,,ib  ,union ,cal5d> ,no4 #cee  #aae?   
,,congress  #a/ ,session  ,h4 ,r4 #cgbg 
,report ,no4 #aae-dhj1 ,"p ,i  ,,9 ,,!  
,,h\se ,,( ,,repres5tatives  ,septemb]  
#aa1 #bjag ,mrs4 ,black 7= h]self1 ,mr4 
,?ompson ( ,cali=nia1 ,mrs4 ,brooks (   
,indiana1 & ,ms4 ,matsui7 introduc$ !   
foll[+ bill2 :i* 0 ref]r$ to !          
,committee on ,ways & ,means1 & 9       
addition to ! ,committee on ,en]gy &    
,comm]ce1 = a p]iod to be subsequ5tly   
det]m9$ by ! ,speak]1 9 ea* case =      
consid]ation ( su* provisions z fall )9 
! jurisdiction ( ! committee conc]n$    
,decemb] #ba1 #bjag ,additional         
sponsors3 ,mr4 ,curbelo ( ,florida1 ,mr4
 ,co/ello ( ,p5nsylvania1 & ,mr4 ,khanna
  ,decemb] #ba1 #bjag ,report$ f !      
,committee on ,ways & ,means ) an       
am5dm5t ,/rike out all aft] ! enact+    
clause & ins]t ! "p pr9t$ 9 italic      
,decemb] #ba1 #bjag ,! ,committee on    
,en]gy & ,comm]ce dis*>g$2 committ$ to !
 ,committee ( ! ,:ole ,h\se on ! ,/ate (
 ! ,union & ord]$ to be pr9t$ ,= text ( 

introduc$ bill1 see copy ( bill z       
introduc$ on ,septemb] #aa1 #bjag  ,a   
,,bill  ,to am5d title ,,xviii ( !      
,social ,security ,act to include       
additional teleheal? s]vices = purposes 
( ,,ma organization bids1 & = o!r       
purposes4  #a4 ,%ort title ,?is ,act may
 be cit$ z ! ,increas+ ,teleheal?       
,access 9 ,m$ic>e ,act or ! ,,itam ,act4
  #b4 ,inclusion ( additional teleheal? 
s]vices 9 ,m$ic>e ,advantage            
organization bids  7a7 ,9 g5]al ,section
 #aheb ( ! ,social ,security ,act 7#db  
,u4,s4,c4 #aciew-#bb7 is am5d$--  7#a7 9
 subsection 7a77#a77;,b77i71 by add+ at 
! end ! foll[+ new s5t5ce3 ,= plan ye>  
#bjbj & ea* subsequ5t plan ye>1 =       
purposes ( subsection 7m7 & section     
#ahed1 9 ! case t an ,,ma plan makes an 
election describ$ 9 subsection 7m77#a7 )
 respect to su* plan ye>1 additional    
teleheal? s]vices %all be treat$ z a    
b5efit "u ! orig9al m$ic>e fee-=-s]vice 
program option ) respect to su* plan &  
plan ye>42 &  7#b7 by add+ at ! end !   

foll[+ new subsection3  7m7 ,provision (
 additional teleheal? s]vices  7#a7 ,,ma
 plan option ,= purposes ( subsection   
7a77#a77;,b77i71 an election describ$ 9 
?is p>agraph1 ) respect to an ,,ma plan 
& plan ye>1 is an election by ! sponsor 
( su* plan to provide "u ! plan = su*   
plan ye>1 9 accordance ) ! subsequ5t    
provisions ( ?is subsection1 additional 
teleheal? s]vices 7z def9$ 9 p>agraph   
7#b77 z a b5efit "u ! orig9al m$ic>e    
fee-=-s]vice program option4 ,su*       
additional teleheal? s]vices1 ) respect 
to a plan ye>1 %all be 9 addition to    
b5efits includ$ "u ! orig9al m$ic>e     
fee-=-s]vice program option = su* ye>4  
7#b7 ,additional teleheal? s]vices def9$
  7,a7 ,9 g5]al ,= purposes ( ?is       
subsection & section #ahed1 ! t]m       
additional teleheal? s]vices means1     
subject to subp>agraph 7,c71 s]vices1 ) 
respect to a ye>-- 7i7 = :i* paym5t may 
be made "u "p ,b 7)\t reg>d to          
application ( section #ahcd7m772  7ii7  
t1 if furni%$ via a telecommunications  

sy/em1 w\ld n be payable "u section     
#ahcd7m72  7iii7 furni%$ us+ electronic 
in=mation & telecommunications          
te*nology2  7iv7 furni%$ 9 accordance ) 
su* requirem5ts z ! ,secret>y specifies 
pursuant to p>agraph 7#c72 &  7v7 :i*   
are id5tifi$ = su* ye> by ! ,secret>y z 
appropriate to furni% us+ electronic    
in=mation & telecommunications te*nology
 :]e a physician 7z def9$ 9 section     
#ahfa7r77 or practition] 7describ$ 9    
section #ahdb7;b77#ah77;,c77 furni%+ !  
s]vice is n at ! same location z ! plan 
enrollee4  7,b7 ,flexibility = phas+ 9  
id5tifications ,9 mak+ id5tifications "u
 subp>agraph 7,a77v71 ! ,secret>y %all  
make su* id5tifications annually & may  
make su* id5tifications 9 a mann] t     
results 9 additional teleheal? s]vices  
be+ phas$ 91 z det]m9$ appropriate by ! 
,secret>y4  7,c7 ,exclusion ( capital & 
infra/ructure co/s & inve/m5ts ,=       
purposes ( ?is subsection & section     
#ahed1 ! t]m additional teleheal?       
s]vices does n include capital &        

