[House Report 118-621]
[From the U.S. Government Publishing Office]


118th Congress    }                                      {      Report
                        HOUSE OF REPRESENTATIVES
 2d Session       }                                      {     118-621

======================================================================



 
         SUPPORTING PATIENT EDUCATION AND KNOWLEDGE ACT OF 2024

                                _______
                                

 July 30, 2024.--Committed to the Committee of the Whole House on the 
              State of the Union and ordered to be printed

                                _______
                                

Mrs. Rodgers of Washington, from the Committee on Energy and Commerce, 
                        submitted the following

                              R E P O R T

                        [To accompany H.R. 6033]

    The Committee on Energy and Commerce, to whom was referred 
the bill (H.R. 6033) to require the Secretary of Health and 
Human Services to establish a task force to improve access to 
health care information technology for non-English speakers, 
having considered the same, reports favorably thereon with an 
amendment and recommends that the bill as amended do pass.

                                CONTENTS

                                                                   Page
Purpose and Summary..............................................     2
Background and Need for Legislation..............................     2
Committee Action.................................................     3
Committee Votes..................................................     3
Oversight Findings and Recommendations...........................     5
New Budget Authority, Entitlement Authority, and Tax Expenditures     5
Congressional Budget Office Estimate.............................     5
Federal Mandates Statement.......................................     5
Statement of General Performance Goals and Objectives............     5
Duplication of Federal Programs..................................     5
Related Committee and Subcommittee Hearings......................     5
Committee Cost Estimate..........................................     6
Earmark, Limited Tax Benefits, and Limited Tariff Benefits.......     6
Advisory Committee Statement.....................................     6
Applicability to Legislative Branch..............................     6
Section-by-Section Analysis of the Legislation...................     6
Changes in Existing Law Made by the Bill, as Reported............     6

    The amendment is as follows:
  Strike all after the enacting clause and insert the 
following:

SECTION 1. SHORT TITLE.

  This Act may be cited as the ``Supporting Patient Education And 
Knowledge Act of 2024'' or the ``SPEAK Act of 2024''.

SEC. 2. GUIDANCE ON FURNISHING SERVICES VIA TELEHEALTH TO INDIVIDUALS 
                    WITH LIMITED ENGLISH PROFICIENCY.

  (a) In General.--Not later than 1 year after the date of the 
enactment of this section, the Secretary of Health and Human Services, 
in consultation with 1 or more entities from each of the categories 
described in paragraphs (1) through (7) of subsection (b), shall issue 
and disseminate, or update and revise as applicable, guidance for the 
entities described in such subsection on the following:
          (1) Best practices on facilitating and integrating use of 
        interpreters during a telemedicine appointment.
          (2) Best practices on providing accessible instructions on 
        how to access telecommunications systems (as such term is used 
        for purposes of section 1834(m) of the Social Security Act (42 
        U.S.C. 1395m(m)) for individuals with limited English 
        proficiency.
          (3) Best practices on improving access to digital patient 
        portals for individuals with limited English proficiency.
          (4) Best practices on integrating the use of video platforms 
        that enable multi-person video calls furnished via a 
        telecommunications system for purposes of providing 
        interpretation during a telemedicine appointment for an 
        individual with limited English proficiency.
          (5) Best practices for providing patient materials, 
        communications, and instructions in multiple languages, 
        including text message appointment reminders and prescription 
        information.
  (b) Entities Described.--For purposes of subsection (a), an entity 
described in this subsection is an entity in 1 or more of the following 
categories:
          (1) Health information technology service providers, 
        including--
                  (A) electronic medical record companies;
                  (B) remote patient monitoring companies; and
                  (C) telehealth or mobile health vendors and 
                companies.
          (2) Health care providers, including--
                  (A) physicians; and
                  (B) hospitals.
          (3) Health insurers.
          (4) Language service companies.
          (5) Interpreter or translator professional associations.
          (6) Health and language services quality certification 
        organizations.
          (7) Patient and consumer advocates, including such advocates 
        that work with individuals with limited English proficiency.

                          PURPOSE AND SUMMARY

    H.R. 6033 requires the Secretary of Health and Human 
Services to, in consultation with stakeholders, to issue and 
disseminate best practices for delivering quality care via 
telehealth to beneficiaries with limited English language 
proficiency.

                  BACKGROUND AND NEED FOR LEGISLATION

    Congress greatly expanded Medicare's coverage of telehealth 
during the COVID-19 Public Health Emergency (PHE). As many as 1 
in 4 beneficiaries utilized telehealth during the PHE.\1\ 
Congress further extended these telehealth expansions in the 
Consolidated Appropriations Act of 2022 beyond the PHE through 
the end of 2024. As Congress considers further extensions of 
telehealth flexibilities, this bill will ensure more 
beneficiaries benefit from quality telehealth access by 
improving the delivery of telehealth services to patients with 
limited English language proficiency.
---------------------------------------------------------------------------
    \1\Koma, Wyatt, Juliette Cubanski, Tricia Neuman, ``Medicare and 
Telehealth: Coverage and Use During the COVID-19 Pandemic and Options 
for the Future'', KFF, 2021, https://www.kff.org/medicare/issue-brief/
medicare-and-telehealth-coverage-and-use-during-the-covid-19-pandemic-
and-options-for-the-future/.
---------------------------------------------------------------------------

