,i  #aai? ,,congress  #a/ ,session  ,h4 
,r4 #dbjf  ,,9 ,,! ,,h\se ,,(           
,,repres5tatives  ,june #bf1 #bjbe,mr4  
,?ompson ( ,cali=nia 7= himself1 ,mr4   
,s*weik]t1 ,ms4 ,matsui1 & ,mr4         
,bald]son7 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 title      
,,xviii ( ! ,social ,security ,act to   
exp& access to teleheal? s]vices1 & =   
o!r purposes4  #a4 ,%ort title2 table ( 
cont5ts  7a7 ,%ort title ,?is ,act may  
be cit$ z ! ,creat+ ,opportunities ,n[ =
 ,necess>y & ,effective ,c>e            
,te*nologies 7,,connect7 = ,heal? ,act (
 #bjbe or ! ,,connect = ,heal? ,act (   
#bjbe4  7b7 ,table ( cont5ts ,! table ( 
cont5ts ( ?is ,act is z foll[s3  ,sec4  
#a4 ,%ort title2 table ( cont5ts4 ,sec4 
#b4 ,f9d+s & s5se ( ,congress4 ,,title  

,i--,remov+ b>ri]s to teleheal? cov]age 
,sec4 #aja4 ,remov+ geographic          
requirem5ts = teleheal? s]vices4 ,sec4  
#ajb4 ,exp&+ orig9at+ sites4 ,sec4 #ajc4
 ,exp&+ au?ority = practition]s eligible
 to furni% teleheal? s]vices4 ,sec4     
#ajd4 ,f$]ally qualifi$ heal? c5t]s &   
rural heal? cl9ics4 ,sec4 #aje4 ,native 
,am]ican heal? facilities4 ,sec4 #ajf4  
,repeal ( six-mon? 9-p]son visit        
requirem5t = telem5tal heal? s]vices4   
,sec4 #ajg4 ,waiv] ( teleheal?          
requirem5ts dur+ public heal? em]g5cies4
 ,sec4 #ajh4 ,use ( teleheal? 9         
rec]tification = hospice c>e4 ,,title   
,,ii--,program integrity ,sec4 #bja4    
,cl>ification = fraud & abuse laws      
reg>d+ te*nologies provid$ to           
b5efici>ies4 ,sec4 #bjb4 ,additional    
res\rces = teleheal? ov]sight4 ,sec4    
#bjc4 ,address+ significant outli] bill+
 patt]ns = teleheal? s]vices4 ,,title   
,,iii--,b5efici>y & provid] supports1   
quality ( c>e1 & data ,sec4 #cja4       
,b5efici>y engagem5t on teleheal?4 ,sec4

 #cjb4 ,provid] supports on teleheal?4  
,sec4 #cjc4 ,ensur+ ! inclusion (       
teleheal? 9 measur+ quality ( c>e4 ,sec4
 #cjd4 ,po/+ ( in=mation on teleheal?   
s]vices4  #b4 ,f9d+s & s5se ( ,congress 
7a7 ,f9d+s ,congress f9ds ! foll[+3 7#a7
 ,! use ( te*nology 9 heal? c>e &       
cov]age ( teleheal? s]vices are rapidly 
evolv+4  7#b7 ,rese>* has f\nd t        
teleheal? s]vices c exp& access to c>e1 
improve ! quality ( c>e1 & r$uce sp5d+4 
7#c7 ,9 #bjbc1 #ij p]c5t ( pati5ts      
receiv+ teleheal? s]vices 7 satisfi$ )  
_! exp]i5ces4  7#d7 ,heal? c>e work=ce  
%ortages are a significant problem 9 _m 
areas & = _m types ( heal? c>e          
cl9icians4  7#e7 ,teleheal? increases   
access to c>e 9 areas ) work=ce %ortages
 & = individuals :o live f> away f heal?
 c>e facilities1 h limit$ mobility or   
transportation1 or h o!r b>ri]s to      
access+ c>e4  7#f7 ,! use ( heal?       
te*nologies c /r5g!n ! exp]tise ( !     
heal? c>e work=ce1 includ+ by connect+  
cl9icians to specialty consultations4   

