any other clinically 
                                appropriate site at which an eligible 
                                telehealth individual is located at the 
                                time a telehealth service is furnished 
                                via a telecommunications system. Not 
                                later than January 1, 2025, the 
                                Secretary shall issue regulations that 
                                establish parameters for the 
                                determination of whether a site is 
                                clinically appropriate for purposes of 
                                the preceding sentence.''.
    (c) Parameters for New Originating Sites.--Section 1834(m)(4)(C) of 
the Social Security Act (42 U.S.C. 1395m(m)(4)(C)), as amended by 
section 101, is amended by adding at the end the following new clause:
                            ``(v) Requirements for new sites.--
                                    ``(I) In general.--The Secretary 
                                may establish requirements for the 
                                furnishing of telehealth services at 
                                sites described in clause (ii)(XII) to 
                                provide for beneficiary and program 
                                integrity protections.
                                    ``(II) Rule of construction.--
                                Nothing in this clause shall be 
                                construed to preclude the Secretary 
                                from establishing requirements for 
                                other originating sites described in 
                                clause (ii)''.
    (d) No Originating Site Facility Fee for New Sites.--Section 
1834(m)(2)(B)(ii) of the Social Security Act (42 U.S.C. 
1395m(m)(2)(B)(ii)) is amended--
            (1) in the heading, by striking ``if originating site is 
        the home'' and inserting ``for certain sites''; and
            (2) by striking ``paragraph (4)(C)(ii)(X)'' and inserting 
        ``subclause (X) or (XII) of paragraph (4)(C)(ii)''.

SEC. 103. EXPANDING AUTHORITY FOR PRACTITIONERS ELIGIBLE TO FURNISH 
              TELEHEALTH SERVICES.

    Section 1834(m)(4)(E) of the Social Security Act (42 U.S.C. 
1395m(m)(4)(E)) is amended--
            (1) by striking ``Practitioner.--The term'' and inserting 
        ``Practitioner.--
                            ``(i) In general.--Subject to clause (ii), 
                        the term''; and
            (2) by adding at the end the following new clause:
                            ``(ii) Expanding practitioners eligible to 
                        furnish telehealth services.--
                                    ``(I) In general.--Notwithstanding 
                                any other provision of this subsection, 
                                in the case of telehealth services 
                                furnished on or after January 1, 2024, 
                                the Secretary may waive any limitation 
                                on the types of practitioners who are 
                                eligible to furnish telehealth services 
                                (other than the requirement that the 
                                practitioner is enrolled under section 
                                1866(j)) if the Secretary determines 
                                that such waiver is clinically 
                                appropriate.
                                    ``(II) Implementation.--In 
                                implementing a waiver under this 
                                clause, the Secretary may establish 
                                parameters, as appropriate, for 
                                telehealth services under such waiver, 
                                including with respect to beneficiary 
                                and program integrity protections.
                                    ``(III) Public comment.--The 
                                Secretary shall establish a process by 
                                which stakeholders may (on at least an 
                                annual basis) provide public comment on 
                                such waiver under this clause.
                                    ``(IV) Periodic review.--The 
                                Secretary shall periodically, but not 
                                more frequently than every 3 years, 
                                reassess the waiver under this clause 
                                to determine whether such waiver 
                                continues to be clinically appropriate. 
                                The Secretary shall terminate any 
                                waiver that the Secretary determines is 
                                no longer clinically appropriate.''.

SEC. 104. IMPROVEMENTS TO THE PROCESS FOR ADDING TELEHEALTH SERVICES.

