,i  #aai? ,,congress  #a/ ,session  ,h4 
,r4 #edif  ,,9 ,,! ,,h\se ,,(           
,,repres5tatives  ,septemb] #ah1        
#bjbe,mr4 ,?ompson ( ,p5nsylvania 7=    
himself & ,ms4 ,tokuda7 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 provide =     
p]man5t paym5ts = teleheal? s]vices     
furni%$ by f$]ally qualifi$ heal? c5t]s 
& rural heal? cl9ics "u ! ,m$ic>e       
program4  #a4 ,%ort title ,?is ,act may 
be cit$ z ! ,help+ ,ensure ,access to   
,local ,tele,health ,act ( #bjbe or !   
,,heal? ,act ( #bjbe4  #b4 ,provid+ =   
p]man5t co/-relat$ paym5ts = teleheal?  
s]vices furni%$ by f$]ally qualifi$     
heal? c5t]s & rural heal? cl9ics "u !   
,m$ic>e program & p]man5tly remov+      

orig9at+ site facility & location       
requirem5ts = di/ant site teleheal?     
s]vices furni%$ by su* c5t]s & su*      
cl9ics  7a7 ,cov]age ( audio-,only      
teleheal? s]vices  7#a7 ,9 g5]al        
,section #ahcd7m77#d7 ( ! ,social       
,security ,act 7#db ,u4,s4,c4           
#aciem7m77#d77 is am5d$ by add+ at ! end
 ! foll[+ new subp>agraph3  7,g7        
,telecommunications sy/em ,except z     
provid$ 9 p>agraph 7#a71 ! t]m          
telecommunications sy/em means a        
two-way1 real-"t int]active             
communications sy/em1 :e!r by           
audiovisual or audio-only               
communications4  4  7#b7 ,requir$       
implem5tation /eps ,n lat] ?an #fj days 
aft] ! date ( ! enactm5t ( ?is ,act1 !  
,secret>y ( ,heal? & ,human ,s]vices    
%all--  7,a7 revise section             
#daj4gh7;a77#c7 ( title #db1 ,code (    
,f$]al ,regulations 7or a successor     
regulation7 to def9e ! t]m int]active   
telecommunications sy/em 9 accordance ) 
! am5dm5t made by p>agraph 7#a72 &  7,b7

 revise section #dje4bdfc ( su* title   
7or a successor regulation7 to provide  
t1 = purposes ( di/ant site teleheal?   
s]vices furni%$ by f$]ally qualifi$     
heal? c5t]s & rural heal? cl9ics "u     
section #ahcd7m77#h7 ( ! ,social        
,security ,act 7#db ,u4,s4,c4           
#aciem7m77#h771 a visit includes any    
two-way1 real-"t int]active             
communication betwe5 an individual & !  
di/ant site ,f$]ally qualifi$ heal? c5t]
 provid] or rural heal? cl9ic1 :e!r by  
audiovisual or audio-only communication4
  7b7 ,p]man5t teleheal? paym5ts        
,section #ahcd7m77#h7 ( ! ,social       
,security ,act 7#db ,u4,s4,c4           
#aciem7m77#h77 is am5d$-- 7#a7 9        
subp>agraph 7,a71 9 ! matt] prec$+      
clause 7i71 by /rik+ ,dur+ ! em]g5cy    
p]iod & all t foll[s ?r\gh #bjbe-- &    
ins]t+ ,) respect to teleheal? s]vices  
furni%$ on or aft] ! date ( ! beg9n+ ( !
 em]g5cy p]iod describ$ 9 section       
#aace7;g77#a77;,b7--2 &  7#b7 by /rik+  
subp>agraph 7,b7 & ins]t+ ! foll[+ new  

subp>agraph3  7,b7 ,paym5t  7i7 ,9 g5]al
 ,a teleheal? s]vice furni%$ by a rural 
heal? cl9ic or a f$]ally qualifi$ heal? 
c5t] s]v+ z a di/ant site to an         
individual %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 rural heal? cl9ic s]vice or 
f$]ally qualifi$ heal? c5t] s]vice 7z   
applicable7 "u section #ahcc7;a77#c7 or 
"u ! prospective paym5t sy/em e/abli%$  
"u section #ahcd7o71 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  7c7    

,elim9ation ( orig9at+ site requirem5ts 
= teleheal? s]vices furni%$ by ,f,q,h,cs
 or ,r,h,cs  7#a7 ,9 g5]al ,section     
#ahcd7m7 ( ! ,social ,security ,act 7#db
 ,u4,s4,c4 #aciem7m771 z am5d$ by       
subsection 7b71 is fur!r am5d$--  7,a7 9
 p>agraph 7#d77;,c77i71 by /rik+ & 7#g7 
& ins]t+ 7#g71 & 7#h72 &  7,b7 9        
p>agraph 7#h71 by add+ at ! end ! foll[+
 new subp>agraph3  7,c7 ,nonapplication 
( orig9at+ site requirem5ts ,!          
geographic & site requirem5ts describ$ 9
 p>agraph 7#d77;,c7 %all n apply )      
respect to teleheal? s]vices furni%$ by 
a f$]ally qualifi$ heal? c5t] or a rural
 heal? cl9ic s]v+ z a di/ant site4  4   
7#b7 ,special paym5t rule = orig9at+    
sites ) respect to teleheal? s]vices    
furni%$ by an ,,fqhc or ,,rhc ,section  
#ahcd7m77#b77;,b7 ( ! ,social ,security 
,act 7#db ,u4,s4,c4 #aciem7m77#b77;,b77 
is am5d$--  7,a7 9 clause 7i71 by /rik+ 
clause 7ii7 & ins]t+ clauses 7ii7 &     
7iii72 &  7,b7 by add+ at ! end ! foll[+
 new clause3  7iii7 ,special rule =     

teleheal? s]vices furni%$ by ,f,q,h,cs &
 ,r,h,cs ,no facility fee %all be paid  
"u ?is subp>agraph to an orig9at+ site )
 respect to teleheal? s]vices furni%$ by
 a f$]ally qualifi$ heal? c5t] or rural 
heal? cl9ic s]v+ z a di/ant site unless 
su* orig9at+ site is a site describ$ 9  
any ( subclauses 7,i7 ?r\gh 7,,ix7 or   
7,,xi7 ( p>agraph 7#d77;,c77ii74  4