7#g7 ,prior to ! ,,covid-#ai p&emic1 !  
utilization ( teleheal? s]vices 9 !     
,m$ic>e program "u title ,,xviii ( !    
,social ,security ,act 7#db ,u4,s4,c4   
#acie et seq47 0 l[1 acc\nt+ = #j4a     
p]c5t ( ,m$ic>e ,"p ,b visits 9 #bjai4  
7#h7 ,teleheal? n[ repres5ts a critical 
compon5t ( c>e deliv]y4 ,9 #bjbc1 #bd   
p]c5t ( ,m$ic>e fee-=-s]vice b5efici>ies
 receiv$ a teleheal? s]vice4  7#i7      
,long-t]m c]ta9ty ab\t cov]age (        
teleheal? s]vices "u ! ,m$ic>e program  
is necess>y to fully realize ! b5efits (
 teleheal?4  7b7 ,s5se ( ,congress ,x is
 ! s5se ( ,congress t-- 7#a7 heal? c>e  
provid]s c furni% safe1 effective1 &    
high-quality heal? c>e s]vices ?r\gh    
teleheal?2  7#b7 ! ,secret>y ( ,heal? & 
,human ,s]vices %\ld promptly take all  
necess>y measures to ensure t provid]s &
 b5efici>ies c cont9ue to furni% &      
utilize1 respectively1 teleheal? s]vices
 9 ! ,m$ic>e program1 & support rec5t   
modifications to ! def9ition (          
int]active telecommunications sy/em 9   

regulations & program in/ruction "u !   
,m$ic>e program to ensure t provid]s c  
utilize all appropriate means & types ( 
te*nology1 includ+ audio-visual1        
audio-only1 & o!r types ( te*nologies1  
to furni% teleheal? s]vices2 &  7#c7    
b>ri]s to ! use ( teleheal? %\ld be     
remov$4  ,i ,remov+ b>ri]s to teleheal? 
cov]age  #aja4 ,remov+ geographic       
requirem5ts = teleheal? s]vices ,section
 #ahcd7m77#d77;,c7 ( ! ,social ,security
 ,act 7#db ,u4,s4,c4 #aciem7m77#d77;,c77
 is am5d$-- 7#a7 9 clause 7i71 9 ! matt]
 prec$+ subclause 7,i71 by /rik+ clause 
7iii7 & ins]t+ clauses 7iii7 & 7iv72 &  
7#b7 by add+ at ! end ! foll[+ new      
clause3  7iv7 ,removal ( geographic     
requirem5ts ,! geographic requirem5ts   
describ$ 9 clause 7i7 %all n apply )    
respect to teleheal? s]vices furni%$ on 
or aft] ,octob] #a1 #bjbe4  4  #ajb4    
,exp&+ orig9at+ sites  7a7 ,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  
,septemb] #cj1 #bjbe1 & ins]t+ ,beg9n+  
on ! date ( ! enactm5t ( ! ,,connect =  
,heal? ,act ( #bjbe14  7b7 ,con=m+      
am5dm5ts ,section #ahcd7m7 ( ! ,social  
,security ,act 7#db ,u4,s4,c4 #aciem7m77
 is am5d$--  7#a7 9 p>agraph            
7#b77;,b77iii71 by /rik+ ,9 ! case t &  
all t foll[s ?r\gh ,septemb] #cj1 #bjbe1
 & ins]t+ ,) respect to teleheal?       
s]vices furni%$ on or aft] ! date ( !   
enactm5t ( ! ,,connect = ,heal? ,act (  
#bjbe12 &  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#g74  #ajc4 ,exp&+ au?ority =          
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+          
8,practition]4--  7i7 ,9 g5]al ,subject 
to clause 7ii71 ! t]m  2 &  7#b7 by add+