    (a) Review.--The Secretary shall undertake a review of the process 
established pursuant to section 1834(m)(4)(F)(ii) of the Social 
Security Act (42 U.S.C. 1395m(m)(4)(F)(ii)), and based on the results 
of such review--
            (1) implement revisions to the process so that the criteria 
        to add services prioritizes, as appropriate, improved access to 
        care through clinically appropriate telehealth services; and
            (2) provide clarification on what requests to add 
        telehealth services under such process should include.
    (b) Temporary Coverage of Certain Telehealth Services.--Section 
1834(m)(4)(F) of the Social Security Act (42 U.S.C. 1395m(m)(4)(F)) is 
amended by adding at the end the following new clause:
                            ``(iii) Temporary coverage of certain 
                        telehealth services.--The Secretary may add 
                        services with a reasonable potential likelihood 
                        of clinical benefit and improved access to care 
                        when furnished via a telecommunications system 
                        (as determined by the Secretary) on a temporary 
                        basis to those specified in clause (i) for 
                        authorized payment under paragraph (1).''.

SEC. 105. FEDERALLY QUALIFIED HEALTH CENTERS AND RURAL HEALTH CLINICS.

    Section 1834(m) of the Social Security Act (42 U.S.C. 1395m(m)) is 
amended--
            (1) in paragraph (4)(C)(i), in the matter preceding 
        subclause (I), by striking ``and (7)'' and inserting ``(7), and 
        (8)''; and
            (2) in paragraph (8)--
                    (A) in subparagraph (A)--
                            (i) in the matter preceding clause (i), by 
                        striking ``During'' and all that follows 
                        through ``December 31, 2024--'' and inserting 
                        the following: ``During and after the emergency 
                        period described in section 1135(g)(1)(B)--'';
                            (ii) in clause (ii), by striking ``and'' at 
                        the end;
                            (iii) by redesignating clause (iii) as 
                        clause (iv); and
                            (iv) by inserting after clause (ii) the 
                        following new clause:
                            ``(iii) the geographic requirements 
                        described in paragraph (4)(C)(i) shall not 
                        apply with respect to such a telehealth 
                        service; and''; and
                    (B) by striking subparagraph (B) and inserting the 
                following:
                    ``(B) Payment.--
                            ``(i) In general.--A telehealth service 
                        furnished by a Federally qualified health 
                        center or a rural health clinic to an 
                        individual pursuant to this paragraph on or 
                        after the date of the enactment of this 
                        subparagraph 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 Federally 
                        qualified health center service or rural health 
                        clinic service (as applicable) under the 
                        prospective payment system established under 
                        section 1834(o) or under section 1833(a)(3), 
                        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.''.

SEC. 106. NATIVE AMERICAN HEALTH FACILITIES.

    (a) In General.--Section 1834(m)(4)(C) of the Social Security Act 
(42 U.S.C. 1395m(m)(4)(C)), as amended by sections 101 and 102, is 
amended--
            (1) in clause (i), by striking ``and (iv)'' and inserting 
        ``, (iv), and (vi)''; and
            (2) by adding at the end the following new clause:
                            ``(vi) Native american health facilities.--
                        With respect to telehealth services furnished 
                        on or after January 1, 2024, the originating 
                        site requirements described in clauses (i) and 
                        (ii) shall not apply with respect to a facility 
                        of the Indian Health Service, whether operated 
                        by such Service, or by an Indian tribe (as that 
                        term is defined in section 4 of the Indian 
                        Health Care Improvement Act (25 U.S.C. 1603)) 
                        or a tribal organization (as that term is 
                        defined in section 4 of the Indian Self-
                        Determination and Education Assistance Act (25 
                        U.S.C. 5304)), or a facility of the Native 
                        Hawaiian health care systems authorized under 
                        the Native Hawaiian Health Care Improvement Act 
                        (42 U.S.C. 11701 et seq.).''.
    (b) No Originating Site Facility Fee for Certain Native American 
Facilities.--Section 1834(m)(2)(B)(i) of the Social Security Act (42 
U.S.C. 1395m(m)(2)(B)(i)) is amended, in the matter preceding subclause 
(I), by inserting ``(other than an originating site that is only 
described in clause (v) of paragraph (4)(C), and does not meet the 
requirement for an originating site under clauses (i) and (ii) of such 
paragraph)'' after ``the originating site''.