infra/ructure co/s & inve/m5ts relat+ to
 su* b5efits provid$ pursuant to ?is    
subsection4  7#c7 ,requirem5ts =        
additional teleheal? s]vices ,!         
,secret>y %all specify requirem5ts = !  
provision ( additional teleheal? s]vices
 ) respect to--  7,a7 qualifications    
7o!r ?an lic5sure7 ( physicians &       
practition]s :o furni% su* s]vices2     
7,b7 ! te*nology us$ 9 furni%+ su*      
s]vices2  7,c7 factors necess>y =       
coord9ation ( additional teleheal?      
s]vices ) o!r s]vices2 &  7,d7 su* o!r  
crit]ia 7su* z cl9ical crit]ia7 z       
det]m9$ by ! ,secret>y4  7#d7 ,enrollee 
*oice ,an ,,ma plan t provides a s]vice 
z an additional teleheal? s]vice may n1 
:5 furni%$ )\t use ( electronic         
in=mation & telecommunications          
te*nology1 d5y access to ! equival5t    
9-p]son s]vice4  7#e7 ,con/ruction  7,a7
 ,9 g5]al ,9 det]m9+ if an ,,ma         
organization or ,,ma plan1 z applicable1
 is 9 compliance ) ea* requirem5t       
specifi$ 9 subp>agraph 7,b71 su*        

det]m9ation %all be made )\t reg>d to   
any additional teleheal? s]vices cov]$  
by ! plan (f]$ by su* organization or   
plan pursuant to ?is subsection4  7,b7  
,requirem5ts specifi$ ,! requirem5ts    
specifi$ 9 ?is subp>agraph are ! foll[+3
 7i7 ,! requirem5ts "u subsection 7d74  
7ii7 ,! requirem5t "u subsection 7a77#a7
 ) respect to cov]+ b5efits "u ! orig9al
 m$ic>e fee-=-s]vice program option1 z  
def9$ 9 ! fir/ s5t5ce ( p>agraph 7,b77i7
 ( su* subsection4  4  7b7 ,inclusion ( 
additional teleheal? s]vices 9 ,,ma     
organization bid am\nt ,section         
#ahed7;a77#f77;,a77ii77,i7 ( ! ,social  
,security ,act 7#db ,u4,s4,c4           
#aciew-#bd7;a77#f77;,a77ii77,i77 is     
am5d$ by ins]t+ 1 includ+1 = plan ye>   
#bjbj & subsequ5t plan ye>s1 ! provision
 ( su* b5efits ?r\gh ! use ( additional 
teleheal? s]vices "u section #aheb7m7   
be=e ! semicolon at ! end4  #c4 ,use (  
telecommunications sy/ems 9 furni%+     
*ronic c>e managem5t s]vices ,section   
#ahdh7;b77#h7 ( ! ,social ,security ,act

 7#db ,u4,s4,c4 #acie7;b77#h77 is am5d$ 
by add+ at ! end ! foll[+ new           
subp>agraph3  7,c7 ,cl>ification ,9     
c>ry+ out ?is p>agraph1 ) respect to    
*ronic c>e managem5t s]vices1 !         
,secret>y may1 subject to subp>agraph   
7,b71 make paym5t = su* s]vices furni%$ 
?r\gh ! use ( secure messag+1 ,int]net1 
/ore & =w>d te*nologies1 or o!r         
non-face-to-face communication me?ods   
det]m9$ appropriate by ! ,secret>y4  4  
#d4 ,s5se ( ,congress reg>d+ p>ity (    
teleheal? s]vices ,x is ! s5se (        
,congress t !re %\ld be-- 7#a7 p>ity1 ) 
respect to access to teleheal?1 betwe5 !
 orig9al m$ic>e fee-=-s]vice program "u 
p>ts ,a & ,b ( title ,,xviii ( ! ,social
 ,security ,act & ! ,m$ic>e ,advantage  
program "u "p ,c ( su* title2 &  7#b7   
access to m$ically appropriate1 quality 
teleheal? = all ,m$ic>e b5efici>ies4    
#e4 ,deposit ( sav+s into ,m$ic>e       
,improvem5t ,fund ,section #ahih7;b77#a7
 ( ! ,social ,security ,act 7#db        
,u4,s4,c4 #acie;iii7b77#a77 is am5d$ by 

/rik+ dur+ & aft] fiscal ye> #bjba1     
#bgj1jjj1jjj & ins]t+ dur+ & aft] fiscal
 ye> #bjba1 #cbe1jjj1jjj4  ,decemb] #ba1
 #bjag ,report$ f ! ,committee on ,ways 
& ,means ) an amendment,december #ba1   
#bjag,! ,committee on ,en]gy & ,comm]ce 
dis*>g$2 committ$ to ! ,committee ( !   
,:ole ,h\se on ! ,/ate ( ! ,union &     
ord]$ to be pr9t$