 at ! end ! foll[+ new clause3  7ii7    
,exp&+ practition]s eligible to furni%  
teleheal? s]vices  7,i7 ,9 g5]al        
,not)/&+ any o!r provision ( ?is        
subsection1 9 ! case ( teleheal? s]vices
 furni%$ on or aft] ,octob] #a1 #bjbe1 !
 ,secret>y may waive any limitation on !
 types ( practition]s :o are eligible to
 furni% teleheal? s]vices if ! ,secret>y
 det]m9es t su* waiv] is cl9ically      
appropriate4  7,,ii7 ,implem5tation ,9  
implem5t+ a waiv] "u ?is clause1 !      
,secret>y may e/abli% requirem5ts1 z    
appropriate1 = practition]s "u su*      
waiv]1 includ+ ) respect to b5efici>y & 
program integrity protections4  7,,iii7 
,public comm5t ,! ,secret>y %all e/abli%
 a process by :i* /akehold]s may 7on at 
lea/ an annual basis7 provide public    
comm5t on su* waiv] "u ?is clause4      
7,,iv7 ,p]iodic review ,! ,secret>y %all
 p]iodically1 b n m frequ5tly ?an e #c  
ye>s1 reassess ! waiv] "u ?is clause to 
det]m9e :e!r su* waiv] cont9ues to be   
cl9ically appropriate4 ,! ,secret>y %all

 t]m9ate any waiv] t ! ,secret>y        
det]m9es is no long] cl9ically          
appropriate4  4  #ajd4 ,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#g7 & ins]t+ 7#g71 & 7#h72 &  7#b7 9 
p>agraph 7#h7-- 7,a7 9 subp>agraph      
7,a7--  7i7 9 ! matt] prec$+ clause 7i71
 by /rik+ ,dur+ & all t foll[s ?r\gh    
,septemb] #cj1 #bjbe & ins]t+ ! foll[+3 
,beg9n+ on ! fir/ day ( ! em]g5cy p]iod 
describ$ 9 section #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,b7 9 subp>agraph 7,b7--  7i7 9 !      
subp>agraph head+1 by ins]t+ dur+       
initial p]iod aft] rule2  7ii7 9 ! fir/ 

s5t5ce ( clause 7i7 by /rik+ dur+ !     
p]iods = :i* subp>agraph 7,a7 applies & 
ins]t+ dur+ ! p]iod beg9n+ on ! fir/ day
 ( ! em]g5cy p]iod & end+ on ,septemb]  
#cj1 #bjbe2 &  7iii7 9 clause 7ii71 by  
/rik+ ,co/s associat$ & ins]t+ ,dur+ !  
p]iod = :i* clause 7i7 applies1 co/s    
associat$2 &  7,c7 by add+ at ! end !   
foll[+ new subp>agraph3  7,c7 ,paym5t   
aft] initial p]iod  7i7 ,9 g5]al ,a     
teleheal? s]vice furni%$ by a ,f$]ally  
qualifi$ heal? c5t] or a rural heal?    
cl9ic to an individual pursuant to ?is  
p>agraph on or aft] ,octob] #a1 #bjbe1  
%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$ ) ! furni%+ ( 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 on 
or aft] ,octob] #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  #aje4  
,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 section 
#aja1 is am5d$--  7#a7 9 clause 7i71 by 
/rik+ & 7iv7 & ins]t+ 1 7iv71 & 7v72 &  
7#b7 by add+ at ! end ! foll[+ new      
clause3  7v7 ,native ,am]ican heal?     
facilities ,) respect to teleheal?      
s]vices furni%$ on or aft] ,janu>y #a1  
#bjbf1 ! 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    
#ajf4 ,repeal ( six-mon? 9-p]son visit  
requirem5t = telem5tal heal? s]vices    

