,,ii #aahth ,,congress #ast ,session ,s4 #bjaf ,,in ,,the ,,senate ,,of ,,the ,,united ,,states ,june #ae1 #bjbc ,mr4 ,schatz 7for himself1 ,mr4 ,wicker1 ,mr4 ,cardin1 ,mr4 ,thune1 ,mr4 ,warner1 ,mrs4 ,hyde-,smith1 ,mr4 ,king1 ,mrs4 ,capito1 ,mr4 ,merkley1 ,mr4 ,rounds1 ,mr4 ,casey1 ,ms4 ,collins1 ,mr4 ,kelly1 ,mr4 ,scott of ,south ,carolina1 ,ms4 ,warren1 ,mr4 ,lankford1 ,mrs4 ,shaheen1 ,mr4 ,cramer1 ,mrs4 ,gillibrand1 ,mr4 ,tuberville1 ,mr4 ,welch1 ,mr4 ,tillis1 ,ms4 ,duckworth1 ,mrs4 ,fischer1 ,mr4 ,blumenthal1 ,ms4 ,murkowski1 ,ms4 ,rosen1 ,mr4 ,sullivan1 ,mr4 ,van ,hollen1 ,mr4 ,daines1 ,ms4 ,cantwell1 ,ms4 ,lummis1 ,ms4 ,sinema1 ,mr4 ,hoeven1 ,mr4 ,hickenlooper1 ,mr4 ,boozman1 ,mr4 ,tester1 ,mr4 ,vance1 ,mr4 ,whitehouse1 ,mr4 ,cassidy1 ,mr4 ,sanders1 ,mr4 ,graham1 ,mr4 ,bennet1 ,mrs4 ,britt1 ,ms4 ,smith1 ,mr4 ,barrasso1 ,ms4 ,klobuchar1 ,mr4 ,grassley1 ,mr4 ,padilla1 ,mr4 ,moran1 ,mr4 ,kaine1 ,mr4 ,young1 ,mr4 ,warnock1 ,mr4 ,rubio1 ,mr4 ,heinrich1 ,mr4 ,cotton1 ,mr4 ,carper1 ,mr4 ,mullin1 ,mr4 ,booker1 and ,mr4 ,marshall7 introduced the following bill2 which was read twice and referred to the ,committee on ,finance ,a ,,bill ,to amend title ,,xviii of the ,social ,security ,act to expand access to telehealth services1 and for other purposes4 #a4 ,short title2 table of contents 7a7 ,short title ,this ,act may be cited as the ,creating ,opportunities ,now for ,necessary and ,effective ,care ,technologies 7,,connect7 for ,health ,act of #bjbc or the ,,connect for ,health ,act of #bjbc4 7b7 ,table of contents ,the table of contents of this ,act is as follows3 ,sec4 #a4 ,short title2 table of contents4 ,sec4 #b4 ,findings and sense of ,congress4 ,,title ,i--,removing barriers to telehealth coverage ,sec4 #aja4 ,removing geographic requirements for telehealth services4 ,sec4 #ajb4 ,expanding originating sites4 ,sec4 #ajc4 ,expanding authority for practitioners eligible to furnish telehealth services4 ,sec4 #ajd4 ,improvements to the process for adding telehealth services4 ,sec4 #aje4 ,federally qualified health centers and rural health clinics4 ,sec4 #ajf4 ,native ,american health facilities4 ,sec4 #ajg4 ,repeal of six-month in-person visit requirement for telemental health services4 ,sec4 #ajh4 ,waiver of telehealth requirements during public health emergencies4 ,sec4 #aji4 ,use of telehealth in recertification for hospice care4 ,,title ,,ii--,program integrity ,sec4 #bja4 ,clarification for fraud and abuse laws regarding technologies provided to beneficiaries4 ,sec4 #bjb4 ,additional resources for telehealth oversight4 ,sec4 #bjc4 ,addressing significant outlier billing patterns for telehealth services4 ,,title ,,iii--,beneficiary and provider supports1 quality of care1 and data ,sec4 #cja4 ,beneficiary engagement on telehealth4 ,sec4 #cjb4 ,provider supports on telehealth4 ,sec4 #cjc4 ,ensuring the inclusion of telehealth in measuring quality of care4 ,sec4 #cjd4 ,posting of information on telehealth services4 #b4 ,findings and sense of ,congress 7a7 ,findings ,congress finds the following3 7#a7 ,the use of technology in health care and coverage of telehealth services are rapidly evolving4 7#b7 ,research has found that telehealth services can expand access to care1 improve the quality of care1 and reduce spending4 7#c7 ,in #bjba1 #ia percent of patients receiving telehealth services were satisfied with their experiences4 7#d7 ,health care workforce shortages are a significant problem in many areas and for many types of health care clinicians4 7#e7 ,telehealth increases access to care in areas with workforce shortages and for individuals who live far away from health care facilities1 have limited mobility or transportation1 or have other barriers to accessing care4 7#f7 ,the use of health technologies can strengthen the expertise of the health care workforce1 including by connecting clinicians to specialty consultations4 7#g7 ,prior to the ,,covid-#ai pandemic1 the utilization of telehealth services in the ,medicare program under title ,,xviii of the ,social ,security ,act 7#db ,u4,s4,c4 #acie et seq47 was low1 accounting for #j4a percent of ,medicare ,part ,b visits in #bjai4 7#h7 ,telehealth now represents a critical component of care delivery4 ,as of ,february #bjbc1 #ae percent of ,medicare fee-for-service beneficiaries have had a telehealth service in the past quarter4 7#i7 ,long-term certainty about