SEC. 107. REPEAL OF SIX-MONTH IN-PERSON VISIT REQUIREMENT FOR 
              TELEMENTAL HEALTH SERVICES.

    Section 1834(m)(7) of the Social Security Act (42 U.S.C. 
1395m(m)(7)(B)) is amended--
            (1) in subparagraph (A), by striking ``, subject to 
        subparagraph (B),'';
            (2) by striking ``(A) In general.--The geographic'' and 
        inserting ``The geographic''; and
            (3) by striking subparagraph (B).

SEC. 108. WAIVER OF TELEHEALTH REQUIREMENTS DURING PUBLIC HEALTH 
              EMERGENCIES.

    Section 1135(g)(1) of the Social Security Act (42 U.S.C. 1320b-
5(g)(1)) is amended--
            (1) in subparagraph (A), in the matter preceding clause 
        (i), by striking ``subparagraph (B)'' and inserting 
        ``subparagraphs (B) and (C)''; and
            (2) by adding at the end the following new subparagraph:
                    ``(C) Exception for waiver of telehealth 
                requirements during public health emergencies.--For 
                purposes of subsection (b)(8), in addition to the 
                emergency period described in subparagraph (B), an 
                `emergency area' is a geographical area in which, and 
                an `emergency period' is the period during which, there 
                exists a public health emergency declared by the 
                Secretary pursuant to section 319 of the Public Health 
                Service Act.''.

SEC. 109. USE OF TELEHEALTH IN RECERTIFICATION FOR HOSPICE CARE.

    (a) In General.--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 
``during the emergency period'' and all that follows through ``ending 
on December 31, 2024'' and inserting the following: ``during and after 
the emergency period described in section 1135(g)(1)(B)''.
    (b) National Academy of Medicine Report.--The Secretary of Health 
and Human Services shall request the National Academy of Medicine to 
submit a report to Congress, not later than 3 years after the date of 
enactment of this Act, evaluating the impact of section 
1814(a)(7)(D)(i)(II) of the Social Security Act (42 U.S.C. 
1395f(a)(7)(D)(i)(II)), as amended by subsection (a), on--
            (1) the number and percentage of beneficiaries recertified 
        for the Medicare hospice benefit at 180 days and for subsequent 
        benefit periods;
            (2) the appropriateness for hospice care of the patients 
        recertified through the use of telehealth; and
            (3) any other factors determined appropriate by the 
        National Academy of Medicine.

                      TITLE II--PROGRAM INTEGRITY

SEC. 201. CLARIFICATION FOR FRAUD AND ABUSE LAWS REGARDING TECHNOLOGIES 
              PROVIDED TO BENEFICIARIES.

    Section 1128A(i)(6) of the Social Security Act (42 U.S.C. 1320a-
7a(i)(6)) is amended--
            (1) in subparagraph (I), by striking ``; or'' and inserting 
        a semicolon;
            (2) in subparagraph (J), by striking the period at the end 
        and inserting ``; or''; and
            (3) by adding at the end the following new subparagraph:
                    ``(K) the provision of technologies (as defined by 
                the Secretary) on or after the date of the enactment of 
                this subparagraph, by a provider of services or 
                supplier (as such terms are defined for purposes of 
                title XVIII) directly to an individual who is entitled 
                to benefits under part A of title XVIII, enrolled under 
                part B of such title, or both, for the purpose of 
                furnishing telehealth services, remote patient 
                monitoring services, or other services furnished 
                through the use of technology (as defined by the 
                Secretary), if--
                            ``(i) the technologies are not offered as 
                        part of any advertisement or solicitation; and
                            ``(ii) the provision of the technologies 
                        meets any other requirements set forth in 
                        regulations promulgated by the Secretary.''.

SEC. 202. ADDITIONAL RESOURCES FOR TELEHEALTH OVERSIGHT.