7a7 ,9 g5]al ,section #ahcd7m77#g7 ( !  
,social ,security ,act 7#db ,u4,s4,c4   
#aciem7m77#g77;,b77 is am5d$-- 7#a7 9   
subp>agraph 7,a71 by /rik+ 1 subject to 
subp>agraph 7,b712  7#b7 by /rik+ 7,a7  
,9 g5]al4--,! geographic & ins]t+ ,!    
geographic2 &  7#c7 by /rik+ subp>agraph
 7,b74  7b7 ,rural heal? cl9ics ,section
 #ahcd7y77#b7 ( ! ,social ,security ,act
 7#db ,u4,s4,c4 #aciem7y77#b77 is am5d$ 
by /rik+ prior to ,octob] #a1 #bjbe4    
7c7 ,f$]ally qualifi$ heal? c5t]s       
,section #ahcd7o77#d77;,b7 ( ! ,social  
,security ,act 7#db ,u4,s4,c4           
#aciem7o77#d77;,b77 is am5d$ by /rik+   
prior to ,octob] #a1 #bjbe4  #ajg4      
,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 ,act on or aft] ! date (        
enactm5t ( ?is subp>agraph4  4  #ajh4   
,use ( teleheal? 9 rec]tification =     
hospice c>e  7a7 ,9 g5]al ,section      
#ahad7;a77#g77;,d77i77,,ii7 ( ! ,social 
,security ,act 7#db ,u4,s4,c4           
#acie;f7a77#g77;,d77i77,,ii77 is am5d$  
by /rik+ dur+ ! em]g5cy p]iod & all t   
foll[s ?r\gh ,septemb] #cj1 #bjbe &     
ins]t+ ! foll[+3 dur+ & aft] ! em]g5cy  
p]iod describ$ 9 section                
#aace7;g77#a77;,b74  7b7 ,,gao report ,n
 lat] ?an #c ye>s aft] ! date ( enactm5t
 ( ?is ,act1 ! ,comptroll] ,g5]al ( !   
,unit$ ,/ates %all submit to ,congress a
 report evaluat+ ! impact ( section     

#ahad7;a77#g77;,d77i77,,ii7 ( ! ,social 
,security ,act 7#db ,u4,s4,c4           
#acie;f7a77#g77;,d77i77,,ii771 z am5d$  
by subsection 7a71 on--  7#a7 ! numb] & 
p]c5tage ( b5efici>ies rec]tifi$ = !    
,m$ic>e hospice b5efit at #ahj days & = 
subsequ5t b5efit p]iods1 to ! ext5t su* 
data is available2  7#b7 ,f$]al ov]sight
 ( ! appropriat5ess = hospice c>e ( !   
pati5ts rec]tifi$ ?r\gh ! use (         
teleheal?2 &  7#c7 any o!r factors      
det]m9$ appropriate by ! ,comptroll]    
,g5]al4  ,,ii ,program integrity  #bja4 
,cl>ification = fraud & abuse laws      
reg>d+ te*nologies provid$ to           
b5efici>ies ,section #aabh;,a7i77#f7 ( !
 ,social ,security ,act 7#db ,u4,s4,c4  
#acbj;a-#g;a7i77#f77 is am5d$--  7#a7 9 
subp>agraph 7,i71 by /rik+ 2 or & ins]t+
 a semicolon2  7#b7 9 subp>agraph 7,j71 
by /rik+ ! p]iod at ! end & ins]t+ 2 or2
 &  7#c7 by add+ at ! end ! foll[+ new  
subp>agraph3  7,k7 ! provision (        
te*nologies 7z def9$ by ! ,secret>y7 on 
or aft] ! date ( ! enactm5t ( ?is       

subp>agraph1 by a provid] ( s]vices or  
suppli] 7z su* t]ms are def9$ = purposes
 ( title ,,xviii7 directly to an        
individual :o is entitl$ to b5efits "u  
"p ,a ( title ,,xviii1 enroll$ "u "p ,b 
( su* title1 or bo?1 = ! purpose (      
furni%+ teleheal? s]vices1 remote pati5t
 monitor+ s]vices1 or o!r s]vices       
furni%$ ?r\gh ! use ( te*nology 7z def9$
 by ! ,secret>y71 if--  7i7 !           
te*nologies are n (f]$ z "p ( any       
adv]tisem5t or solicitation2 &  7ii7 !  
provision ( ! te*nologies meets any o!r 
requirem5ts set =? 9 regulations        
promulgat$ by ! ,secret>y4  4  #bjb4    
,additional res\rces = teleheal?        
ov]sight ,9 addition to am\nts o!rwise  
available1 !re are au?oriz$ to be       
appropriat$ to ! ,inspector ,g5]al ( !  
,dep>tm5t ( ,heal? & ,human ,s]vices =  
ea* ( fiscal ye>s #bjbf ?r\gh #bjcj1 out
 ( any money 9 ! ,treasury n o!rwise    
appropriat$1 #c1jjj1jjj1 to rema9       
available until exp5d$1 = purposes (    
conduct+ audits1 inve/igations1 & o!r   

