,i  #aag? ,,congress  #a/ ,session  ,h4 
,r4 #fbjb  ,,9 ,,! ,,h\se ,,(           
,,repres5tatives  ,decemb] #i1 #bjba,mr4
 ,doggett 7= himself1 ,mr4 ,nunes1 ,mr4 
,?ompson ( ,cali=nia1 ,mr4 ,kelly (     
,p5nsylvania1 ,mr4 ,s*weik]t1 ,mrs4     
,axne1 ,mr4 ,blum5au]1 ,mr4 ,br5dan ,f4 
,boyle ( ,p5nsylvania1 ,mr4 ,butt]field1
 ,mr4 ,c>son1 ,ms4 ,craig1 ,mr4 ,danny  
,k4 ,davis ( ,ill9ois1 ,mr4             
,fitzpatrick1 ,mrs4 ,flet*]1 ,mr4       
,higg9s ( ,new ,york1 ,mr4 ,kildee1 ,mr4
 ,la,hood1 ,mrs4 ,lesko1 ,mrs4 ,mill] ( 
,we/ ,virg9ia1 ,mr4 ,o',hall]an1 ,mr4   
,rask91 ,mr4 ,rice ( ,s\? ,c>ol9a1 ,ms4 
,s*ak[sky1 ,ms4 ,sewell1 ,mr4 ,smi? (   
,nebraska1 ,mr4 ,smuck]1 ,mr4 ,veasey1  
,mrs4 ,walorski1 ,ms4 ,wild1 ,mr4 ,gre5 
( ,texas1 & ,mr4 ,bu*anan7 introduc$ !  
foll[+ bill2 :i* 0 ref]r$ to !          
,committee on ,en]gy & ,comm]ce1 & 9    
addition to ! ,committee on ,ways &     
,means1 = 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$  ,a
 ,,bill  ,to am5d titles ,,xi & ,,xviii 
( ! ,social ,security ,act to e/abli%   
requirem5ts = ! provision ( c]ta9       
high-co/ durable m$ical equipm5t &      
laboratory te/+2 to ext5d & exp& access 
to teleheal? s]vices2 & = o!r purposes4 
#a4 ,%ort title ,?is ,act may be cit$ z 
! ,teleheal? ,ext5sion ,act ( #bjba4    
#b4 ,requirem5t = provision ( high-co/  
durable m$ical equipm5t & laboratory    
te/s  7a7 ,high-,co/ durable m$ical     
equipm5t ,section #ahcd7;a77#a77;,e7 ( !
 ,social ,security ,act 7#db ,u4,s4,c4  
#aciem7a77#a77;,e77 is am5d$ by add+ at 
! end ! foll[+ new clause3  7vi7 ,/&>ds 
= high-co/ durable m$ical equipm5t  7,i7
 ,limitation on paym5t = high-co/       
durable m$ical equipm5t ,paym5t may n be
 made "u ?is subsection = a high-co/    
durable m$ical equipm5t ord]$ by a      
physician or o!r practition] describ$ 9 
clause 7ii7 via teleheal? = an          
individual1 unless su* physician or     
practition] furni%$ to su* individual a 

s]vice 9-p]son at lea/ once dur+ !      
#f-mon? p]iod prior to ord]+ su*        
high-co/ durable m$ical equipm5t4       
7,,ii7 ,high-,co/ durable m$ical        
equipm5t det]m9ation ,= purposes ( ?is  
clause1 ! ,adm9i/rator ( ! ,c5t]s =     
,m$ic>e  ,m$icaid ,s]vices %all def9e ! 
t]m high-co/ durable m$ical equipm5t &  
specify ! durable m$ical equipm5t = :i* 
su* def9ition %all apply4  7vii7 ,audit 
( provid]s & practition]s furni%+ a high
 volume ( durable m$ical equipm5t via   
teleheal?  7,i7 ,id5tification (        
provid]s ,beg9n+ #f mon?s aft] !        
effective date ( ?is clause1 ,m$ic>e    
adm9i/rative contractors %all conduct   
reviews on a s*$ule det]m9$ by !        
,secret>y1 ( claims = durable m$ical    
equipm5t prescrib$ by a physician or o!r
 practition] describ$ 9 clause 7ii7 dur+
 ! #ab-mon? p]iod prec$+ su* review to  
id5tify physicians or o!r practition]s )
 respect to :om at lea/ #ij p]c5t ( all 
durable m$ical equipm5t prescrib$ by su*
 physician or practition] dur+ su* p]iod