    In addition to amounts otherwise available, there are authorized to 
be appropriated to the Inspector General of the Department of Health 
and Human Services for each of fiscal years 2024 through 2028, out of 
any money in the Treasury not otherwise appropriated, $3,000,000, to 
remain available until expended, for purposes of conducting audits, 
investigations, and other oversight and enforcement activities with 
respect to telehealth services, remote patient monitoring services, or 
other services furnished through the use of technology (as defined by 
the Secretary).

SEC. 203. ADDRESSING SIGNIFICANT OUTLIER BILLING PATTERNS FOR 
              TELEHEALTH SERVICES.

    (a) Identification and Notification of Outlier Billers of 
Telehealth.--
            (1) In general.--The Secretary shall, using national 
        provider identifiers on claims for telehealth services 
        furnished to individuals under section 1834(m) of the Social 
        Security Act (42 U.S.C. 1395m(m)), identify physicians and 
        practitioners that demonstrate significant outlier billing 
        patterns (such as coding of telehealth services for 
        inappropriate length of time and inaccurate complexity and 
        inappropriate or duplicate billing) for telehealth services or 
        items or services ordered or prescribed concurrent to a 
        telehealth service over a period of time specified by the 
        Secretary.
            (2) Establishment of thresholds.--For purposes of this 
        subsection, the Secretary shall establish thresholds for 
        outlier billing patterns to identify whether a physician or 
        practitioner is a significant outlier biller for telehealth 
        services or items or services ordered or prescribed concurrent 
        to a telehealth service as compared to other physicians or 
        practitioners within the same specialty and geographic area.
    (b) Notification.--
            (1) In general.--The Secretary shall notify any physician 
        or practitioner identified as a significant outlier biller for 
        telehealth services or items or services ordered or prescribed 
        concurrent to a telehealth service under subsection (a). Each 
        notification under the preceding sentence shall include the 
        following:
                    (A) Information on how the physician or 
                practitioner compares to physicians or practitioners 
                within the same specialty and geographic area with 
                respect to billing for telehealth services or items or 
                services ordered or prescribed concurrent to a 
                telehealth service under the Medicare program under 
                title XVIII of the Social Security Act (42 U.S.C. 1395 
                et seq.).
                    (B) Information on telehealth billing guidelines 
                under the Medicare program.
                    (C) Other information determined appropriate by the 
                Secretary.
            (2) Clarification.--Nothing in this subsection or 
        subsection (a) shall be construed as directing the Centers for 
        Medicare & Medicaid Services to pursue further audits of 
        providers of services and suppliers outside of those permitted 
        or required under titles XI or XVIII of the Social Security 
        Act, or otherwise under applicable Federal law.
    (c) Public Availability of Information.--The Secretary shall make 
aggregate information on outlier billing patterns identified under 
subsection (a) available on the internet website of the Centers for 
Medicare & Medicaid Services. Such information shall be in a form and 
manner determined appropriate by the Secretary and shall not identify 
any specific physician or practitioner.
    (d) Other Activities.--Nothing in this section shall preclude the 
Secretary from conducting activities that provide physicians and 
practitioners with information as to how they compare to other 
physicians and practitioners that are in addition to the activities 
under this section.
    (e) Telehealth Resource Centers Education Activities.--Section 
330I(j)(2) of the Public Health Service Act (42 U.S.C. 254c-14(j)(2)) 
is amended--
            (1) in subparagraph (F), by striking ``and'' at the end;
            (2) in subparagraph (G), by striking the period at the end 
        and inserting ``; and''; and
            (3) by adding at the end the following new subparagraph:
                    ``(H) providing technical assistance and education 
                to physicians and practitioners that the Secretary 
                identifies pursuant to section 203(a) of the CONNECT 
                for Health Act of 2023 as having significant levels of 
                outlier billing patterns with respect to telehealth 
                services or items or services ordered or prescribed 
                concurrent to a telehealth service under the Medicare 
                program under title XVIII of the Social Security Act, 
                including--
                            ``(i) education on practices to ensure 
                        coding of telehealth services for appropriate 
                        length of time and accurate complexity;
                            ``(ii) education on prevention of 
                        inappropriate or duplicate billing; and
                            ``(iii) information on--
                                    ``(I) services specified in 
                                paragraph (4)(F)(i) of section 1834(m) 
                                of the Social Security Act (42 U.S.C. 
                                1395m(m)) for authorized payment under 
                                paragraph (1) of such section; and
                                    ``(II) the process used to update 
                                such services under clauses (ii) and 
                                (iii) (as added by section 104) of 
                                paragraph (4)(F) of such section 
                                1834(m); and
                            ``(iv) referral to the appropriate medicare 
                        administrative contractor for specific 
                        questions that fall outside of the scope of 
                        broad best practices.''.
    (f) Definitions.--In this section:
            (1) Secretary.--The term ``Secretary'' means the Secretary 
        of Health and Human Services.
            (2) Telehealth service.--The term ``telehealth service'' 
        has the meaning given that term in section 1834(m)(4)(F) of the 
        Social Security Act (42 U.S.C. 1395m(m)(4)(F)).
            (3) Physician; practitioner.--The terms ``physician'' and 
        ``practitioner'' have the meaning given those terms for 
        purposes of section 1834(m) of the Social Security Act (42 
        U.S.C. 1395m(m)).