ov]sight & en=cem5t activities ) respect
 to teleheal? s]vices1 remote pati5t    
monitor+ s]vices1 or o!r s]vices furni%$
 ?r\gh ! use ( te*nology 7z def9$ by !  
,secret>y74  #bjc4 ,address+ significant
 outli] bill+ patt]ns = teleheal?       
s]vices  7a7 ,id5tification &           
notification ( outli] bill]s ( teleheal?
  7#a7 ,9 g5]al ,! ,secret>y %all1 us+  
/&>d unique heal? id5tifi]s 7describ$ 9 
section #aagc7;b7 ( ! ,social ,security 
,act 7#db ,u4,s4,c4 #acbj;d-#b7 report$ 
on claims = teleheal? s]vices furni%$ to
 individuals "u section #ahcd7m7 ( su*  
,act 7#db ,u4,s4,c4 #aciem7m7771 id5tify
 physicians & practition]s t demon/rate 
significant outli] bill+ patt]ns 7su* z 
cod+ ( teleheal? s]vices = inappropriate
 l5g? ( "t & inaccurate complexity &    
inappropriate or duplicate bill+7 =     
teleheal? s]vices or items or s]vices   
ord]$ or prescrib$ concurr5t to a       
teleheal? s]vice ov] a p]iod ( "t       
specifi$ by ! ,secret>y4  7#b7          
,e/abli%m5t ( ?re%olds ,= purposes ( ?is

 subsection1 ! ,secret>y %all e/abli%   
?re%olds = outli] bill+ patt]ns to      
id5tify :e!r a physician or practition] 
is a significant outli] bill] =         
teleheal? s]vices or items or s]vices   
ord]$ or prescrib$ concurr5t to a       
teleheal? s]vice z comp>$ to o!r        
physicians or practition]s )9 ! same    
specialty & geographic area4  7b7       
,notification  7#a7 ,9 g5]al ,!         
,secret>y %all notify physicians &      
practition]s id5tifi$ z a significant   
outli] bill] = teleheal? s]vices or     
items or s]vices ord]$ or prescrib$     
concurr5t to a teleheal? s]vice "u      
subsection 7a74 ,ea* notification "u !  
prec$+ s5t5ce %all include ! foll[+3    
7,a7 ,in=mation on h[ ! physician or    
practition] comp>es to physicians or    
practition]s )9 ! same specialty &      
geographic area ) respect to bill+ =    
teleheal? s]vices or items or s]vices   
ord]$ or prescrib$ concurr5t to a       
teleheal? s]vice "u ! ,m$ic>e program "u
 title ,,xviii ( ! ,social ,security    

,act 7#db ,u4,s4,c4 #acie et seq474     
7,b7 ,in=mation on teleheal? bill+      
guidel9es "u ! ,m$ic>e program4  7,c7   
,o!r in=mation det]m9$ appropriate by ! 
,secret>y4  7#b7 ,cl>ification ,no?+ 9  
?is subsection or subsection 7a7 %all be
 con/ru$ z direct+ ! ,c5t]s = ,m$ic>e   
,m$icaid ,s]vices to pursue fur!r audits
 ( provid]s ( s]vices & suppli]s outside
 ( ^? p]mitt$ or requir$ "u titles ,,xi 
or ,,xviii ( ! ,social ,security ,act1  
or o!rwise "u applicable ,f$]al law4    
7c7 ,public ,availability ( ,in=mation  
,! ,secret>y %all make aggregate        
in=mation on outli] bill+ patt]ns       
id5tifi$ "u subsection 7a7 available on 
! int]net website ( ! ,c5t]s = ,m$ic>e  
,m$icaid ,s]vices4 ,su* in=mation %all  
be 9 a =m & mann] det]m9$ appropriate by
 ! ,secret>y & %all n id5tify any       
specific physician or practition]4  7d7 
,o!r activities ,no?+ 9 ?is section %all
 preclude ! ,secret>y f conduct+        
activities t provide physicians &       
practition]s ) in=mation z to h[ !y     