coverage of telehealth services under the ,medicare program is necessary to fully realize the benefits of telehealth4 7b7 ,sense of ,congress ,it is the sense of ,congress that-- 7#a7 health care providers can furnish safe1 effective1 and high-quality health care services through telehealth2 7#b7 the ,secretary of ,health and ,human ,services should promptly take all necessary measures to ensure that providers and beneficiaries can continue to furnish and utilize1 respectively1 telehealth services in the ,medicare program1 including modifying1 as appropriate1 the definition of interactive telecommunications system in regulations and program instruction under the ,medicare program to ensure that providers can utilize all appropriate means and types of technology1 including audio-visual1 audio-only1 and other types of technologies1 to furnish telehealth services2 and 7#c7 barriers to the use of telehealth should be removed4 ,i ,removing barriers to telehealth coverage #aja4 ,removing geographic requirements for telehealth services ,section #ahcd7m77#d77;,c7 of the ,social ,security ,act 7#db ,u4,s4,c4 #aciem7m77#d77;,c77 is amended-- 7#a7 in clause 7i71 in the matter preceding subclause 7,i71 by striking clause 7iii7 and inserting clauses 7iii7 and 7iv72 and 7#b7 by adding at the end the following new clause3 7iv7 ,removal of geographic requirements ,the geographic requirements described in clause 7i7 shall not apply with respect to telehealth services furnished on or after ,january #a1 #bjbe4 4 #ajb4 ,expanding originating sites 7a7 ,expanding the home as an originating site ,section #ahcd7m77#d77;,c77ii77,x7 of the ,social ,security ,act 7#db ,u4,s4,c4 #aciem7m77#d77;,c77ii77,x77 is amended to read as follows3 7,x7 7aa7 ,prior to ,january #a1 #bjbe1 the home of an individual but only for purposes of section #ahha7;b77#c77;,b7 or telehealth services described in paragraph 7#g74 7bb7 ,on or after ,january #a1 #bjbe1 the home of an individual4 ,for purposes of the preceding sentence1 the home of an individual includes temporary lodging and1 in the case where1 for privacy or other personal reasons1 an individual chooses to travel a short distance from the home for the furnishing of a telehealth service1 includes such location1 as described in the final rule entitled ,medicare ,program2 ,,cy #bjbb ,payment ,policies ,under the ,physician ,fee ,schedule and ,other ,changes to ,part ,b ,payment ,policies2 ,medicare ,shared ,savings ,program ,requirements2 ,provider ,enrollment ,regulation ,updates2 and ,provider and ,supplier ,prepayment and ,post-,payment ,medical ,review ,requirements published in the ,federal ,register on ,november #ai1 #bjba 7#hf ,fed4 ,reg4 #fdiif71 or a successor regulation4 4 7b7 ,allowing additional originating sites ,section #ahcd7m77#d77;,c77ii7 of the ,social ,security ,act 7#db ,u4,s4,c4 #aciem7m77#d77;,c77ii77 is amended by adding at the end the following new subclause3 7,,xii7 ,any other clinically appropriate site at which an eligible telehealth individual is located at the time a telehealth service is furnished via a telecommunications system4 ,not later than ,january #a1 #bjbe1 the ,secretary shall issue regulations that establish parameters for the determination of whether a site is clinically appropriate for purposes of the preceding sentence4 4 7c7 ,parameters for new originating sites ,section #ahcd7m77#d77;,c7 of the ,social ,security ,act 7#db ,u4,s4,c4 #aciem7m77#d77;,c771 as amended by section #aja1 is amended by adding at the end the following new clause3 7v7 ,requirements for new sites 7,i7 ,in general ,the ,secretary may establish requirements for the furnishing of telehealth services at sites described in clause 7ii77,,xii7 to provide for beneficiary and program integrity protections4 7,,ii7 ,rule of construction ,nothing in this clause shall be construed to preclude the ,secretary from establishing requirements for other originating sites described in clause 7ii7 4 7d7 ,no originating site facility fee for new sites ,section #ahcd7m77#b77;,b77ii7 of the ,social ,security ,act 7#db ,u4,s4,c4 #aciem7m77#b77;,b77ii77 is amended-- 7#a7 in the heading1 by striking if originating site is the home and inserting for certain sites2 and 7#b7 by striking paragraph 7#d77;,c77ii77,x7 and inserting subclause 7,x7 or 7,,xii7 of paragraph 7#d77;,c77ii74 #ajc4 ,expanding authority for practitioners