[House Report 119-322]
[From the U.S. Government Publishing Office]
119th Congress } { Report
HOUSE OF REPRESENTATIVES
1st Session } { 119-322
=======================================================================
TO AMEND THE PUBLIC HEALTH SERVICE ACT TO REAUTHORIZE THE TELEHEALTH
NETWORK AND TELEHEALTH RESOURCE CENTERS GRANT PROGRAMS
----------------
October 3, 2025.--Committed to the Committee of the Whole House on the
State of the Union and ordered to be printed
----------------
Mr. Guthrie, from the Committee on Energy and Commerce,
submitted the following
R E P O R T
[To accompany H.R. 3419]
The Committee on Energy and Commerce, to whom was referred
the bill (H.R. 3419) to amend the Public Health Service Act to
reauthorize the telehealth network and telehealth resource
centers grant programs, having considered the same, reports
favorably thereon without amendment and recommends that the
bill do pass.
CONTENTS
Page
Purpose and Summary.............................................. 2
Background and Need for Legislation.............................. 2
Committee Action................................................. 2
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
Purpose and Summary
H.R. 3419 would reauthorize the telehealth network and
telehealth resource centers grant programs at the Health
Resources and Services Administration (HRSA) through Fiscal
Year 2030.
Background and Need for Legislation
Telehealth, or the use of electronic and telecommunication
technology to utilize clinical health care services, has become
a vital resource for many patients seeking health care services
by helping them overcome various physical, geographical, and
logistical barriers to accessing health care in the United
States.\1\ In 2021, 37 percent of adults utilized
telehealth.\2\ Telehealth services have been an effective and
efficient mode to deliver health care services in hard-to-reach
areas.\3\
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\1\Health Resources and Serv. Admin. (HRSA), What is Telehealth?
(Mar. 2022), https://www.hrsa.gov/telehealth/what-is-telehealth; see
also HRSA, Telehealth Research Recap: Economic Impact (Sept. 30, 2024),
https://telehealth.hhs.gov/documents/
ResearchRecapTelehealth_and_Economic_Impact_09-30-24.pdf.
\2\Ctrs. for Disease Control and Prevention (CDC), National Health
Statistics Data Brief, Telemedicine Use Among Adults: United States,
2021 (Oct. 2022), https://www.cdc.gov/nchs/data/databriefs/db445.pdf.
\3\Gajarawala & Pelkowski, Telehealth Benefits and Barriers, The
Journal for Nurse Practitioners (Oct. 21, 2020), https://
www.npjournal.org/article/S1555-4155(20)30515-8/fulltext.
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According to HRSA, a nonprofit or for-profit entity may be
awarded funding under the Telehealth Network Grant Program
(TNGP) if it demonstrates that it provides health services via
a telehealth network to improve access to health care services
in rural and underserved communities.\4\ Alternatively,
Telehealth Resource Centers (TRCs) provide telehealth technical
assistance both regionally and nationally through various
outreach events, which may take the form of consultations,
trainings, and webinars.\5\
---------------------------------------------------------------------------
\4\HRSA, Report to Congress, Telehealth Network and Telehealth
Resource Centers Grant Programs 2023 (2023), https://www.govinfo.gov/
content/pkg/CMR-HE20_9000-00185926/pdf/CMR-
HE20_9000-
00185926.pdf#::text=This%20is%20the%202023%20report%20to%20Congress%20
on,Public%20Health%20Service%20Act%20%2842%20U.S.C.%20%C2%A7%20254c-
14%29.
\5\Id.
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Reauthorizing the telehealth network and telehealth
resource center grant programs would continue to offer vital
support at the last enacted appropriated level, with the goal
of improving health care outcomes for patients, especially
those in rural and medically underserved areas.
Committee Action
On July 16, 2025, the Subcommittee on Health held a
legislative hearing on H.R. 3419. The title of the hearing was
``Legislative Proposals to Maintain and Improve the Public
Health Workforce, Rural Health, and Over-the-Counter
Medicines.'' The Subcommittee received testimony from:
Dr. Jacqueline Corrigan-Curay, JD, MD,
Acting Director for Center for Drug Evaluation and
Research (CDER), U.S. Food and Drug Administration;
Dr. Candice Chen, MD, MPH, Acting Associate
Administrator for Health Workforce, U.S. Health
Resources and Services Administration; and
Tom Morris, MPA, Associate Administrator for
Rural Health Policy, U.S. Health Resources and Services
Administration.
On September 10, 2025, the Subcommittee on Health met in
open markup session and forwarded H.R. 3419, without amendment,
to the full Committee by a voice vote.