 0 prescrib$ pursuant to a teleheal?    
visit4  7,,ii7 ,audit ,9 ! case ( a     
physician or practition] id5tifi$ "u    
subclause 7,i71 ) respect to a p]iod    
describ$ 9 su* subclause1 ! ,m$ic>e     
adm9i/rative contractors %all conduct   
audits ( all claims = durable m$ical    
equipm5t prescrib$ by su* physicians or 
practition]s to det]m9e :e!r su* claims 
comply ) ! requirem5ts = cov]age "u ?is 
title4  4  7b7 ,high-,co/ laboratory    
te/s ,section #ahcd;,a7b7 ( ! ,social   
,security ,act 7#db ,u4,s4,c4           
#aciem-#a7;b77 is am5d$ by add+ at ! end
 ! foll[+ new p>agraph3  7#f7           
,requirem5t = high-co/ laboratory te/s  
7,a7 ,limitation on paym5t = high-co/   
laboratory te/s ,paym5t may n be made "u
 ?is subsection = a high-co/ laboratory 
te/ ord]$ by a physician or practition] 
via teleheal? = an individual1 unless   
su* physician or practition] furni%$ to 
su* individual a s]vice 9-p]son at lea/ 
once dur+ ! #f-mon? p]iod prior to ord]+
 su* high-co/ laboratory te/4  7,b7     

,high-co/ laboratory te/ def9$ ,=       
purposes ( ?is p>agraph1 ! ,adm9i/rator 
= ! ,c5t]s = ,m$ic>e  ,m$icaid ,s]vices 
%all def9e ! t]m high-co/ laboratory te/
 & specify :i* laboratory te/s su*      
def9ition %all apply to4  7#g7 ,audit ( 
laboratory te/+ ord]$ pursuant to       
teleheal? visit  7,a7 ,id5tification (  
provid]s ,beg9n+ #f mon?s aft] !        
effective date ( ?is p>agraph1 ,m$ic>e  
adm9i/rative contractors %all conduct   
p]iodic reviews on a s*$ule det]m9$ by !
 ,secret>y1 ( claims = laboratory te/s  
prescrib$ by a physician or practition] 
dur+ ! #ab-mon? p]iod prec$+ su* review 
to id5tify physicians or o!r            
practition]s ) respect to :om at lea/   
#ij p]c5t ( all laboratory te/s         
prescrib$ by su* physician or           
practition] dur+ su* p]iod 0 prescrib$  
pursuant to a teleheal? visit4  7,b7    
,audit ,9 ! case ( a physician or       
practition] id5tifi$ "u subp>agraph     
7,a71 ) respect to a p]iod describ$ 9   
su* subp>agraph1 ! ,m$ic>e adm9i/rative 

contractors %all conduct audits ( all   
claims = laboratory te/s prescrib$ by   
su* physicians or practition]s dur+ su* 
p]iod beg9n+ to det]m9e :e!r su* claims 
comply ) ! requirem5ts = cov]age "u ?is 
title4  4  7c7 ,effective date ,!       
am5dm5ts made by ?is section %all take  
effect ^u ! t]m9ation ( ! em]g5cy p]iod 
describ$ 9 section #aace7;g77#a77;,b7 ( 
! ,social ,security ,act 7#db ,u4,s4,c4 
#acbj;b-#e7;g77#a77;,b774  #c4          
,requirem5t to submit ,,npi numb] =     
sep>ately billable teleheal? s]vices    
7a7 ,requirem5t ,to submit ,,npi numb] =
 sep>ately billable teleheal? s]vices   
,section #ahcd7m7 ( ! ,social ,security 
,act 7#db ,u4,s4,c4 #aciem7m77 is am5d$ 
by add+ at ! end ! foll[+ new p>agraph3 
7#i7 ,requirem5t to submit ,,npi numb] =
 sep>ately billable teleheal? s]vices   
,paym5t may n be made "u ?is subsection 
= sep>ately billable teleheal? s]vices  
furni%$ by a physician or practition]   
unless su* physician or practition]     
submits a claim = paym5t "u ! national  