eligible to furnish telehealth services ,section #ahcd7m77#d77;,e7 of the ,social ,security ,act 7#db ,u4,s4,c4 #aciem7m77#d77;,e77 is amended-- 7#a7 by striking ,practitioner4--,the term and inserting 8,practitioner4-- 7i7 ,in general ,subject to clause 7ii71 the term 2 and 7#b7 by adding at the end the following new clause3 7ii7 ,expanding practitioners eligible to furnish telehealth services 7,i7 ,in general ,notwithstanding any other provision of this subsection1 in the case of telehealth services furnished on or after ,january #a1 #bjbd1 the ,secretary may waive any limitation on the types of practitioners who are eligible to furnish telehealth services 7other than the requirement that the practitioner is enrolled under section #ahff7;j77 if the ,secretary determines that such waiver is clinically appropriate4 7,,ii7 ,implementation ,in implementing a waiver under this clause1 the ,secretary may establish parameters1 as appropriate1 for telehealth services under such waiver1 including with respect to beneficiary and program integrity protections4 7,,iii7 ,public comment ,the ,secretary shall establish a process by which stakeholders may 7on at least an annual basis7 provide public comment on such waiver under this clause4 7,,iv7 ,periodic review ,the ,secretary shall periodically1 but not more frequently than every #c years1 reassess the waiver under this clause to determine whether such waiver continues to be clinically appropriate4 ,the ,secretary shall terminate any waiver that the ,secretary determines is no longer clinically appropriate4 4 #ajd4 ,improvements to the process for adding telehealth services 7a7 ,review ,the ,secretary shall undertake a review of the process established pursuant to section #ahcd7m77#d77;,f77ii7 of the ,social ,security ,act 7#db ,u4,s4,c4 #aciem7m77#d77;,f77ii771 and based on the results of such review-- 7#a7 implement revisions to the process so that the criteria to add services prioritizes1 as appropriate1 improved access to care through clinically appropriate telehealth services2 and 7#b7 provide clarification on what requests to add telehealth services under such process should include4 7b7 ,temporary coverage of certain telehealth services ,section #ahcd7m77#d77;,f7 of the ,social ,security ,act 7#db ,u4,s4,c4 #aciem7m77#d77;,f77 is amended by adding at the end the following new clause3 7iii7 ,temporary coverage of certain telehealth services ,the ,secretary may add services with a reasonable potential likelihood of clinical benefit and improved access to care when furnished via a telecommunications system 7as determined by the ,secretary7 on a temporary basis to those specified in clause 7i7 for authorized payment under paragraph 7#a74 4 #aje4 ,federally qualified health centers and rural health clinics ,section #ahcd7m7 of the ,social ,security ,act 7#db ,u4,s4,c4 #aciem7m77 is amended-- 7#a7 in paragraph 7#d77;,c77i71 in the matter preceding subclause 7,i71 by striking and 7#g7 and inserting 7#g71 and 7#h72 and 7#b7 in paragraph 7#h7-- 7,a7 in subparagraph 7,a7-- 7i7 in the matter preceding clause 7i71 by striking ,during and all that follows through ,december #ca1 #bjbd-- and inserting the following3 ,during and after the emergency period described in section #aace7;g77#a77;,b7--2 7ii7 in clause 7ii71 by striking and at the end2 7iii7 by redesignating clause 7iii7 as clause 7iv72 and 7iv7 by inserting after clause 7ii7 the following new clause3 7iii7 the geographic requirements described in paragraph 7#d77;,c77i7 shall not apply with respect to such a telehealth service2 and 2 and 7,b7 by striking subparagraph 7,b7 and inserting the following3 7,b7 ,payment 7i7 ,in general ,a telehealth service furnished by a ,federally qualified health center or a rural health clinic to an individual pursuant to this paragraph on or after the date of the enactment of this subparagraph 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 ,federally qualified health center service or rural health clinic service 7as applicable7 under the prospective payment system established under section #ahcd7o7 or under section #ahcc7;a77#c71 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 #ajf4 ,native ,american health facilities 7a7 ,in general ,section #ahcd7m77#d77;,c7 of the ,social ,security ,act 7#db ,u4,s4,c4 #aciem7m77#d77;,c771 as amended by sections #aja and #ajb1 is amended-- 