On September 17, 2025, the full Committee on Energy and
Commerce met in open markup session and ordered H.R. 3419,
without amendment, favorably reported to the House by a record
vote of 48 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 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. 3419 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
reauthorize the telehealth network and telehealth resource
centers grant programs through Fiscal Year 2030.
Duplication of Federal Programs
Pursuant to clause 3(c)(5) of rule XIII, no provision of
H.R. 3419 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. 3419:
On July 16, 2025, the Subcommittee on Health
held a legislative hearing on H.R. 3419. The title of
the hearing was ``Legislative Proposals to Maintain and
Improve the Public Health Workforce, Rural Health, and
Over-the-Counter Medicines.'' The Subcommittee received
testimony from:
Dr. Jacqueline Corrigan-Curay,
JD, MD, Acting Director for Center for Drug
Evaluation and Research (CDER), U.S. Food and
Drug Administration;
Dr. Candice Chen, MD, MPH,
Acting Associate Administrator for Health
Workforce, U.S. Health Resources and Services
Administration; and
Tom Morris, MPA, Associate
Administrator for Rural Health Policy, U.S.
Health Resources and Services Administration.
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. 2493 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. Reauthorization of telehealth network and telehealth
resource centers grant programs
Section 1 reauthorizes the telehealth network and
telehealth resource centers grant programs through Fiscal Year
2030.
Changes in Existing Law Made by the Bill, as Reported
In compliance with clause 3(e) of rule XIII of the Rules of
the House of Representatives, changes in existing law made by
the bill, as reported, are shown as follows (existing law
proposed to be omitted is enclosed in black brackets, new
matter is printed in italics, and existing law in which no
change is proposed is shown in roman):
PUBLIC HEALTH SERVICE ACT
* * * * * * *
TITLE III--GENERAL POWERS AND DUTIES OF PUBLIC
HEALTH SERVICE
* * * * * * *
Part D--Primary Health Care
Subpart I--Health Centers
* * * * * * *
SEC. 330I. TELEHEALTH NETWORK AND TELEHEALTH RESOURCE CENTERS GRANT
PROGRAMS.
(a) Definitions.--In this section:
(1) Director; office.--The terms ``Director'' and
``Office'' mean the Director and Office specified in
subsection (c).
(2) Federally qualified health center and rural
health clinic.--The term ``Federally qualified health
center'' and ``rural health clinic'' have the meanings
given the terms in section 1861(aa) of the Social
Security Act (42 U.S.C. 1395x(aa)).
(3) Frontier community.--The term ``frontier
community'' shall have the meaning given the term in
regulations issued under subsection (r).
(4) Medically underserved area.--The term ``medically
underserved area'' has the meaning given the term
``medically underserved community'' in section 799B(6).
(5) Medically underserved population.--The term
``medically underserved population'' has the meaning
given the term in section 330(b)(3).
(6) Telehealth services.--The term ``telehealth
services'' means services provided through telehealth
technologies.
(7) Telehealth technologies.--The term ``telehealth
technologies'' means technologies relating to the use
of electronic information, and telecommunications
technologies, to support and promote, at a distance,
health care, patient and professional health-related
education, health administration, and public health.
(b) Programs.--The Secretary shall establish, under section
301, telehealth network and telehealth resource centers grant
programs.
(c) Administration.--
(1) Establishment.--There is established in the
Health Resources and Services Administration an Office
for the Advancement of Telehealth. The Office shall be
headed by a Director.
(2) Duties.--The telehealth network and telehealth
resource centers grant programs established under
section 301 shall be administered by the Director, in
consultation with the State offices of rural health,
State offices concerning primary care, or other
appropriate State government entities.
(d) Grants.--
(1) Telehealth network grants.--The Director may, in
carrying out the telehealth network grant program
referred to in subsection (b), award grants to eligible
entities for evidence-based projects that utilize
telehealth technologies through telehealth networks in
rural areas, frontier communities, and medically
underserved areas, and for medically underserved
populations, to--
(A) expand access to, coordinate, and improve
access to, and the quality of, health care
services; and
(B) expand and improve the quality of health
information available to health care
providers,, patients, and their families.
(2) Telehealth resource centers grants.--The Director
may, in carrying out the telehealth resource centers
grant program referred to in subsection (b), award
grants to eligible entities for projects to support
initiatives that utilize telehealth technologies in the
areas and communities, and for the populations,
described in paragraph (1).
(e) Grant Periods.--The Director may award grants under this
section for periods of not more than 5 years.
(f) Eligible Entities.--
(1) In general.--To be eligible to receive a grant
under subsection (d)(1), an entity shall demonstrate
that the entity will provide services through a
telehealth network.
