,,ii  #aad? ,,congress  #a/ ,session    
,s4 #aggh  ,,9 ,,! ,,s5ate ,,( ,,!      
,,unit$ ,,/ates  ,july #ae1 #bjae ,ms4  
,hirono 7= h]self & ,mrs4 ,ern/7        
introduc$ ! foll[+ bill2 :i* 0 read     
twice & ref]r$ to ! ,committee on       
,f9ance  ,a ,,bill  ,to am5d title      
,,xviii ( ! ,social ,security ,act to   
p]mit c]ta9 ,m$ic>e provid]s lic5s$ 9 a 
,/ate to provide telem$ic9e s]vices to  
c]ta9 ,m$ic>e b5efici>ies 9 a diff]5t   
,/ate4  #a4 ,%ort title  ,?is ,act may  
be cit$ z ! ,t,e,l,emedicine =          
,m,e,dicare ,act ( #bjae or !           
,,tele-,,m$ ,act ( #bjae4  #b4 ,p]mitt+ 
c]ta9 ,m$ic>e provid]s lic5s$ 9 a ,/ate 
to provide telem$ic9e s]vices to c]ta9  
,m$ic>e b5efici>ies 9 a diff]5t ,/ate   
,title ,,xviii ( ! ,social ,security    
,act 7#db ,u4,s4,c4 #acie et seq47 is   
am5d$ by add+ at ! end ! foll[+ new     
section3  #ahii;,c4 ,p]mitt+ c]ta9      
,m$ic>e provid]s lic5s$ 9 a ,/ate to    
provide telem$ic9e s]vices to c]ta9     
,m$ic>e b5efici>ies 9 a diff]5t ,/ate   

7a7 ,9 g5]al ,9 ! case ( a ,m$ic>e      
p>ticipat+ physician or practition] :o  
is lic5s$ or o!rwise legally au?oriz$ to
 provide a heal? c>e s]vice 9 a ,/ate1  
su* physician or practition] may provide
 su* a s]vice z a telem$ic9e s]vice to a
 ,m$ic>e b5efici>y :o is 9 a diff]5t    
,/ate1 & any requirem5t t su* physician 
or practition] obta9 a comp>able lic5se 
or o!r comp>able legal au?orization f   
su* diff]5t ,/ate ) respect to !        
provision ( su* heal? c>e s]vice by su* 
physician or practition] to su*         
b5efici>y %all n apply4  7b7 ,en=cem5t  
,) respect to ! provision ( a s]vice    
pursuant to ?is section1 ! lic5s+ or    
au?oriz+ ,/ate has jurisdiction to en=ce
 ! lic5sure or o!r legal au?orization   
requirem5ts ( su* prim>y ,/ate1 includ+ 
?r\gh discipl9>y actions us$ by su*     
,/ate z ( ! day be=e ! date ( ! enactm5t
 ( ?is section4  7c7 ,process ,to       
e/abli% telem$ic9e s]vice def9ition ,n  
lat] ?an #ab mon?s aft] ! date ( !      
enactm5t ( ?is section1 ! ,secret>y %all

 issue guidance to ! ,/ates = develop+ a
 def9ition ( ! t]m telem$ic9e s]vices = 
purposes ( apply+ ?is section4 ,=       
purposes ( issu+ su* guidance1 !        
,secret>y %all solicit input f relevant 
/akehold]s1 includ+ pati5ts1 heal? c>e  
provid]s1 ,/ate gov]nm5t (ficials1 heal?
 te*nology develop]s1 insur]s1 employ]s1
 lic5s+ bo>ds1 community heal?          
organizations1 & o!r ,f$]al ag5cies4    
7d7 ,report ,n lat] ?an #ab mon?s aft] !
 date ( ! enactm5t ( ?is section1 !     
,secret>y %all submit to ,congress a    
report on ! plans to develop & exp& !   
use ( curr5t & em]g+ ,int]net &         
communications te*nologies to exp&      
access ( ,m$ic>e b5efici>ies to heal?   
programs4  7e7 ,def9itions ,= purposes (
 ?is section3 7#a7 ,m$ic>e b5efici>y ,! 
t]m ,m$ic>e b5efici>y means an          
individual entitl$ to b5efits "u "p ,a  
or enroll$ "u "p ,b4  7#b7 ,qualify+    
physician or practition] ,! t]m ,m$ic>e 
p>ticipat+ physician or practition]     
means ! foll[+3 7,a7 ,a physician 7z    

def9$ 9 section #ahfa7r77 :o is a       
p>ticipat+ physician or suppli] 7z def9$
 9 section #ahdb7;h77#a774  7,b7 ,a     
practition] 7z def9$ 9 section          
#ahdb7;b77#ah77;,c77 :o is a p>ticipat+ 
physician or suppli] 7z def9$ 9 section 
#ahdb7;h77#a774  7f7 ,con/ruction relat+
 to ,controll$ ,sub/ances ,act ,no?+ 9  
?is section may be con/ru$ to remove1   
limit1 or o!rwise affect any obligation 
( a cov]$ heal? c>e pr(essional "u !    
,controll$ ,sub/ances ,act 7#ba         
,u4,s4,c4 #hja et seq474  7g7 ,no effect
 on ,/ate malpractice laws or           
jurisdiction ,to he> civil claims ,no?+ 
9 ?is section may be con/ru$ to-- 7#a7  
replace or sup]s$e any ,/ate law reg>d+ 
neglig5ce or m$ical malpractice2 or     
7#b7 dive/ any c\rt ( its jurisdiction  
to he> civil claims aris+ f a           
physician's provision ( telem$ic9e      
s]vices4  4