TITLE III--BENEFICIARY AND PROVIDER SUPPORTS, QUALITY OF CARE, AND DATA

SEC. 301. BENEFICIARY ENGAGEMENT ON TELEHEALTH.

    (a) Resources, Guidance, and Training Sessions.--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:
            ``(10) Resources, guidance, and training sessions.--
                    ``(A) In general.--Not later than 6 months after 
                the date of the enactment of this paragraph, the 
                Secretary, in consultation with stakeholders, shall 
                issue resources, guidance, and training sessions for 
                beneficiaries, physicians, practitioners, and health 
                information technology software vendors on best 
                practices for ensuring telehealth services are 
                accessible for--
                            ``(i) individuals with limited English 
                        proficiency, including instructions on how to--
                                    ``(I) access telehealth platforms;
                                    ``(II) utilize interpreter 
                                services; and
                                    ``(III) integrate telehealth and 
                                virtual interpreter services; and
                            ``(ii) individuals with Disabilities, 
                        including instructions on accessibility of the 
                        telecommunications system being used for 
                        telehealth services, engagement with 
                        beneficiaries with disabilities prior to, 
                        during, and after the furnishing of the 
                        telehealth service, and training on captioning 
                        and transcripts.
                    ``(B) Accounting for age and other differences.--
                Resources, guidance, and training sessions issued under 
                this paragraph shall account for age and 
                sociodemographic, geographic, literacy, cultural, 
                cognitive, and linguistic differences in how 
                individuals interact with technology.''.
    (b) Study and Report on Tactics To Improve Beneficiary Engagement 
on Telehealth.--
            (1) Study.--The Secretary of Health and Human Services 
        shall collect and analyze qualitative and quantitative data on 
        strategies that clinicians, payers, and other health care 
        organizations use to improve beneficiary engagement on 
        telehealth services (as defined in section 1834(m)(4)(F) of the 
        Social Security Act (42 U.S.C. 1395m(m)(4)(F))), with an 
        emphasis on underserved communities, such as the use of digital 
        navigators, providing patients with pre-visit information on 
        telehealth, caregiver engagement, and training on 
        telecommunications systems, and the investments necessary for 
        health care professionals to effectively furnish telehealth 
        services, including the costs of necessary technology and of 
        training staff.
            (2) Report.--Not later than 1 year after the date of the 
        enactment of this Act, the Secretary shall submit to Congress 
        and make available on the internet website of the Centers for 
        Medicare & Medicaid Services a report containing the results of 
        the study under paragraph (1), together with recommendations 
        for such legislation and administrative action as the Secretary 
        determines appropriate.
    (c) Funding.--There are authorized to be appropriated such sums as 
necessary to carry out the provisions of, including the amendments made 
by, this section.

