,,ii #aah? ,,congress #b;d ,session ,s4 #cifg ,,9 ,,! ,,s5ate ,,( ,,! ,,unit$ ,,/ates ,m>* #ai1 #bjbd,mr4 ,scott ( ,s\? ,c>ol9a 7= himself1 ,mr4 ,s*atz1 ,mrs4 ,blackburn1 ,ms4 ,smi?1 ,mr4 ,sullivan1 ,mr4 ,w>nock1 ,mr4 ,m>%all1 & ,mr4 ,k+7 introduc$ ! foll[+ bill2 :i* 0 read twice & ref]r$ to ! ,committee on ,f9ance ,a ,,bill ,to am5d title ,,xviii ( ! ,social ,security ,act to make p]man5t c]ta9 teleheal? flexibilities "u ! ,m$ic>e program4 #a4 ,%ort title ,?is ,act may be cit$ z ! ,teleheal? ,mod]nization ,act4 #b4 ,ext5d+ ,m$ic>e teleheal? flexibilities 7a7 ,exp&+ access to teleheal? s]vices 7#a7 ,9 g5]al ,section #ahcd7m77#d77;,c77iii7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #aciem7m77#d77;,c77iii77 is am5d$ by /rik+ ,9 ! case t & all t foll[s ?r\gh end+ on ,decemb] #ca1 #bjbd1 & ins]t+ ,beg9n+ on ! date ( ! enactm5t ( ! ,teleheal? ,mod]nization ,act14 7#b7 ,con=m+ am5dm5ts ,section #ahcd7m7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #aciem7m77 is am5d$-- 7,a7 9 p>agraph 7#b77;,b77iii71 by /rik+ ,9 ! case t & all t foll[s ?r\gh end+ ,decemb] #ca1 #bjbd1 & ins]t+ ,) respect to teleheal? s]vices furni%$ on or aft] ! date ( ! enactm5t ( ! ,teleheal? ,mod]nization ,act12 7,b7 9 p>agraph 7#d77;,c77ii77,x71 by /rik+ 1 b only = purposes ( section #ahha7;b77#c77;,b7 or teleheal? s]vices describ$ 9 p>agraph 7#g72 7,c7 9 p>agraph 7#e71 by ins]t+ & prior to ! date ( ! enactm5t ( ! ,teleheal? ,mod]nization ,act1 aft] ,janu>y #a1 #bjai12 7,d7 9 p>agraph 7#f77;,a71 by ins]t+ & prior to ! date ( ! enactm5t ( ! ,teleheal? ,mod]nization ,act1 aft] ,janu>y #a1 #bjai12 & 7,e7 9 p>agraph 7#g71 by add+ at ! end ! foll[+ new subp>agraph3 7,c7 ,sunset ,! provisions ( ?is p>agraph %all n apply ) respect to s]vices furni%$ on or aft] ! date ( ! enactm5t ( ?is subp>agraph4 4 7b7 ,exp&+ practition]s eligible ,to furni% teleheal? s]vices ,section #ahcd7m77#d77;,e7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #aciem7m77#d77;,e77 is am5d$-- 7#a7 by /rik+ practition]4--,! t]m & ins]t+ 8practition]4-- 7,a7 ,9 g5]al ,subject to subp>agraph 7,b71 ! t]m 2 7#b7 9 subp>agraph 7,a71 z s ins]t$1 by /rik+ 1 9 ! case t ! em]g5cy p]iod describ$ 9 section #aace7;g77#a77;,b7 ends be=e ,decemb] #ca1 #bjbd1 = ! p]iod beg9n+ on ! fir/ day aft] ! end ( su* em]g5cy p]iod & end+ on ,decemb] #ca1 #bjbd12 & 7#c7 by add+ at ! end ! foll[+ new subp>agraph3 7,b7 ,expansion ,! ,secret>y1 aft] consult+ ) /akehold]s reg>d+ s]vices t are cl9ically appropriate1 may exp& ! types ( practition]s :o may furni% teleheal? s]vices to include any heal? c>e pr(essional t is eligible to bill ! program "u ?is title = _! pr(essional s]vices4 4 7c7 ,ret5tion ( additional s]vices & subregulatory process = modifications foll[+ em]g5cy p]iod ,section #ahcd7m77#d77;,f7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #aciem7m77#d77;,f77 is am5d$-- 7#a7 9 clause 7i71 by ins]t+ & clause 7iii7 aft] p>agraph 7#h72 7#b7 9 clause 7ii71 by /rik+ ,! ,secret>y & ins]t+ ,subject to clause 7iii71 ! ,secret>y2 & 7#c7 by add+ at ! end ! foll[+ new clause3 7iii7 ,ret5tion ( additional s]vices & subregulatory process = modifications foll[+ em]g5cy p]iod ,) respect to teleheal? s]vices