7#a7 in clause 7i71 by striking and 7iv7 and inserting 1 7iv71 and 7vi72 and 7#b7 by adding at the end the following new clause3 7vi7 ,native ,american health facilities ,with respect to telehealth services furnished on or after ,january #a1 #bjbd1 the originating site requirements described in clauses 7i7 and 7ii7 shall not apply with respect to a facility of the ,indian ,health ,service1 whether operated by such ,service1 or by an ,indian tribe 7as that term is defined in section #d of the ,indian ,health ,care ,improvement ,act 7#be ,u4,s4,c4 #afjc77 or a tribal organization 7as that term is defined in section #d of the ,indian ,self-,determination and ,education ,assistance ,act 7#be ,u4,s4,c4 #ecjd771 or a facility of the ,native ,hawaiian health care systems authorized under the ,native ,hawaiian ,health ,care ,improvement ,act 7#db ,u4,s4,c4 #aagja et seq474 4 7b7 ,no originating site facility fee for ,certain ,native ,american facilities ,section #ahcd7m77#b77;,b77i7 of the ,social ,security ,act 7#db ,u4,s4,c4 #aciem7m77#b77;,b77i77 is amended1 in the matter preceding subclause 7,i71 by inserting 7other than an originating site that is only described in clause 7v7 of paragraph 7#d77;,c71 and does not meet the requirement for an originating site under clauses 7i7 and 7ii7 of such paragraph7 after the originating site4 #ajg4 ,repeal of six-month in-person visit requirement for telemental health services ,section #ahcd7m77#g7 of the ,social ,security ,act 7#db ,u4,s4,c4 #aciem7m77#g77;,b77 is amended-- 7#a7 in subparagraph 7,a71 by striking 1 subject to subparagraph 7,b712 7#b7 by striking 7,a7 ,in general4--,the geographic and inserting ,the geographic2 and 7#c7 by striking subparagraph 7,b74 #ajh4 ,waiver of telehealth requirements during public health emergencies ,section #aace7;g77#a7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acbj;b-#e7;g77#a77 is amended-- 7#a7 in subparagraph 7,a71 in the matter preceding clause 7i71 by striking subparagraph 7,b7 and inserting subparagraphs 7,b7 and 7,c72 and 7#b7 by adding at the end the following new subparagraph3 7,c7 ,exception for waiver of telehealth requirements during public health emergencies ,for purposes of subsection 7b77#h71 in addition to the emergency period described in subparagraph 7,b71 an emergency area is a geographical area in which1 and an emergency period is the period during which1 there exists a public health emergency declared by the ,secretary pursuant to section #cai of the ,public ,health ,service ,act4 4 #aji4 ,use of telehealth in recertification for hospice care 7a7 ,in general ,section #ahad7;a77#g77;,d77i77,,ii7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acie;f7a77#g77;,d77i77,,ii77 is amended by striking during the emergency period and all that follows through ending on ,december #ca1 #bjbd and inserting the following3 during and after the emergency period described in section #aace7;g77#a77;,b74 7b7 ,national ,academy of ,medicine report ,the ,secretary of ,health and ,human ,services shall request the ,national ,academy of ,medicine to submit a report to ,congress1 not later than #c years after the date of enactment of this ,act1 evaluating the impact of section #ahad7;a77#g77;,d77i77,,ii7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acie;f7a77#g77;,d77i77,,ii771 as amended by subsection 7a71 on-- 7#a7 the number and percentage of beneficiaries recertified for the ,medicare hospice benefit at #ahj days and for subsequent benefit periods2 7#b7 the appropriateness for hospice care of the patients recertified through the use of telehealth2 and 7#c7 any other factors determined appropriate by the ,national ,academy of ,medicine4 ,,ii ,program integrity #bja4 ,clarification for fraud and abuse laws regarding technologies provided to beneficiaries ,section #aabh;,a7i77#f7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acbj;a-#g;a7i77#f77 is amended-- 7#a7 in subparagraph 7,i71 by striking 2 or and inserting a semicolon2 7#b7 in subparagraph 7,j71 by striking the period at the end and inserting 2 or2 and 7#c7 by adding at the end the following new subparagraph3 7,k7 the provision of technologies 7as defined by the ,secretary7 on or after the date of the enactment of this subparagraph1 by a provider of services or supplier 7as such terms are defined for purposes of title ,,xviii7 directly to an individual