comp>e to o!r physicians & practition]s 
t are 9 addition to ! activities "u ?is 
section4  7e7 ,teleheal? res\rce c5t]s  
education activities ,section           
#ccj;,i7j77#b7 ( ! ,public ,heal?       
,s]vice ,act 7#db ,u4,s4,c4             
#bed;c-#ad7;j77#b77 is am5d$-- 7#a7 9   
subp>agraph 7,f71 by /rik+ & at ! end2  
7#b7 9 subp>agraph 7,g71 by /rik+ !     
p]iod at ! end & ins]t+ 2 &2 &  7#c7 by 
add+ at ! end ! foll[+ new subp>agraph3 
7,h7 provid+ te*nical assi/ance &       
education to physicians & practition]s t
 ! ,secret>y id5tifies pursuant to      
section #bjc7;a7 ( ! ,,connect = ,heal? 
,act ( #bjbe z hav+ significant levels (
 outli] bill+ patt]ns ) respect to      
teleheal? s]vices or items or s]vices   
ord]$ or prescrib$ concurr5t to a       
teleheal? s]vice "u ! ,m$ic>e program "u
 title ,,xviii ( ! ,social ,security    
,act1 includ+-- 7i7 education on        
practices to ensure cod+ ( teleheal?    
s]vices = appropriate l5g? ( "t &       
accurate complexity2  7ii7 education on 

prev5tion ( inappropriate or duplicate  
bill+2 &  7iii7 in=mation provid$ 9 !   
annual physician fee s*$ule rulemak+    
reg>d+--  7,i7 s]vices specifi$ 9       
p>agraph 7#d77;,f77i7 ( section #ahcd7m7
 ( ! ,social ,security ,act 7#db        
,u4,s4,c4 #aciem7m77 = au?oriz$ paym5t  
"u p>agraph 7#a7 ( su* section2 &       
7,,ii7 ! process us$ to update su*      
s]vices "u p>agraph 7#d77;,f77ii7 ( su* 
section #ahcd7m72 &  7iv7 ref]ral to !  
appropriate m$ic>e adm9i/rative         
contractor = specific que/ions t fall   
outside ( ! scope ( broad be/ practices4
  4  7f7 ,def9itions ,9 ?is section3    
7#a7 ,secret>y ,! t]m ,secret>y means ! 
,secret>y ( ,heal? & ,human ,s]vices4   
7#b7 ,teleheal? s]vice ,! t]m teleheal? 
s]vice has ! mean+ giv5 t t]m 9 section 
#ahcd7m77#d77;,f7 ( ! ,social ,security 
,act 7#db ,u4,s4,c4 #aciem7m77#d77;,f774
  7#c7 ,physician2 practition] ,! t]ms  
physician & practition] h ! mean+ giv5  
^? t]ms = purposes ( section #ahcd7m7 ( 
! ,social ,security ,act 7#db ,u4,s4,c4 

#aciem7m774  ,,iii ,b5efici>y & provid] 
supports1 quality ( c>e1 & data  #cja4  
,b5efici>y engagem5t on teleheal?  7a7  
,res\rces1 guidance1 & tra9+ sessions   
,section #ahcd7m7 ( ! ,social ,security 
,act 7#db ,u4,s4,c4 #aciem7m77 is am5d$ 
by add+ at ! end ! foll[+ new p>agraph3 
7#aj7 ,res\rces1 guidance1 & tra9+      
sessions  7,a7 ,9 g5]al ,n lat] ?an #f  
mon?s aft] ! date ( ! enactm5t ( ?is    
p>agraph1 ! ,secret>y1 9 consultation ) 
/akehold]s1 %all issue res\rces1        
guidance1 & tra9+ sessions =            
b5efici>ies1 physicians1 practition]s1 &
 heal? in=mation te*nology s(tw>e v5dors
 on be/ practices = ensur+ teleheal?    
s]vices are accessible =-- 7i7          
individuals ) limit$ ,engli% pr(ici5cy1 
includ+ in/ructions on h[ to--  7,i7    
access teleheal? plat=ms2  7,,ii7       
utilize int]pret] s]vices2 &  7,,iii7   
integrate teleheal? & virtual int]pret] 
s]vices2 &  7ii7 individuals )          
disabilities1 includ+ in/ructions on    
accessibility ( ! telecommunications    