furni%$ on or aft] ! date ( ! enactm5t ( ?is clause1 ! ,secret>y may-- 7,i7 reta9 z appropriate ! exp&$ li/ ( teleheal? s]vices specifi$ 9 clause 7i7 pursuant to ! waiv] au?ority "u section #aace7;b77#h7 dur+ ! em]g5cy p]iod describ$ 9 section #aace7;g77#a77;,b72 & 7,,ii7 reta9 ! subregulatory process us$ to modify ! s]vices includ$ on ! li/ ( su* teleheal? s]vices pursuant to clause 7ii7 dur+ su* em]g5cy p]iod4 4 7d7 ,enhanc+ teleheal? s]vices = f$]ally qualifi$ heal? c5t]s & rural heal? cl9ics ,section #ahcd7m77#h7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #aciem7m77#h77 is am5d$-- 7#a7 9 subp>agraph 7,a7-- 7,a7 9 ! matt] prec$+ clause 7i71 by /rik+ &1 9 ! case & all t foll[s ?r\gh #bjbd-- & ins]t+ & aft] su* p]iod--2 & 7,b7 9 clause 7ii71 by ins]t+ or 7,c71 z applicable aft] subp>agraph 7,b72 & 7#b7 9 subp>agraph 7,b7-- 7,a7 9 ! head]1 by ins]t+ be=e #bjbe aft] rule2 & 7,b7 9 clause 7i71 by /rik+ dur+ ! p]iods = :i* subp>agraph 7,a7 applies & ins]t+ be=e ,janu>y #a1 #bjbe2 & 7#c7 by add+ at ! end ! foll[+ new subp>agraph3 7,c7 ,paym5t rule = #bjbe & subsequ5t ye>s 7i7 ,9 g5]al ,a teleheal? s]vice furni%$ to an eligible teleheal? individual by a ,f$]ally qualifi$ heal? c5t] or rural heal? cl9ic on or aft] ,janu>y #a1 #bjbe1 %all be deem$ to be s furni%$ to su* individual z an outpati5t ( su* c5t] or cl9ic 7z applicable7 = purposes ( p>agraphs 7#a7 & 7#c71 respectively1 ( section #ahfa7;aa71 & 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 ! paym5t me?odology e/abli%$ "u section #ahcc7;a77#c71 respectively4 7ii7 ,treatm5t ( co/s ,co/s associat$ ) ! deliv]y ( teleheal? s]vices by a ,f$]ally qualifi$ heal? c5t] or rural heal? cl9ic on or aft] ,janu>y #a1 #bjbe1 %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 7e7 ,use ( teleheal?1 z cl9ically appropriate1 ,to conduct face-to-,face enc\nt] = hospice c>e ,section #ahad7;a77#g77;,d77i77,,ii7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acie;f7a77#g77;,d77i77,,ii77 is am5d$ by /rik+ 1 &1 9 ! case & all t foll[s ?r\gh end+ on ,decemb] #ca1 #bjbd1 & ins]t+ & aft] su* p]iod1 z cl9ically appropriate14 7f7 ,use ( teleheal?1 z cl9ically appropriate1 ,to conduct face-to-,face cl9ical assessm5ts = home dialysis ,clause 7iii7 ( section #ahha7;b77#c77;,b7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acierr7b77#c77;,b77 is am5d$-- 7#a7 by mov+ su* clause #d ems to ! left2 & 7#b7 by ins]t+ & aft] su* em]g5cy p]iod z cl9ically appropriate be=e ! p]iod4 7g7 ,all[+ = ! use ( audio-,only telecommunications te*nology ,section #ahcd7m77#i7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #aciem7m77#i77 is am5d$-- 7#a7 by /rik+ ! fir/ s5t5ce & ins]t+ ! foll[+3 ,! ,secret>y %all provide cov]age & paym5t "u ?is "p = teleheal? s]vices id5tifi$ 9 p>agraph 7#d77;,f77i7 z ( ! date ( ! enactm5t ( ?is p>agraph t are furni%$ via an audio-only communications sy/em42 & 7#b7 9 ! second s5t5ce1 by /rik+ dur+ su* em]g5cy p]iod & ins]t+ dur+ ! em]g5cy p]iod describ$ 9 section #aace7;g77#a77;,b74 7h7 ,implem5tation ,not)/&+ any provision ( law1 ! ,secret>y may implem5t ! provisions (1 & am5dm5ts made by1 ?is section by int]im f9al rule1 program in/ruction1 or o!rwise4