who is entitled to benefits under part ,a of title ,,xviii1 enrolled under part ,b of such title1 or both1 for the purpose of furnishing telehealth services1 remote patient monitoring services1 or other services furnished through the use of technology 7as defined by the ,secretary71 if-- 7i7 the technologies are not offered as part of any advertisement or solicitation2 and 7ii7 the provision of the technologies meets any other requirements set forth in regulations promulgated by the ,secretary4 4 #bjb4 ,additional resources for telehealth oversight ,in addition to amounts otherwise available1 there are authorized to be appropriated to the ,inspector ,general of the ,department of ,health and ,human ,services for each of fiscal years #bjbd through #bjbh1 out of any money in the ,treasury not otherwise appropriated1 #c1jjj1jjj1 to remain available until expended1 for purposes of conducting audits1 investigations1 and other oversight and enforcement activities with respect to telehealth services1 remote patient monitoring services1 or other services furnished through the use of technology 7as defined by the ,secretary74 #bjc4 ,addressing significant outlier billing patterns for telehealth services 7a7 ,identification and notification of outlier billers of telehealth 7#a7 ,in general ,the ,secretary shall1 using national provider identifiers on claims for telehealth services furnished to individuals under section #ahcd7m7 of the ,social ,security ,act 7#db ,u4,s4,c4 #aciem7m771 identify physicians and practitioners that demonstrate significant outlier billing patterns 7such as coding of telehealth services for inappropriate length of time and inaccurate complexity and inappropriate or duplicate billing7 for telehealth services or items or services ordered or prescribed concurrent to a telehealth service over a period of time specified by the ,secretary4 7#b7 ,establishment of thresholds ,for purposes of this subsection1 the ,secretary shall establish thresholds for outlier billing patterns to identify whether a physician or practitioner is a significant outlier biller for telehealth services or items or services ordered or prescribed concurrent to a telehealth service as compared to other physicians or practitioners within the same specialty and geographic area4 7b7 ,notification 7#a7 ,in general ,the ,secretary shall notify any physician or practitioner identified as a significant outlier biller for telehealth services or items or services ordered or prescribed concurrent to a telehealth service under subsection 7a74 ,each notification under the preceding sentence shall include the following3 7,a7 ,information on how the physician or practitioner compares to physicians or practitioners within the same specialty and geographic area with respect to billing for telehealth services or items or services ordered or prescribed concurrent to a telehealth service under the ,medicare program under title ,,xviii of the ,social ,security ,act 7#db ,u4,s4,c4 #acie et seq474 7,b7 ,information on telehealth billing guidelines under the ,medicare program4 7,c7 ,other information determined appropriate by the ,secretary4 7#b7 ,clarification ,nothing in this subsection or subsection 7a7 shall be construed as directing the ,centers for ,medicare ,medicaid ,services to pursue further audits of providers of services and suppliers outside of those permitted or required under titles ,,xi or ,,xviii of the ,social ,security ,act1 or otherwise under applicable ,federal law4 7c7 ,public ,availability of ,information ,the ,secretary shall make aggregate information on outlier billing patterns identified under subsection 7a7 available on the internet website of the ,centers for ,medicare ,medicaid ,services4 ,such information shall be in a form and manner determined appropriate by the ,secretary and shall not identify any specific physician or practitioner4 7d7 ,other activities ,nothing in this section shall preclude the ,secretary from conducting activities that provide physicians and practitioners with information as to how they compare to other physicians and practitioners that are in addition to the activities under this section4 7e7 ,telehealth resource centers education activities ,section #ccj;,i7j77#b7 of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bed;c-#ad7;j77#b77 is amended-- 7#a7 in subparagraph 7,f71 by striking and at