SEC. 302. PROVIDER SUPPORTS ON TELEHEALTH.

    (a) Educational Resources and Training Sessions.--Not later than 6 
months after the date of enactment of this Act, the Secretary of Health 
and Human Services shall develop and make available to health care 
professionals educational resources and training sessions on 
requirements relating to the furnishing of telehealth services under 
section 1834(m) of the Social Security Act (42 U.S.C. 1395m(m)) and 
topics including--
            (1) requirements for payment for telehealth services;
            (2) telehealth-specific health care privacy and security 
        training;
            (3) utilizing telehealth services to engage and support 
        underserved, high-risk, and vulnerable patient populations; and
            (4) other topics as determined appropriate by the 
        Secretary.
    (b) Telehealth Resource Centers.--The Secretary shall consider 
including technical assistance, education, and training on telehealth 
services as a required activity for telehealth resource centers under 
section 330I of the Public Health Service Act (42 U.S.C. 254c-14).
    (c) Funding.--There are authorized to be appropriated such sums as 
necessary to carry out this section.

SEC. 303. ENSURING THE INCLUSION OF TELEHEALTH IN MEASURING QUALITY OF 
              CARE.

    Section 1890A of the Social Security Act (42 U.S.C. 1395aaa-1) is 
amended by adding at the end the following new subsection:
    ``(h) Measuring Quality of Telehealth Services.--
            ``(1) In general.--Not later than 180 days after the date 
        of the enactment of this subsection, the Secretary shall review 
        quality measures to ensure inclusion of measures relating to 
        telehealth services, including care, prevention, diagnosis, 
        patient experience, health outcomes, and treatment.
            ``(2) Consultation.--In conducting the review and 
        assessment under paragraph (1), the Secretary shall consult 
        external technical experts in quality measurement, including 
        patient organizations, providers, and experts in telehealth.
            ``(3) Review and assessment.--The review and assessment 
        under this subsection shall--
                    ``(A) include review of existing and under 
                development quality measures to identify measures that 
                are currently inclusive of, and measures that fail to 
                account for, telehealth services; and
                    ``(B) identify gaps in areas of quality measurement 
                that relate to telehealth services, including health 
                outcomes and patient experience of care.
            ``(4) Technical guidance.--The Secretary shall issue 
        technical guidance on--
                    ``(A) how to effectively streamline, implement, and 
                assign accountability for health outcomes for quality 
                measures for telehealth services across health care 
                settings and providers;
                    ``(B) how to stratify measures by care modality and 
                population to identify differences in health outcomes;
                    ``(C) the use of uniform data elements;
                    ``(D) how to identify and catalogue best practices 
                related to the use of quality measurement and quality 
                improvement for telehealth services; and
                    ``(E) other areas determined appropriate by the 
                Secretary.
            ``(5) Report.--Not later than 2 years after the date of the 
        enactment of this subsection, the Secretary shall submit to 
        Congress and post on the internet website of the Centers for 
        Medicare & Medicaid Services a report on the review and 
        assessment conducted under this subsection.''.

SEC. 304. POSTING OF INFORMATION ON TELEHEALTH SERVICES.

    Not later than 180 days after the date of enactment, and quarterly 
thereafter, the Secretary of Health and Human Services shall post on 
the internet website of the Centers for Medicare & Medicaid Services 
information on--
            (1) the furnishing of telehealth services under the 
        Medicare program under title XVIII of the Social Security Act 
        (42 U.S.C. 1395 et seq.), described by patient population, type 
        of service, geography, place of service, and provider type;
            (2) the impact of telehealth services on expenditures and 
        utilization under the Medicare program; and
            (3) other outcomes related to the furnishing of telehealth 
        services under the Medicare program, as determined appropriate 
        by the Secretary.
                                 <all>