sy/em be+ us$ = teleheal? s]vices1      
engagem5t ) b5efici>ies ) disabilities  
prior to1 dur+1 & aft] ! furni%+ ( !    
teleheal? s]vice1 & tra9+ on caption+ & 
transcripts4  7,b7 ,acc\nt+ = age & o!r 
diff]5ces ,res\rces1 guidance1 & tra9+  
sessions issu$ "u ?is p>agraph %all     
acc\nt = age & sociodemographic1        
geographic1 lit]acy1 cultural1          
cognitive1 & l+ui/ic diff]5ces 9 h[     
individuals int]act ) te*nology4  4  7b7
 ,/udy & report on tactics ,to improve  
b5efici>y engagem5t on teleheal?  7#a7  
,/udy ,! ,secret>y ( ,heal? & ,human    
,s]vices %all1 to ! maximum ext5t       
feasible1 collect & analyze qualitative 
& quantitative data on /rategies t      
cl9icians1 pay]s1 & o!r heal? c>e       
organizations use to improve b5efici>y  
engagem5t on teleheal? s]vices 7z def9$ 
9 section #ahcd7m77#d77;,f7 ( ! ,social 
,security ,act 7#db ,u4,s4,c4           
#aciem7m77#d77;,f7771 ) an emphasis on  
und]s]v$ communities1 su* z ! use (     
digital navigators1 provid+ pati5ts )   

pre-visit in=mation on teleheal?1       
c>egiv] engagem5t1 & tra9+ on           
telecommunications sy/ems1 & ! inve/m5ts
 necess>y = heal? c>e pr(essionals to   
effectively furni% teleheal? s]vices1   
includ+ ! co/s ( necess>y te*nology & ( 
tra9+ /aff4  7#b7  ,report  ,n lat] ?an 
#b ye>s aft] ! date ( ! enactm5t ( ?is  
,act1 ! ,secret>y %all submit to        
,congress & make available on ! int]net 
website ( ! ,secret>y ( ,heal? & ,human 
,s]vices a report conta9+ ! results ( ! 
/udy "u p>agraph 7#a71 toge!r )         
recomm5dations = su* legislation &      
adm9i/rative action z ! ,secret>y       
det]m9es appropriate4  7c7 ,fund+ ,!re  
are au?oriz$ to be appropriat$ su* sums 
z necess>y to c>ry out ! provisions (1  
includ+ ! am5dm5ts made by1 ?is section4
  #cjb4 ,provid] supports on teleheal?  
7a7 ,educational res\rces & tra9+       
sessions ,n lat] ?an #f mon?s aft] !    
date ( enactm5t ( ?is ,act1 ! ,secret>y 
( ,heal? & ,human ,s]vices %all develop 
& make available to heal? c>e           

pr(essionals educational res\rces &     
tra9+ sessions on requirem5ts relat+ to 
! furni%+ ( teleheal? s]vices "u section
 #ahcd7m7 ( ! ,social ,security ,act    
7#db ,u4,s4,c4 #aciem7m77 & topics      
includ+--  7#a7 requirem5ts = paym5t =  
teleheal? s]vices2  7#b7                
teleheal?-specific heal? c>e privacy &  
security tra9+2  7#c7 utiliz+ teleheal? 
s]vices to engage & support und]s]v$1   
high-risk1 & vuln]able pati5t           
populations2 &  7#d7 o!r topics z       
det]m9$ appropriate by ! ,secret>y4  7b7
 ,fund+ ,!re are au?oriz$ to be         
appropriat$ su* sums z necess>y to c>ry 
out ?is section4  #cjc4 ,ensur+ !       
inclusion ( teleheal? 9 measur+ quality 
( c>e ,section #ahij;,a ( ! ,social     
,security ,act 7#db ,u4,s4,c4           
#acie;aaa-#a7 is am5d$ by add+ at ! end 
! foll[+ new subsection3  7h7 ,measur+  
quality ( teleheal? s]vices  7#a7 ,9    
g5]al ,n lat] ?an #ahj days aft] ! date 
( ! enactm5t ( ?is subsection1 !        
,secret>y %all review quality measures  