the end2 7#b7 in subparagraph 7,g71 by striking the period at the end and inserting 2 and2 and 7#c7 by adding at the end the following new subparagraph3 7,h7 providing technical assistance and education to physicians and practitioners that the ,secretary identifies pursuant to section #bjc7;a7 of the ,,connect for ,health ,act of #bjbc as having significant levels of outlier billing patterns with respect to telehealth services or items or services ordered or prescribed concurrent to a telehealth service under the ,medicare program under title ,,xviii of the ,social ,security ,act1 including-- 7i7 education on practices to ensure coding of telehealth services for appropriate length of time and accurate complexity2 7ii7 education on prevention of inappropriate or duplicate billing2 and 7iii7 information on-- 7,i7 services specified in paragraph 7#d77;,f77i7 of section #ahcd7m7 of the ,social ,security ,act 7#db ,u4,s4,c4 #aciem7m77 for authorized payment under paragraph 7#a7 of such section2 and 7,,ii7 the process used to update such services under clauses 7ii7 and 7iii7 7as added by section #ajd7 of paragraph 7#d77;,f7 of such section #ahcd7m72 and 7iv7 referral to the appropriate medicare administrative contractor for specific questions that fall outside of the scope of broad best practices4 4 7f7 ,definitions ,in this section3 7#a7 ,secretary ,the term ,secretary means the ,secretary of ,health and ,human ,services4 7#b7 ,telehealth service ,the term telehealth service has the meaning given that term in section #ahcd7m77#d77;,f7 of the ,social ,security ,act 7#db ,u4,s4,c4 #aciem7m77#d77;,f774 7#c7 ,physician2 practitioner ,the terms physician and practitioner have the meaning given those terms for purposes of section #ahcd7m7 of the ,social ,security ,act 7#db ,u4,s4,c4 #aciem7m774 ,,iii ,beneficiary and provider supports1 quality of care1 and data #cja4 ,beneficiary engagement on telehealth 7a7 ,resources1 guidance1 and training sessions ,section #ahcd7m7 of the ,social ,security ,act 7#db ,u4,s4,c4 #aciem7m77 is amended by adding at the end the following new paragraph3 7#aj7 ,resources1 guidance1 and training sessions 7,a7 ,in general ,not later than #f months after the date of the enactment of this paragraph1 the ,secretary1 in consultation with stakeholders1 shall issue resources1 guidance1 and training sessions for beneficiaries1 physicians1 practitioners1 and health information technology software vendors on best practices for ensuring telehealth services are accessible for-- 7i7 individuals with limited ,english proficiency1 including instructions on how to-- 7,i7 access telehealth platforms2 7,,ii7 utilize interpreter services2 and 7,,iii7 integrate telehealth and virtual interpreter services2 and 7ii7 individuals with ,disabilities1 including instructions on accessibility of the telecommunications system being used for telehealth services1 engagement with beneficiaries with disabilities prior to1 during1 and after the furnishing of the telehealth service1 and training on captioning and transcripts4 7,b7 ,accounting for age and other differences ,resources1 guidance1 and training sessions issued under this paragraph shall account for age and sociodemographic1 geographic1 literacy1 cultural1 cognitive1 and linguistic differences in how individuals interact with technology4 4 7b7 ,study and report on tactics ,to improve beneficiary engagement on telehealth 7#a7 ,study ,the ,secretary of ,health and ,human ,services shall collect and analyze qualitative and quantitative data on strategies that clinicians1 payers1 and other health care organizations use to improve beneficiary engagement on telehealth services 7as defined in section #ahcd7m77#d77;,f7 of the ,social ,security ,act 7#db ,u4,s4,c4 #aciem7m77#d77;,f7771 with an emphasis on underserved communities1 such as the use of digital navigators1 providing patients with pre-visit information on telehealth1 caregiver engagement1 and training on telecommunications systems1 and the investments necessary for health care professionals to effectively furnish telehealth services1 including the costs of necessary technology and of training staff4 7#b7 ,report ,not later than #a year after the date of the enactment of this ,act1 the ,secretary shall submit to ,congress and make available on the internet website of the ,centers for ,medicare ,medicaid ,services a