,i  #aaith ,,congress  #ast ,session    
,h4 ,r4 #bbfc  ,,in ,,the ,,house ,,of  
,,representatives  ,march #ba1 #bjbe,mr4
 ,khanna 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 make permanent certain
 telehealth flexibilities under the     
,medicare program1 and for other        
purposes4  #a4 ,short title ,this ,act  
may be cited as the ,telehealth         
,coverage ,act of #bjbe4  #b4 ,making   
permanent certain telehealth            
flexibilities under ,medicare  7a7      
,expanded access to telehealth services 
,section #ahcd7m7 of the ,social        
,security ,act 7#db ,u4,s4,c4 #aciem7m77
 is amended-- 7#a7 in paragraph         

7#b77;,b77iii71 by striking ,in the case
 that and all that follows through      
ending ,march #ca1 #bjbe1 and inserting 
,with respect to telehealth services    
that are furnished on or after the first
 day of the emergency period described  
in section #aace7;g77#a77;,b712 and     
7#b7 in paragraph 7#d77;,c77iii71 by    
striking ,in the case that and all that 
follows through ending on ,march #ca1   
#bjbe1 and inserting ,with respect to   
telehealth services that are furnished  
on or after the first day of the        
emergency period described in section   
#aace7;g77#a77;,b714  7b7 ,expansion of 
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 by       
striking in the case that and all that  
follows through ending on ,march #ca1   
#bjbe1 and inserting beginning on the   
first day of the emergency period       
described in section                    

#aace7;g77#a77;,b714  7c7 ,extension of 
telehealth services furnished by        
,federally qualified health centers and 
rural health clinics ,section           
#ahcd7m77#h77;,a7 of the ,social        
,security ,act 7#db ,u4,s4,c4           
#aciem7m77#h77;,a77 is amended by       
striking ,during the emergency and all  
that follows through ending on ,march   
#ca1 #bjbe and inserting ,beginning on  
the first day of the emergency period   
described in section #aace7;g77#a77;,b74
  7d7 ,treatment of telehealth services 
furnished using audio-,only             
telecommunications technology ,section  
#ahcd7m77#i7 of the ,social ,security   
,act 7#db ,u4,s4,c4 #aciem7m77#i77 is   
amended-- 7#a7 by striking ,in the case 
that and all that follows through the   
,secretary shall continue to and        
inserting ,the ,secretary shall2  7#b7  
by striking identified in paragraph     
7#d77;,f77i7 as of the date of the      
enactment of this paragraph2 and  7#c7  
by striking during the period and all   

that follows through the period at the  
end and inserting on or after the first 
day of the emergency period described in
 section #aace7;g77#a77;,b744  7e7      
,elimination of in-,person requirements 
under ,medicare for certain services    
furnished through telehealth  7#a7 ,home
 dialysis monthly ,,esrd-related visit2 
stroke telehealth services2 substance   
use disorder services and mental health 
services  7,a7 ,in general ,section     
#ahcd7m7 of the ,social ,security ,act  
7#db ,u4,s4,c4 #aciem7m77 is amended by 
striking paragraphs 7#e7 through 7#g7   
and redesignating paragraphs 7#h7 and   
7#i7 as paragraphs 7#e7 and 7#f71       
accordingly4  7,b7 ,conforming changes  
,section #ahcd7m7 of the ,social        
,security ,act 7#db ,u4,s4,c4 #aciem7m77
 is amended-- 7i7 in paragraph 7#a71 by 
striking ,subject to paragraphs 7#h7 and
 7#i7 and inserting ,subject to         
paragraphs 7#e7 and 7#f72  7ii7 in      
paragraph 7#b7-- 7,i7 in subparagraph   
7,a71 by striking ,subject to paragraph 

7#h7 and inserting ,subject to paragraph
 7#e72 and  7,,ii7 in subparagraph 7,b71
 by striking and paragraph 7#f77;,c72   
and  7iii7 in paragraph 7#d7-- 7,i7 in  
subparagraph 7,a71 by striking ,subject 
to paragraph 7#h7 and inserting ,subject
 to paragraph 7#e72  7,,ii7 in          
subparagraph 7,c7-- 7aa7 in clause 7i71 
by striking and paragraphs 7#e71 7#f71  
and 7#g72 and  7bb7 in clause 7ii77,x71 
by striking or telehealth services      
described in paragraph 7#g72 and        
7,,iii7 in subparagraph 7,f71 by        
striking ,subject to paragraph 7#h7 and 
inserting ,subject to paragraph 7#e74   
7#b7 ,mental health visits furnished by 
,federally qualified health centers     
,section #ahcd7o77#d77;,b7 of the       
,social ,security ,act 7#db ,u4,s4,c4   
#aciem7o77#d77;,b77 is amended by       
striking prior to ,april #a1 #bjbe4     
7#c7 ,mental health visits furnished by 
rural health clinics ,section           
#ahcd7y77#b7 of the ,social ,security   
,act 7#db ,u4,s4,c4 #aciem7y77#b77 is   