(2) Nature of entities.--Each entity participating in
the telehealth network may be a nonprofit or for-profit
entity
(3) Composition of network.--The telehealth network
shall include at least 2 of the following entities (at
least 1 of which shall be a community-based health care
provider):
(A) Community or migrant health centers or
other Federally qualified health centers.
(B) Health care providers, including
pharmacists, in private practice.
(C) Entities operating clinics, including
rural health clinics.
(D) Local health departments.
(E) Nonprofit hospitals, including community
access hospitals.
(F) Other publicly funded health or social
service agencies.
(G) Long-term care providers.
(H) Providers of health care services in the
home.
(I) Providers of outpatient mental health and
substance disorder services and entities
operating outpatient mental health and
substance disorder facilities.
(J) Local or regional emergency health care
providers.
(K) Institutions of higher education.
(L) Entities operating dental clinics.
(M) Providers of prenatal, labor care,
birthing, and postpartum care services,
including hospitals that operate obstetric care
units.
(g) Applications.--To be eligible to receive a grant under
subsection (d), an eligible entity, in consultation with the
appropriate State office of rural health or another appropriate
State entity, shall prepare and submit to the Secretary an
application, at such time, in such manner, and containing such
information as the Secretary may require, including--
(1) a description of the project that the eligible
entity will carry out using the funds provided under
the grant;
(2) a description of the manner in which the project
funded under the grant will meet the health care needs
of rural or other populations to be served through the
project, and improve the access to services of, and the
quality of the services received by, those populations;
(3) evidence of local support for the project, and a
description of how the areas, communities, or
populations to be served will be involved in the
development and ongoing operations of the project;
(4) a plan for sustaining the project after Federal
support for the project has ended;
(5) information on the source and amount of non-
Federal funds that the entity will provide for the
project;
(6) information demonstrating the long-term viability
of the project, and other evidence of institutional
commitment of the entity to the project;
(7) in the case of an application for a project
involving a telehealth network, information
demonstrating how the project will promote the
integration of telehealth technologies into the
operations of health care providers, to avoid
redundancy, and improve access to and the quality of
care; and
(8) other such information as the Secretary
determines to be appropriate.
(h) Preferences.--
(1) Telehealth networks.--In awarding grants under
subsection (d)(1) for projects involving telehealth
networks, the Secretary shall give preference to an
eligible entity that meets at least 1 of the following
requirements:
(A) Organization.--The eligible entity is a
rural community-based organization or another
community-based organization.
(B) Services.--The eligible entity proposes
to use Federal funds made available through
such a grant to develop plans for, or to
establish, telehealth networks that provide
mental health care, public health services,
long-term care, home care, preventive care,
case management services, prenatal care, labor
care, birthing care, or postpartum care.
(C) Coordination.--The eligible entity
demonstrates how the project to be carried out
under the grant will be coordinated with other
relevant federally funded projects in the
areas, communities, and populations to be
served through the grant.
(D) Network.--The eligible entity
demonstrates that the project involves a
telehealth network that includes an entity
that--
(i) provides clinical health care
services, or educational services for
health care providers and for patients
or their families; and
(ii) is--
(I) a public library;
(II) an institution of higher
education; or
(III) a local government
entity.
(E) Connectivity.--The eligible entity
proposes a project that promotes local and
regional connectivity within areas,
communities, or populations to be served
through the project.
(2) Telehealth resource centers.--In awarding grants
under subsection (d)(2) for projects involving
telehealth resource centers, the Secretary shall give
preference to an eligible entity that meets at least 1
of the following requirements:
(A) Provision of services.--The eligible
entity has a record of success in the provision
of telehealth services to rural areas,
medically underserved areas, or medically
underserved populations.
(B) Collaboration and sharing of expertise.--
The eligible entity has a demonstrated record
of collaborating and sharing expertise with
providers of telehealth services at the
national, regional, State, and local levels.
(C) Broad range of telehealth services.--The
eligible entity has a record of providing a
broad range of telehealth services, which may
include--
(i) a variety of clinical specialty
services;
(ii) patient or family education;
(iii) health care professional
education; and
(iv) rural residency support
programs.
(i) Distribution of Funds.--
(1) In general.--In awarding grants under this
section, the Director shall ensure, to the greatest
extent possible, that such grants are equitably
distributed among the geographical regions of the
United States.
(2) Telehealth networks.--In awarding grants under
subsection (d)(1) for a fiscal year, the Director shall
ensure that not less than 50 percent of the funds
awarded shall be awarded for projects in rural areas.