to ensure inclusion ( measures relat+ to
 teleheal? s]vices1 includ+ c>e1        
prev5tion1 diagnosis1 pati5t exp]i5ce1  
heal? outcomes1 & treatm5t4  7#b7       
,consultation ,9 conduct+ ! review &    
assessm5t "u p>agraph 7#a71 ! ,secret>y 
%all consult ext]nal te*nical exp]ts 9  
quality measurem5t1 includ+ pati5t      
organizations1 provid]s1 & exp]ts 9     
teleheal?4  7#c7 ,review & assessm5t ,! 
review & assessm5t "u ?is subsection    
%all-- 7,a7 include review ( exi/+ & "u 
developm5t quality measures to id5tify  
measures t are curr5tly inclusive (1 &  
measures t fail to acc\nt =1 teleheal?  
s]vices2  7,b7 id5tify gaps 9 areas (   
quality measurem5t t relate to teleheal?
 s]vices1 includ+ heal? outcomes &      
pati5t exp]i5ce ( c>e2 &  7,c7 assess h[
 to effectively /reaml9e1 implem5t1 &   
assign acc\ntability = heal? outcomes = 
quality measures = teleheal? s]vices    
across heal? c>e sett+s & provid]s4     
7#d7 ,te*nical guidance ,! ,secret>y    
%all issue te*nical guidance on ! foll[+

 = heal? c>e provid]s & o!r /akehold]s1 
z det]m9$ appropriate by ! ,secret>y3   
7,a7 ,h[ to /ratify measures by c>e     
modality & population to id5tify        
diff]5ces 9 heal? outcomes4  7,b7 ,! use
 ( uni=m data elem5ts4  7,c7 ,h[ to     
id5tify & catalogue be/ practices relat$
 to ! use ( quality measurem5t & quality
 improvem5t = teleheal? s]vices4  7,d7  
,o!r areas det]m9$ appropriate by !     
,secret>y4  7#e7 ,report ,n lat] ?an #b 
ye>s aft] ! date ( ! enactm5t ( ?is     
subsection1 ! ,secret>y %all submit to  
,congress & po/ on ! int]net website ( !
 ,c5t]s = ,m$ic>e  ,m$icaid ,s]vices a  
report on ! review & assessm5t conduct$ 
"u ?is subsection4  4  #cjd4 ,po/+ (    
in=mation on teleheal? s]vices ,n lat]  
?an #ahj days aft] ! date ( ! enactm5t (
 ?is ,act1 & qu>t]ly !reaft]1 !         
,secret>y ( ,heal? & ,human ,s]vices    
%all po/ on ! int]net website ( ! ,c5t]s
 = ,m$ic>e  ,m$icaid ,s]vices in=mation 
on-- 7#a7 ! furni%+ ( teleheal? s]vices 
"u ! ,m$ic>e program "u title ,,xviii ( 

! ,social ,security ,act 7#db ,u4,s4,c4 
#acie et seq471 describ$ by pati5t      
population1 type ( s]vice1 geography1   
place ( s]vice1 & provid] type2  7#b7 ! 
impact ( teleheal? s]vices on           
exp5ditures & utilization "u ! ,m$ic>e  
program = ! mo/ rec5t #d qu>t]s = :i*   
,m$ic>e claims data is available2 &     
7#c7 o!r outcomes relat$ to ! furni%+ ( 
teleheal? s]vices "u ! ,m$ic>e program1 
z det]m9$ appropriate by ! ,secret>y4