amended by striking prior to ,april #a1 
#bjbe4  7f7 ,use of telehealth ,to      
conduct face-to-face encounter prior to 
recertification of eligibility for      
hospice care ,section                   
#ahad7;a77#g77;,d77i77,,ii7 of the      
,social ,security ,act 7#db ,u4,s4,c4   
#acie;f7a77#g77;,d77i77,,ii77 is        
amended-- 7#a7 by striking during the   
emergency period and all that follows   
through and ending on ,march #ca1 #bjbe 
and inserting beginning on the first day
 of the emergency period described in   
section #aace7;g77#a77;,b72 and  7#b7 by
 inserting 1 except that this subclause 
shall not apply in the case of such an  
encounter with an individual occurring  
on or after ,march #ca1 #bjbe1 if such  
individual is located in an area that is
 subject to a moratorium on the         
enrollment of hospice programs under    
this title pursuant to section          
#ahff7;j77#g71 if such individual is    
receiving hospice care from a provider  
that is subject to enhanced oversight   

under this title pursuant to section    
#ahff7;j77#c71 or if such encounter is  
performed by a hospice physician or     
nurse practitioner who is not enrolled  
under section #ahff7;j7 and is not an   
opt-out physician or practitioner 7as   
defined in section #ahjb7;b77#f77;,d77  
before the semicolon4  7g7 ,requiring   
modifiers for telehealth services in    
certain instances ,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 ,required use of      
modifiers in certain instances ,not     
later than ,january #a1 #bjbf1 the      
,secretary shall establish requirements 
to include #a or more codes or          
modifiers1 as determined appropriate by 
the ,secretary1 in the case of-- 7,a7   
claims for telehealth services under    
this subsection that are furnished      
through a telehealth virtual platform-- 
7i7 by a physician or practitioner that 
contracts with an entity that owns such 

virtual platform2 or  7ii7 for which a  
physician or practitioner has a payment 
arrangement with an entity for use of   
such virtual platform2 and  7,b7 claims 
for telehealth services under this      
subsection that are furnished incident  
to a physician's or practitioner's      
professional service4  4  7h7 ,program  
instruction authority ,the ,secretary of
 ,health and ,human ,services may       
implement the amendments made by this   
section through program instruction or  
otherwise4  #c4 ,requiring modifier for 
use of telehealth to conduct            
face-to-face encounter prior to         
recertification of eligibility for      
hospice care ,section                   
#ahad7;a77#g77;,d77i77,,ii7 of the      
,social ,security ,act 7#db ,u4,s4,c4   
#acie;f7a77#g77;,d77i77,,ii771 as       
amended by section #b7;f71 is further   
amended by inserting 1 but only if1 in  
the case of such an encounter occurring 
on or after ,january #a1 #bjbf1 any     
hospice claim includes #a or more       

modifiers or codes 7as specified by the 
,secretary7 to indicate that such       
encounter was conducted via telehealth  
after as determined appropriate by the  
,secretary4  #d4 ,extending acute       
hospital care at home waiver            
flexibilities ,section #ahff;,g7a77#a7  
of the ,social ,security ,act 7#db      
,u4,s4,c4 #acie;cc-#g7;a77#a77 is       
amended by striking during the period   
and all that follows through ,march #ca1
 #bjbe and inserting on or after the    
first day after the end of the emergency
 period described in section            
#aace7;g77#a77;,b74  #e4 ,guidance on   
furnishing services via telehealth to   
individuals with limited ,english       
proficiency  7a7 ,in general ,not later 
than #a year after the date of the      
enactment of this section1 the          
,secretary of ,health and ,human        
,services1 in consultation with #a or   
more entities from each of the          
categories described in paragraphs 7#a7 
through 7#g7 of subsection 7b71 shall   

issue and disseminate1 or update and    
revise as applicable1 guidance for the  
entities described in such subsection on
 the following3 7#a7 ,best practices on 
facilitating and integrating use of     
interpreters during a telemedicine      
appointment4  7#b7 ,best practices on   
providing accessible instructions on how
 to access telecommunications systems   
7as such term is used for purposes of   
section #ahcd7m7 of the ,social         
,security ,act 7#db ,u4,s4,c4 #aciem7m77
 for individuals with limited ,english  
proficiency4  7#c7 ,best practices on   
improving access to digital patient     
portals for individuals with limited    
,english proficiency4  7#d7 ,best       
practices on integrating the use of     
video platforms that enable multi-person
 video calls furnished via a            
telecommunications system for purposes  
of providing interpretation during a    
telemedicine appointment for an         
individual with limited ,english        
proficiency4  7#e7 ,best practices for  

providing patient materials1            
communications1 and instructions in     
multiple languages1 including text      
message appointment reminders and       
prescription information4  7b7 ,entities
 described ,for purposes of subsection  
7a71 an entity described in this        
subsection is an entity in #a or more of
 the following categories3 7#a7 ,health 
information technology service          
providers1 including-- 7,a7 electronic  
medical record companies2  7,b7 remote  
patient monitoring companies2 and  7,c7 
telehealth or mobile health vendors and 
companies4  7#b7 ,health care providers1
 including-- 7,a7 physicians2 and  7,b7 
hospitals4  7#c7 ,health insurers4  7#d7
 ,language service companies4  7#e7     
,interpreter or translator professional 
associations4  7#f7 ,health and language
 services quality certification         
organizations4  7#g7 ,patient and       
consumer advocates1 including such      
advocates that work with individuals    
with limited ,english proficiency4  #f4 