                            COMMITTEE ACTION

    On April 10, 2024, the Subcommittee on Health held a 
hearing on H.R. 6033. The title of the hearing was 
``Legislative Proposals to Support Patient Access to Telehealth 
Services.'' The Subcommittee received testimony from:
           Jeanette Ashlock, Patient Advocate, National 
        Multiple Sclerosis Society;
           Fred Riccardi, President, Medicare Rights 
        Center;
           Lee Schwamm, MD, Volunteer, American Health 
        Association; Senior Vice President and Chief Digital 
        Health Officer, Yale New Haven Health System;
           Eve Cunningham, MD, MBA, Group Vice 
        President and Chief of Virtual Care and Digital Health, 
        Providence; and,
           Ateev Mehrotra, MD, MPH, Professor of Health 
        Care Policy and Medicine, Harvard Medical School; 
        Hospitalist, Beth Israel Deaconess Medical Center.
    On May 16, 2024, the Subcommittee on Health met in open 
markup session and forwarded H.R. 6033, as amended, to the full 
Committee by a recorded vote of 23 yeas and 0 nays.
    On June 12, 2024, the full Committee on Energy and Commerce 
met in open markup session and ordered H.R. 6033, without 
amendment, favorably reported to the House by a recorded vote 
of 40 yeas and 0 nays.

                            COMMITTEE VOTES

    Clause 3(b) of rule XIII requires the Committee to list the 
record votes on the motion to report legislation and amendments 
thereto. The following reflects the record votes taken during 
the Committee consideration: 

    [GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT]

                 OVERSIGHT FINDINGS AND RECOMMENDATIONS

    Pursuant to clause 2(b)(1) of rule X and clause 3(c)(1) of 
rule XIII, the Committee has held a hearing and made findings 
that are reflected in this report.

   NEW BUDGET AUTHORITY, ENTITLEMENT AUTHORITY, AND TAX EXPENDITURES

    Pursuant to clause 3(c)(2) of rule XIII, the Committee 
finds that H.R. 6033 would result in no new or increased budget 
authority, entitlement authority, or tax expenditures or 
revenues.

                  CONGRESSIONAL BUDGET OFFICE ESTIMATE

    Pursuant to clause 3(c)(3) of rule XIII, at the time this 
report was filed, the cost estimate prepared by the Director of 
the Congressional Budget Office pursuant to section 402 of the 
Congressional Budget Act of 1974 was not available.

                       FEDERAL MANDATES STATEMENT

    The Committee adopts as its own the estimate of Federal 
mandates prepared by the Director of the Congressional Budget 
Office pursuant to section 423 of the Unfunded Mandates Reform 
Act.

         STATEMENT OF GENERAL PERFORMANCE GOALS AND OBJECTIVES

    Pursuant to clause 3(c)(4) of rule XIII, the general 
performance goal or objective of this legislation is to improve 
Medicare's delivery of telehealth to patients with limited 
English language proficiency.

                    DUPLICATION OF FEDERAL PROGRAMS

    Pursuant to clause 3(c)(5) of rule XIII, no provision of 
H.R. 6033 is known to be duplicative of another Federal 
program, including any program that was included in a report to 
Congress pursuant to section 21 of Public Law 111-139 or the 
most recent Catalog of Federal Domestic Assistance.

              RELATED COMMITTEE AND SUBCOMMITTEE HEARINGS

    Pursuant to clause 3(c)(6) of rule XIII, the following 
related hearing was used to develop or consider H.R. 6033:
           On April 10, 2024, the Subcommittee on 
        Health held a hearing on H.R. 6033. The title of the 
        hearing was ``Legislative Proposals to Support Patient 
        Access to Telehealth Services.'' The Subcommittee 
        received testimony from:
                   Jeanette Ashlock, Patient 
                Advocate, National Multiple Sclerosis Society;
                   Fred Riccardi, President, 
                Medicare Rights Center;
                   Lee Schwamm, MD, Volunteer, 
                American Health Association; Senior Vice 
                President and Chief Digital Health Officer, 
                Yale New Haven Health System;
                   Eve Cunningham, MD, MBA, Group 
                Vice President and Chief of Virtual Care and 
                Digital Health, Providence; and,
                   Ateev Mehrotra, MD, MPH, 
                Professor of Health Care Policy and Medicine, 
                Harvard Medical School; Hospitalist, Beth 
                Israel Deaconess Medical Center.

                        COMMITTEE COST ESTIMATE

    Pursuant to clause 3(d)(1) of rule XIII, the Committee 
adopts as its own the cost estimate prepared by the Director of 
the Congressional Budget Office pursuant to section 402 of the 
Congressional Budget Act of 1974. At the time this report was 
filed, the estimate was not available.

       EARMARK, LIMITED TAX BENEFITS, AND LIMITED TARIFF BENEFITS

    Pursuant to clause 9(e), 9(f), and 9(g) of rule XXI, the 
Committee finds that H.R. 6033 contains no earmarks, limited 
tax benefits, or limited tariff benefits.

                      ADVISORY COMMITTEE STATEMENT

    No advisory committees within the meaning of section 5(b) 
of the Federal Advisory Committee Act were created by this 
legislation.

                  APPLICABILITY TO LEGISLATIVE BRANCH

    The Committee finds that the legislation does not relate to 
the terms and conditions of employment or access to public 
services or accommodations within the meaning of section 
102(b)(3) of the Congressional Accountability Act.

             SECTION-BY-SECTION ANALYSIS OF THE LEGISLATION

Section 1. Short title

    Section 1 provides a short title of ``Supporting Patient 
Education And Knowledge Act of 2024'' or the ``SPEAK Act of 
2024''.

Section 2. Guidance on furnishing services via telehealth to 
        individuals with limited English proficiency

    Section 2 directs the Secretary, in consultation with 
stakeholders, to issue and disseminate, or update and revise as 
applicable, guidance for telehealth providers on the best 
practices improving telehealth accessibility for patients with 
limited English language proficiency.

         CHANGES IN EXISTING LAW MADE BY THE BILL, AS REPORTED

    This legislation does not amend any existing Federal 
statute.

                                  [all]