provid] id5tification numb] assign$ to  
su* physician or practition]4  4  7b7   
,effective date ,! am5dm5t made by ?is  
section %all take effect ^u ! t]m9ation 
( ! em]g5cy p]iod describ$ 9 section    
#aace7;g77#a77;,b7 ( ! ,social ,security
 ,act 7#db ,u4,s4,c4                    
#acbj;b-#e7;g77#a77;,b774  #d4 ,remov+  
geographic requirem5ts = teleheal?      
s]vices ,section #ahcd7m77#d77;,c7 ( !  
,social ,security ,act 7#db ,u4,s4,c4   
#aciem7m77#d77;,c77 is am5d$ by add+ at 
! end ! foll[+ new clause3  7iii7       
,removal ( geographic requirem5ts ,!    
geographic requirem5ts describ$ 9 clause
 7i7 %all n apply ) respect to teleheal?
 s]vices furni%$ on or aft] ! date ( !  
enactm5t ( ?is clause4  4  #e4 ,exp&+   
orig9at+ sites  7a7 ,exp&+ ! home z an  
orig9at+ site ,section                  
#ahcd7m77#d77;,c77ii77,x7 ( ! ,social   
,security ,act 7#db ,u4,s4,c4           
#aciem7m77#d77;,c77ii77,x77 is am5d$ to 
read z foll[s3  7,x7 ,! home ( an       
individual1 b1 ) respect to s]vices     

furni%$ be=e ! date ( ! enactm5t ( !    
,teleheal? ,ext5sion & ,evaluation ,act1
 only = purposes ( section              
#ahha7;b77#c77;,b7 or teleheal? s]vices 
describ$ 9 p>agraph 7#g74  4  7b7 ,all[+
 additional orig9at+ sites ,section     
#ahcd7m77#d77;,c77ii7 ( ! ,social       
,security ,act 7#db ,u4,s4,c4           
#aciem7m77#d77;,c77ii77 is am5d$ by add+
 at ! end ! foll[+ new subclause3       
7,,xii7 ,any o!r site det]m9$           
appropriate by ! ,secret>y at :i* an    
eligible teleheal? individual is locat$ 
at ! "t a teleheal? s]vice is furni%$   
via a telecommunications sy/em4  4  7c7 
,p>amet]s = new orig9at+ sites ,section 
#ahcd7m77#d77;,c7 ( ! ,social ,security 
,act 7#db ,u4,s4,c4 #aciem7m77#d77;,c771
 z am5d$ by section #d1 is am5d$ by add+
 at ! end ! foll[+ new clause3  7iv7    
,requirem5ts = new sites  7,i7 ,9 g5]al 
,! ,secret>y may e/abli% requirem5ts = !
 furni%+ ( teleheal? s]vices at sites   
describ$ 9 clause 7ii77,,xii7 to provide
 = b5efici>y & program integrity        

protections4  7,,ii7 ,cl>ification ,no?+
 9 ?is clause %all be con/ru$ to        
preclude ! ,secret>y f e/abli%+         
requirem5ts = o!r orig9at+ sites        
describ$ 9 clause 7ii74  4  7d7 ,no     
orig9at+ site facility fee = new sites  
,section #ahcd7m77#b77;,b77ii7 ( !      
,social ,security ,act 7#db ,u4,s4,c4   
#aciem7m77#b77;,b77ii77 is am5d$-- 7#a7 
9 ! head+1 by /rik+ if orig9at+ site is 
! home & ins]t+ = c]ta9 sites2 &  7#b7  
by /rik+ p>agraph 7#d77;,c77ii77,x7 &   
ins]t+ subclause 7,x7 or 7,,xii7 (      
p>agraph 7#d77;,c74  #f4 ,f$]ally       
qualifi$ heal? c5t]s & rural heal?      
cl9ics ,section #ahcd7m7 ( ! ,social    
,security ,act 7#db ,u4,s4,c4 #aciem7m77
 is am5d$-- 7#a7 9 p>agraph             
7#d77;,c77i71 9 ! matt] prec$+ subclause
 7,i71 by /rik+ 7#e71 7#f71 & 7#g7 &    
ins]t+ 7#e7 ?r\gh 7#h72 &  7#b7 9       
p>agraph 7#h7-- 7,a7 9 ! p>agraph head+ 
by ins]t+ & aft] aft] dur+2  7,b7 9     
subp>agraph 7,a7-- 7i7 9 ! matt] prec$+ 
clause 7i71 by ins]t+ & aft] su* em]g5cy