report containing the results of the study under paragraph 7#a71 together with recommendations for such legislation and administrative action as the ,secretary determines appropriate4 7c7 ,funding ,there are authorized to be appropriated such sums as necessary to carry out the provisions of1 including the amendments made by1 this section4 #cjb4 ,provider supports on telehealth 7a7 ,educational resources and training sessions ,not later than #f months after the date of enactment of this ,act1 the ,secretary of ,health and ,human ,services shall develop and make available to health care professionals educational resources and training sessions on requirements relating to the furnishing of telehealth services under section #ahcd7m7 of the ,social ,security ,act 7#db ,u4,s4,c4 #aciem7m77 and topics including-- 7#a7 requirements for payment for telehealth services2 7#b7 telehealth-specific health care privacy and security training2 7#c7 utilizing telehealth services to engage and support underserved1 high-risk1 and vulnerable patient populations2 and 7#d7 other topics as determined appropriate by the ,secretary4 7b7 ,telehealth resource centers ,the ,secretary shall consider including technical assistance1 education1 and training on telehealth services as a required activity for telehealth resource centers under section #ccj;,i of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bed;c-#ad74 7c7 ,funding ,there are authorized to be appropriated such sums as necessary to carry out this section4 #cjc4 ,ensuring the inclusion of telehealth in measuring quality of care ,section #ahij;,a of the ,social ,security ,act 7#db ,u4,s4,c4 #acie;aaa-#a7 is amended by adding at the end the following new subsection3 7h7 ,measuring quality of telehealth services 7#a7 ,in general ,not later than #ahj days after the date of the enactment of this subsection1 the ,secretary shall review quality measures to ensure inclusion of measures relating to telehealth services1 including care1 prevention1 diagnosis1 patient experience1 health outcomes1 and treatment4 7#b7 ,consultation ,in conducting the review and assessment under paragraph 7#a71 the ,secretary shall consult external technical experts in quality measurement1 including patient organizations1 providers1 and experts in telehealth4 7#c7 ,review and assessment ,the review and assessment under this subsection shall-- 7,a7 include review of existing and under development quality measures to identify measures that are currently inclusive of1 and measures that fail to account for1 telehealth services2 and 7,b7 identify gaps in areas of quality measurement that relate to telehealth services1 including health outcomes and patient experience of care4 7#d7 ,technical guidance ,the ,secretary shall issue technical guidance on-- 7,a7 how to effectively streamline1 implement1 and assign accountability for health outcomes for quality measures for telehealth services across health care settings and providers2 7,b7 how to stratify measures by care modality and population to identify differences in health outcomes2 7,c7 the use of uniform data elements2 7,d7 how to identify and catalogue best practices related to the use of quality measurement and quality improvement for telehealth services2 and 7,e7 other areas determined appropriate by the ,secretary4 7#e7 ,report ,not later than #b years after the date of the enactment of this subsection1 the ,secretary shall submit to ,congress and post on the internet website of the ,centers for ,medicare ,medicaid ,services a report on the review and assessment conducted under this subsection4 4 #cjd4 ,posting of information on telehealth services ,not later than #ahj days after the date of enactment1 and quarterly thereafter1 the ,secretary of ,health and ,human ,services shall post on the internet website of the ,centers for ,medicare ,medicaid ,services information on-- 7#a7 the furnishing of telehealth services under the ,medicare program under title ,,xviii of the ,social ,security ,act 7#db ,u4,s4,c4 #acie et seq471 described by patient population1 type of service1 geography1 place of service1 and provider type2 7#b7 the impact of telehealth services on expenditures and utilization under the ,medicare program2 and 7#c7 other outcomes related to the furnishing of telehealth services under the ,medicare program1 as determined appropriate by the ,secretary4