,i  #aafth ,,congress  #b;d ,session    
,h4 ,r4 #gahg  ,,in ,,the ,,house ,,of  
,,representatives  ,june #aa1 #bjbj,mr4 
,thompson of ,pennsylvania 7for himself 
and ,mr4 ,butterfield7 introduced the   
following bill2 which was referred to   
the ,committee on ,energy and ,commerce1
 and in addition to the ,committee on   
,ways and ,means1 for a period to be    
subsequently determined by the ,speaker1
 in each case for consideration of such 
provisions as fall within the           
jurisdiction of the committee concerned 
,a ,,bill  ,to amend title ,,xviii of   
the ,social ,security ,act to provide   
for permanent payments for telehealth   
services furnished by ,federally        
qualified health centers and rural      
health clinics under the ,medicare      
program4  #a4 ,short title ,this ,act   
may be cited as the ,helping ,ensure    
,access to ,local ,tele,health ,act of  
#bjbj or the ,,health ,act of #bjbj4    
#b4 ,providing for permanent            
cost-related payments for telehealth    

services furnished by ,federally        
qualified health centers and rural      
health clinics under the ,medicare      
program and permanently removing        
originating site facility and location  
requirements for distant site telehealth
 services furnished by such centers and 
such clinics  7a7 ,permanent telehealth 
payments ,section #ahcd7m77#h7 of the   
,social ,security ,act 7#db ,u4,s4,c4   
#aciem7m77#h77 is amended-- 7#a7 in the 
header1 by striking during emergency    
period2  7#b7 in subparagraph 7,a71 in  
the matter preceding clause 7i71 by     
striking ,during the emergency period   
described in section #aace7;g77#a77;,b7 
and inserting ,with respect to          
telehealth services furnished on or     
after the date of the beginning of the  
emergency period described in section   
#aace7;g77#a77;,b72 and  7#c7 by        
striking subparagraph 7,b7 and inserting
 the following new subparagraph3  7,b7  
,payment  7i7 ,in general ,a telehealth 
service furnished by a rural health     

clinic or a ,federally qualified health 
center serving as a distant site to an  
individual shall be deemed to be so     
furnished to such individual as an      
outpatient of such clinic or facility   
7as applicable7 for purposes of         
paragraph 7#a7 or 7#c71 respectively1 of
 section #ahfa7;aa7 and payable as a    
rural health clinic service or          
,federally qualified health center      
service 7as applicable7 under section   
#ahcc7;a77#c7 or under the prospective  
payment system established under section
 #ahcd7o71 respectively4  7ii7          
,treatment of costs for ,,fqhc ,,pps    
calculations and ,,rhc ,,air            
calculations ,costs associated with the 
delivery of telehealth services by a    
,federally qualified health center or   
rural health clinic serving as a distant
 site pursuant to this paragraph shall  
be considered allowable costs for       
purposes of the prospective payment     
system established under section        
#ahcd7o7 and any payment methodologies  

developed under section #ahcc7;a77#c71  
as applicable4  4  7b7 ,elimination of  
originating site requirements for       
telehealth services furnished by        
,f,q,h,cs or ,r,h,cs  7#a7 ,in general  
,section #ahcd7m7 of the ,social        
,security ,act 7#db ,u4,s4,c4           
#aciem7m771 as amended by subsection    
7a71 is further amended-- 7,a7 in       
paragraph 7#d77;,c77i71 by striking and 
7#g7 and inserting 7#g71 and 7#h72 and  
7,b7 by adding at the end the following 
new subparagraph3  7,c7 ,nonapplication 
of originating site requirements ,the   
geographic and site requirements        
described in paragraph 7#d77;,c7 shall  
not apply with respect to telehealth    
services furnished by a ,federally      
qualified health center or a rural      
health clinic serving as a distant site4
  4  7#b7 ,special payment rule for     
originating sites with respect to       
telehealth services furnished by an     
,,fqhc or ,,rhc ,section                
#ahcd7m77#b77;,b7 of the ,social        

,security ,act 7#db ,u4,s4,c4           
#aciem7m77#b77;,b77 is amended-- 7,a7 in
 clause 7i71 by striking clause 7ii7 and
 inserting clauses 7ii7 and 7iii72 and  
7,b7 by adding at the end the following 
new clause3  7iii7 ,special rule for    
telehealth services furnished by        
,f,q,h,cs and ,r,h,cs ,no facility fee  
shall be paid under this subparagraph to
 an originating site with respect to    
telehealth services furnished by a      
,federally qualified health center or   
rural health clinic serving as a distant
 site unless such originating site is a 
site described in any of subclauses 7,i7
 through 7,,ix7 of paragraph            
7#d77;,c77ii74  4  7c7 ,treatment of    
,,fqhc and ,,rhc telehealth services as 
a visit ,the ,secretary of ,health and  
,human ,services shall revise section   
#dje4bdfc of title #db1 ,code of        
,federal ,regulations 7or a successor   
regulation7 to provide that1 in the case
 of a ,federally qualified health center
 or a rural health clinic serving as a  

distant site furnishing telehealth      
services to an individual in accordance 
with section #ahcd7m7 of the ,social    
,security ,act 7#db ,u4,s4,c4           
#aciem7m771 such services so furnished  
are considered to constitute a visit to 
such center or such clinic 7as          
applicable7 by such individual4