 p]iod aft] #aace7;g77#a77;,b72  7ii7 9 
clause 7ii71 by /rik+ & at ! end2  7iii7
 by r$esignat+ clause 7iii7 z clause    
7iv72 &  7iv7 by ins]t+ aft] clause 7ii7
 ! foll[+ new clause3  7iii7 !          
geographic requirem5ts describ$ 9       
p>agraph 7#d77;,c77i7 %all n apply )    
respect to su* a teleheal? s]vice2 &  2 
&  7,c7 by /rik+ subp>agraph 7,b7 &     
ins]t+ ! foll[+3  7,b7 ,paym5t  7i7 ,9  
g5]al ,a teleheal? s]vice furni%$ by a  
,f$]ally qualifi$ heal? c5t] or a rural 
heal? cl9ic to an individual pursuant to
 ?is p>agraph on or aft] ! date ( !     
enactm5t ( ?is subp>agraph %all be deem$
 to be s furni%$ to su* individual z an 
outpati5t ( su* cl9ic or facility 7z    
applicable7 = purposes ( p>agraph 7#a7  
or 7#c71 respectively1 ( section        
#ahfa7;aa7 & payable z a ,f$]ally       
qualifi$ heal? c5t] s]vice or rural     
heal? cl9ic s]vice 7z applicable7 "u !  
prospective paym5t sy/em e/abli%$ "u    
section #ahcd7o7 or "u section          
#ahcc7;a77#c71 respectively4  7ii7      

,treatm5t ( co/s = ,,fqhc ,,pps         
calculations & ,,rhc ,,air calculations 
,co/s associat$ ) ! deliv]y ( teleheal? 
s]vices by a ,f$]ally qualifi$ heal?    
c5t] or rural heal? cl9ic s]v+ z a      
di/ant site pursuant to ?is p>agraph    
%all be consid]$ all[able co/s =        
purposes ( ! prospective paym5t sy/em   
e/abli%$ "u section #ahcd7o7 & any      
paym5t me?odologies develop$ "u section 
#ahcc7;a77#c71 z applicable4  4  #g4    
,native ,am]ican heal? facilities  7a7  
,9 g5]al ,section #ahcd7m77#d77;,c7 ( ! 
,social ,security ,act 7#db ,u4,s4,c4   
#aciem7m77#d77;,c771 z am5d$ by sections
 #d & #e7;c71 is am5d$-- 7#a7 9 clause  
7i71 by /rik+ clause 7ii7 & ins]t+      
clauses 7ii7 & 7v72 &  7#b7 by add+ at !
 end ! foll[+ new clause3  7v7 ,native  
,am]ican heal? facilities ,) respect to 
teleheal? s]vices furni%$ on or aft]    
,janu>y #a1 #bjbb1 ! orig9at+ site      
requirem5ts describ$ 9 clauses 7i7 &    
7ii7 %all n apply ) respect to a        
facility ( ! ,indian ,heal? ,s]vice1    

:e!r op]at$ by su* ,s]vice1 or by an    
,indian tribe 7z t t]m is def9$ 9       
section #d ( ! ,indian ,heal? ,c>e      
,improvem5t ,act 7#be ,u4,s4,c4 #afjc77 
or a tribal organization 7z t t]m is    
def9$ 9 section #d ( ! ,indian          
,self-,det]m9ation & ,education         
,assi/ance ,act 7#be ,u4,s4,c4 #ecjd771 
or a facility ( ! ,native ,hawaiian     
heal? c>e sy/ems au?oriz$ "u ! ,native  
,hawaiian ,heal? ,c>e ,improvem5t ,act  
7#db ,u4,s4,c4 #aagja et seq474  4  7b7 
,no orig9at+ site facility fee = ,c]ta9 
,native ,am]ican facilities ,section    
#ahcd7m77#b77;,b77i7 ( ! ,social        
,security ,act 7#db ,u4,s4,c4           
#aciem7m77#b77;,b77i77 is am5d$1 9 !    
matt] prec$+ subclause 7,i71 by ins]t+  
7o!r ?an an orig9at+ site t is only     
describ$ 9 clause 7v7 ( p>agraph        
7#d77;,c71 & does n meet ! requirem5t = 
an orig9at+ site "u clauses 7i7 & 7ii7 (
 su* p>agraph7 aft] ! orig9at+ site4    
#h4 ,waiv] ( teleheal? requirem5ts dur+ 
public heal? em]g5cies ,section         