(j) Use of Funds.--
(1) Telehealth network program.--The recipient of a
grant under subsection (d)(1) may use funds received
through such grant for salaries, equipment, and
operating or other costs, including the cost of--
(A) developing and delivering clinical
telehealth services that enhance access to
community-based health care services in rural
areas, frontier communities, or medically
underserved areas, or for medically underserved
populations;
(B) developing and acquiring, through lease
or purchase, equipment that furthers the
objectives of the telehealth network grant
program;
(C)(i) developing and providing distance
education, in a manner that enhances access to
care in rural areas, frontier communities, or
medically underserved areas, or for medically
underserved populations; or
(ii) mentoring, precepting, or supervising
health care providers and students seeking to
become health care providers, in a manner that
enhances access to care in the areas and
communities, or for the populations, described
in clause (i);
(D) developing and acquiring instructional
programming;
(E)(i) providing for transmission of medical
data, and maintenance of equipment; and
(ii) providing for compensation (including
travel expenses) of specialists, and referring
health care providers, who are providing
telehealth services through the telehealth
network, if no third party payment is available
for the telehealth services delivered through
the telehealth network;
(F) developing projects to use telehealth
technology to facilitate collaboration between
health care providers;
(G) collecting and analyzing usage statistics
and data to document the cost-effectiveness of
the telehealth services; and
(H) carrying out such other activities as are
consistent with achieving the objectives of
this section, as determined by the Secretary.
(2) Telehealth resource centers.--The recipient of a
grant under subsection (d)(2) may use funds received
through such grant for salaries, equipment, and
operating or other costs for--
(A) providing technical assistance, training,
and support, and providing for travel expenses,
for health care providers and a range of health
care entities that provide or will provide
telehealth services;
(B) disseminating information and research
findings related to telehealth services;
(C) promoting effective collaboration among
telehealth resource centers and the Office;
(D) conducting evaluations to determine the
best utilization of telehealth technologies to
meet health care needs;
(E) promoting the integration of the
technologies used in clinical information
systems with other telehealth technologies;
(F) fostering the use of telehealth
technologies to provide health care information
and education for consumers in a more effective
manner; and
(G) implementing special projects or studies
under the direction of the Office.
(k) Prohibited Uses of Funds.--An entity that receives a
grant under this section may not use funds made available
through the grant--
(1) to acquire real property;
(2) for expenditures to purchase or lease equipment,
to the extent that the expenditures would exceed 20
percent of the total grant funds;
(3) in the case of a project involving a telehealth
network, to purchase or install transmission equipment;
(4) to pay for any equipment or transmission costs
not directly related to the purposes for which the
grant is awarded;
(5) to purchase or install general purpose voice
telephone systems;
(6) for construction; or
(7) for expenditures for indirect costs (as
determined by the Secretary), to the extent that the
expenditures would exceed 15 percent of the total grant
funds.
(l) Collaboration.--In providing services under this section,
an eligible entity shall collaborate, if feasible, with
entities that--
(1)(A) are private or public organizations, that
receive Federal or State assistance; or
(B) are public or private entities that operate
centers, or carry out programs, that receive Federal or
State assistance; and
(2) provide telehealth services or related
activities.
(m) Coordination With Other Agencies.--The Secretary shall
coordinate activities carried out under grant programs
described in subsection (b), to the extent practicable, with
Federal and State agencies and nonprofit organizations that are
operating similar programs, to maximize the effect of public
dollars in funding meritorious proposals.
(n) Outreach Activities.--The Secretary shall establish and
implement procedures to carry out outreach activities to advise
potential end users of telehealth services in rural areas,
frontier communities, medically underserved areas, and
medically underserved populations in each State about the grant
programs described in subsection (b).
(o) Telehealth.--It is the sense of Congress that, for
purposes of this section, States should develop reciprocity
agreements so that a provider of services under this section
who is a licensed or otherwise authorized health care provider
under the law of 1 or more States, and who, through telehealth
technology, consults with a licensed or otherwise authorized
health care provider in another State, is exempt, with respect
to such consultation, from any State law of the other State
that prohibits such consultation on the basis that the first
health care provider is not a licensed or authorized health
care provider under the law of that State.
(p) Report.--Not later than 4 years after the date of
enactment of the Coronavirus Aid, Relief, and Economic Security
Act, and every 5 years thereafter, the Secretary shall prepare
and submit to the Committee on Health, Education, Labor, and
Pensions of the Senate and the Committee on Energy and Commerce
of the House of Representatives a report on the activities and
outcomes of the grant programs under subsection (b).
(q) Authorization of Appropriations.--There are authorized to
be appropriated to carry out this [section] section--
(1) $29,000,000 for each of fiscal years 2021 through
2025[.]; and
(2) $42,050,000 for each of fiscal years 2026 through
2030.
* * * * * * *
[all]