,in-home cardiopulmonary rehabilitation 
flexibilities  7a7 ,in general ,section 
#ahfa7;eee77#b7 of the ,social ,security
 ,act 7#db ,u4,s4,c4 #aciex7eee77#b77 is
 amended-- 7#a7 in subparagraph         
7,a77ii71 by inserting 7including1 with 
respect to items and services furnished 
through audio and video real-time       
communications technology 7excluding    
audio-only7 on or after ,march #ca1     
#bjbe1 in the home of an individual who 
is an outpatient of the hospital7 after 
outpatient basis2 and  7#b7 in          
subparagraph 7,b71 by inserting         
7including1 with respect to items and   
services furnished through audio and    
video real-time communications          
technology on or after ,march #ca1      
#bjbe1 the virtual presence of such     
physician1 physician assistant1 nurse   
practitioner1 or clinical nurse         
specialist7 after under the program4    
7b7 ,program instruction authority      
,notwithstanding any other provision of 
law1 the ,secretary of ,health and      

,human ,services may implement the      
amendments made by this section by      
program instruction or otherwise4  #g4  
,inclusion of virtual diabetes          
prevention program suppliers in ,,mdpp  
,expanded ,model  7a7 ,in general ,not  
later than ,january #a1 #bjbf1 the      
,secretary shall revise the regulations 
under parts #daj and #dbd of title #db1 
,code of ,federal ,regulations1 to      
provide that1 beginning ,january #a1    
#bjbf-- 7#a7 an entity may participate  
in the ,,mdpp by offering only online   
,,mdpp services via synchronous or      
asynchronous technology or              
telecommunications if such entity meets 
the conditions for enrollment as an     
,,mdpp supplier 7as specified in section
 #dbd4bje7;b7 of title #db1 ,code of    
,federal ,regulations 7or a successor   
regulation772  7#b7 if an entity        
participates in the ,,mdpp in the manner
 described in paragraph 7#a7-- 7,a7 the 
administrative location of such entity  
shall be the address of the entity on   

file under the ,diabetes ,prevention    
,recognition ,program2 and  7,b7 in the 
case of online ,,mdpp services furnished
 by such entity to an ,,mdpp beneficiary
 who was not located in the same ,state 
as the entity at the time such services 
were furnished1 the entity shall not be 
prohibited from submitting a claim for  
payment for such services solely by     
reason of the location of such          
beneficiary at such time2 and  7#c7 no  
limit is applied on the number of times 
an individual may enroll in the ,,mdpp4 
7b7 ,definitions ,in this section3 7#a7 
,,mdpp ,the term ,,mdpp means the       
,medicare ,diabetes ,prevention ,program
 conducted under section #aaae;,a of the
 ,social ,security ,act 7#db ,u4,s4,c4  
#acae;a71 as described in the final rule
 published in the ,federal ,register    
entitled ,medicare and ,medicaid        
,programs2 ,,cy #bjbd ,payment ,policies
 ,under the ,physician ,fee ,schedule   
and ,other ,changes to ,part ,b ,payment
 and ,coverage ,policies2 ,medicare     

,shared ,savings ,program ,requirements2
 ,medicare ,advantage2 ,medicare and    
,medicaid ,provider and ,supplier       
,enrollment ,policies2 and ,basic       
,health ,program 7#hh ,fed4 ,reg4 #ghhah
 7,november #af1 #bjbc77 7or a successor
 regulation74  7#b7 ,regulatory terms   
,the terms ,diabetes ,prevention        
,recognition ,program1 full ,,cdc ,,dprp
 recognition1 ,,mdpp beneficiary1 ,,mdpp
 services1 and ,,mdpp supplier have the 
meanings given each such term in section
 #daj4gi7;b7 of title #db1 ,code of     
,federal ,regulations4  7#c7 ,secretary 
,the term ,secretary means the          
,secretary of ,health and ,human        
,services4  #h4 ,medication-induced     
movement disorder outreach and education
 ,not later than ,january #a1 #bjbf1 the
 ,secretary shall use existing          
communications mechanisms to provide    
education and outreach to physicians and
 appropriate non-physician practitioners
 participating under the ,medicare      
program under title ,,xviii of the      

,social ,security ,act 7#db ,u4,s4,c4   
#acie et seq47 with respect to periodic 
screening for medication-induced        
movement disorders that are associated  
with the treatment of mental health     
disorders in at-risk patients1 as well  
as resources related to clinical        
guidelines and best practices for       
furnishing such screening services      
through telehealth4 ,such education and 
outreach shall include information on   
how to account for such screening       
services in evaluation and management   
code selection4 ,the ,secretary shall1  
to the extent practicable1 seek input   
from relevant stakeholders to inform    
such education and outreach4 ,such      
education and outreach may also address 
other relevant screening services       
furnished through telehealth1 as the    
,secretary determines appropriate4