#aace7;g77#a7 ( ! ,social ,security ,act
 7#db ,u4,s4,c4 #acbj;b-#e7;g77#a77 is  
am5d$-- 7#a7 9 subp>agraph 7,a71 9 !    
matt] prec$+ clause 7i71 by /rik+       
subp>agraph 7,b7 & ins]t+ subp>agraphs  
7,b7 & 7,c72 &  7#b7 by add+ at ! end ! 
foll[+ new subp>agraph3  7,c7 ,exception
 = waiv] ( teleheal? requirem5ts dur+   
public heal? em]g5cies ,= purposes (    
subsection 7b77#h71 9 addition to !     
em]g5cy p]iod describ$ 9 subp>agraph    
7,b71 an em]g5cy area is a geographical 
area 9 :i*1 & an em]g5cy p]iod is !     
p]iod dur+ :i*1 !re exi/s a public heal?
 em]g5cy decl>$ by ! ,secret>y pursuant 
to section #cai ( ! ,public ,heal?      
,s]vice ,act4  4  #i4 ,two-ye> ext5sion 
( teleheal? s]vices foll[+ ! ,,covid-#ai
 em]g5cy p]iod ,section #aace7;e7 ( !   
,social ,security ,act 7#db ,u4,s4,c4   
#acbj;b-#e7;e77 is am5d$ by add+ at !   
end ! foll[+ new p>agraph3  7#c7        
,two-ye> ext5sion ( teleheal? s]vices   
foll[+ ! ,,covid-#ai em]g5cy p]iod      
,not)/&+ any o!r provision ( ?is        

section1 a waiv] or modification (      
requirem5ts pursuant to subsection      
7b77#h7 %all t]m9ate on ! date t is two 
ye>s aft] ! la/ day ( ! em]g5cy p]iod   
describ$ 9 subsection 7g77#a77;,b74  4  
#aj4 ,outpati5t critical access         
hospitals  7a7 ,9 g5]al ,not)/&+ section
 #ahcd7m7 ( ! ,social ,security ,act    
7#db ,u4,s4,c4 #aciem7m77 & subject to  
subsection 7b71 ! ,secret>y ( ,heal? &  
,human ,s]vices %all provide paym5t "u  
section #ahcd7;g7 ( su* ,act 7#db       
,u4,s4,c4 #aciem7g77 = outpati5t        
critical access hospital s]vices consi/+
 ( behavioral !rapy s]vices furni%$ by a
 critical access hospital to an         
individual dur+ ! p]iod beg9n+ on       
,janu>y #a1 #bjba1 & end+ on ! date t is
 two ye>s aft] ! la/ day ( ! em]g5cy    
p]iod describ$ 9 section                
#aace7;g77#a77;,b7 ( ! ,social ,security
 ,act 7#db ,u4,s4,c4                    
#acbj;b-#e7;g77#a77;,b771 via           
telecommunications te*nology1 not)/&+ ! 
fact t su* individual is n locat$ at su*

 hospital4  7b7 ,initiation ( s]vices   
via teleheal? ,9 ! case ( an individual 
receiv+ s]vices describ$ 9 subsection   
7a7 f a critical access hospital dur+ ! 
p]iod describ$ 9 subsection 7a71 if su* 
individual has n1 prior to receiv+ su*  
s]vices1 receiv$ 9-p]son c>e at su*     
hospital1 paym5t %all be made to su*    
hospital 9 accordance ) su* subsection  
only if su* s]vices complem5t a plan (  
c>e t includes 9-p]son c>e to be furni%$
 at su* hospital n lat] ?an #a ye> aft] 
! date su* s]vices are furni%$4  7c7    
,def9itions ,= purposes ( ?is section3  
7#a7 ,critical access hospital ,! t]m   
8critical access hospital0 has ! mean+  
giv5 su* t]m 9 section #ahfa7mm77#a7 ( !
 ,social ,security ,act 7#db ,u4,s4,c4  
#aciex7mm77#a774  7#b7 ,outpati5t       
critical access hospital s]vices ,! t]m 
8outpati5t critical access hospital     
s]vices0 has ! mean+ giv5 su* t]m 9     
section #ahfa7mm77#c7 ( su* ,act 7#db   
,u4,s4,c4 #aciex7mm77#c774  7#c7        
,telecommunications te*nology ,! t]m    

8telecommunications te*nology0 means a  
communications sy/em p]mitt+ two-way1   
real-"t int]active communication betwe5 
! individuals & heal? c>e pr(essional & 
includes a communications sy/em consi/+ 
( only audio capabilities1 b only if su*
 individual does n h access to a        
communications sy/em ) audio-visual     
capabilities4