H.R. 4040 Text - Introduced in House - 117th Congress (2021-2022)

To amend title XVIII of the Social Security Act to extend telehealth flexibilities under the Medicare program, 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.

This Act may be cited as the “Advancing Telehealth Beyond COVID–19 Act of 2021”.

SEC. 2. Extending Medicare telehealth flexibilities.

(a) Expanding access to telehealth services.—

(1) IN GENERAL.—Section 1834(m)(4)(C) of the Social Security Act (42 U.S.C. 1395m(m)(4)(C)) is amended by adding at the end the following new clause:

“(iii) EXPANDING ACCESS TO TELEHEALTH SERVICES.—With respect to telehealth services furnished beginning on the first day after the end of the emergency period described in section 1135(g)(1)(B), the term ‘originating site’ means any site at which the eligible telehealth individual is located at the time the service is furnished via a telecommunications system, including the home of an individual.”.

(2) CONFORMING AMENDMENTS.—Such section is amended—

(A) in paragraph (2)(B)—

(i) in clause (i), in the matter preceding subclause (I), by striking “clause (ii)” and inserting “clauses (ii) and (iii)”; and

(ii) by adding at the end the following new clause:

“(iii) NO FACILITY FEE FOR NEW SITES.—With respect to telehealth services furnished on or after the date of enactment of this clause, a facility fee shall only be paid under this subparagraph to an originating site that is described in paragraph (4)(C)(ii) (other than subclause (X) of such paragraph).”.

(B) in paragraph (4)(C)—

(i) in clause (i), in the matter preceding subclause (I), by inserting “and clause (iii)” after “and (7)”; and

(ii) in clause (ii)(X), by inserting “prior to the first day after the end of the emergency period described in section 1135(g)(1)(B)” before the period;

(C) in paragraph (5), by inserting “and prior to the first day after the end of the emergency period described in section 1135(g)(1)(B)” after “January 1, 2019,”;

(D) in paragraph (6)(A), by inserting “and prior to the first day after the end of the emergency period described in section 1135(g)(1)(B),” after “January 1, 2019,”; and

(E) in paragraph (7), by inserting “and prior to the first day after the end of the emergency period described in section 1135(g)(1)(B),” after “July 1, 2019,”.

(b) Expanding practitioners eligible To furnish telehealth services.—Section 1834(m) of the Social Security Act (42 U.S.C. 1395m(m)) is amended—

(1) in paragraph (1), by striking “(described in section 1842(b)(18)(C))” and inserting “(defined in paragraph (4)(E))”; and

(2) in paragraph (4)(E)—

(A) by striking “practitioner.—The term” and inserting “practitioner.—

“(A) IN GENERAL.—Subject to subparagraph (B), the term”; and

(B) by adding at the end the following new subparagraph:

“(B) EXPANSION.—The Secretary, after consulting with stakeholders regarding services that are clinically appropriate, may expand the types of practitioners who may furnish telehealth services to include any health care professional that is eligible to bill the program under this title for their professional services.”.

(c) Allowing for the furnishing of audio-only telehealth services.—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.—

“(i) IN GENERAL.—The term ‘telecommunications system’ includes, in the case of a specified telehealth service (as defined in clause (ii)) furnished to an individual, a communications system consisting only of audio capabilities.

“(ii) SPECIFIED TELEHEALTH SERVICE DEFINED.—The term ‘specified telehealth service’ means a telehealth service consisting of—

“(I) evaluation and management services;

“(II) mental and behavioral health services;

“(III) substance use disorder services; or

“(IV) any other service specified by the Secretary.

Such term does not include communication of lab results from a physician or practitioner to an individual via a telecommunications system unless such communication involves a diagnosis of such individual based on such results or the prescription, or modification of a prescription, of a drug based on such results.”.

SEC. 3. Making permanent the ability of federally qualified health centers and rural health clinics to furnish telehealth services under the Medicare program.

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” and inserting “Beginning on the first day of”; and

(3) in subparagraph (B)(i), by striking “during such emergency period”.

SEC. 4. 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.”.