[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[H.R. 2263 Introduced in House (IH)]
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119th CONGRESS
1st Session
H. R. 2263
To amend title XVIII of the Social Security Act to make permanent
certain telehealth flexibilities under the Medicare program, and for
other purposes.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
March 21, 2025
Mr. Khanna introduced the following bill; which was referred to the
Committee on Energy and Commerce, and in addition to the Committee on
Ways and Means, for a period to be subsequently determined by the
Speaker, 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 program, and for
other purposes.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Telehealth Coverage Act of 2025''.
SEC. 2. MAKING PERMANENT CERTAIN TELEHEALTH FLEXIBILITIES UNDER
MEDICARE.
(a) Expanded Access to Telehealth Services.--Section 1834(m) of the
Social Security Act (42 U.S.C. 1395m(m)) is amended--
(1) in paragraph (2)(B)(iii), by striking ``In the case
that'' and all that follows through ``ending March 31, 2025,''
and inserting ``With respect to telehealth services that are
furnished on or after the first day of the emergency period
described in section 1135(g)(1)(B),''; and
(2) in paragraph (4)(C)(iii), by striking ``In the case
that'' and all that follows through ``ending on March 31,
2025,'' and inserting ``With respect to telehealth services
that are furnished on or after the first day of the emergency
period described in section 1135(g)(1)(B),''.
(b) Expansion of Practitioners Eligible To Furnish Telehealth
Services.--Section 1834(m)(4)(E) of the Social Security Act (42 U.S.C.
1395m(m)(4)(E)) is amended by striking ``in the case that'' and all
that follows through ``ending on March 31, 2025,'' and inserting
``beginning on the first day of the emergency period described in
section 1135(g)(1)(B),''.
(c) Extension of Telehealth Services Furnished by Federally
Qualified Health Centers and Rural Health Clinics.--Section
1834(m)(8)(A) of the Social Security Act (42 U.S.C. 1395m(m)(8)(A)) is
amended by striking ``During the emergency'' and all that follows
through ``ending on March 31, 2025'' and inserting ``Beginning on the
first day of the emergency period described in section 1135(g)(1)(B)''.
(d) Treatment of Telehealth Services Furnished Using Audio-Only
Telecommunications Technology.--Section 1834(m)(9) of the Social
Security Act (42 U.S.C. 1395m(m)(9)) is amended--
(1) by striking ``In the case that'' and all that follows
through ``the Secretary shall continue to'' and inserting ``The
Secretary shall'';
(2) by striking ``identified in paragraph (4)(F)(i) as of
the date of the enactment of this paragraph''; and
(3) 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
1135(g)(1)(B).''.
(e) Elimination of In-Person Requirements Under Medicare for
Certain Services Furnished Through Telehealth.--
(1) Home dialysis monthly esrd-related visit; stroke
telehealth services; substance use disorder services and mental
health services.--
(A) In general.--Section 1834(m) of the Social
Security Act (42 U.S.C. 1395m(m)) is amended by
striking paragraphs (5) through (7) and redesignating
paragraphs (8) and (9) as paragraphs (5) and (6),
accordingly.
(B) Conforming changes.--Section 1834(m) of the
Social Security Act (42 U.S.C. 1395m(m)) is amended--
(i) in paragraph (1), by striking ``Subject
to paragraphs (8) and (9)'' and inserting
``Subject to paragraphs (5) and (6)'';
(ii) in paragraph (2)--
(I) in subparagraph (A), by
striking ``Subject to paragraph (8)''
and inserting ``Subject to paragraph
(5)''; and
(II) in subparagraph (B), by
striking ``and paragraph (6)(C)''; and
(iii) in paragraph (4)--
(I) in subparagraph (A), by
striking ``Subject to paragraph (8)''
and inserting ``Subject to paragraph
(5)'';
(II) in subparagraph (C)--
(aa) in clause (i), by
striking ``and paragraphs (5),
(6), and (7)''; and
(bb) in clause (ii)(X), by
striking ``or telehealth
services described in paragraph
(7)''; and
(III) in subparagraph (F), by
striking ``Subject to paragraph (8)''
and inserting ``Subject to paragraph
(5)''.
(2) Mental health visits furnished by federally qualified
health centers.--Section 1834(o)(4)(B) of the Social Security
Act (42 U.S.C. 1395m(o)(4)(B)) is amended by striking ``prior
to April 1, 2025''.
(3) Mental health visits furnished by rural health
clinics.--Section 1834(y)(2) of the Social Security Act (42
U.S.C. 1395m(y)(2)) is amended by striking ``prior to April 1,
2025''.
(f) Use of Telehealth To Conduct Face-to-face Encounter Prior to
Recertification of Eligibility for Hospice Care.--Section
1814(a)(7)(D)(i)(II) of the Social Security Act (42 U.S.C.
1395f(a)(7)(D)(i)(II)) is amended--
(1) by striking ``during the emergency period'' and all
that follows through ``and ending on March 31, 2025'' and
inserting ``beginning on the first day of the emergency period
described in section 1135(g)(1)(B)''; and
(2) by inserting ``, except that this subclause shall not
apply in the case of such an encounter with an individual
occurring on or after March 31, 2025, 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 1866(j)(7), if such individual is receiving hospice
care from a provider that is subject to enhanced oversight
under this title pursuant to section 1866(j)(3), or if such
encounter is performed by a hospice physician or nurse
practitioner who is not enrolled under section 1866(j) and is
not an opt-out physician or practitioner (as defined in section
1802(b)(6)(D))'' before the semicolon.
(g) Requiring Modifiers for Telehealth Services in Certain
Instances.--Section 1834(m) of the Social Security Act (42 U.S.C.
1395m(m)) is amended by adding at the end the following new paragraph:
``(10) Required use of modifiers in certain instances.--Not
later than January 1, 2026, the Secretary shall establish
requirements to include 1 or more codes or modifiers, as
determined appropriate by the Secretary, in the case of--
``(A) claims for telehealth services under this
subsection that are furnished through a telehealth
virtual platform--
``(i) by a physician or practitioner that
contracts with an entity that owns such virtual
platform; or
``(ii) for which a physician or
practitioner has a payment arrangement with an
entity for use of such virtual platform; and
``(B) claims for telehealth services under this
subsection that are furnished incident to a physician's
or practitioner's professional service.''.
(h) Program Instruction Authority.--The Secretary of Health and
Human Services may implement the amendments made by this section
through program instruction or otherwise.
SEC. 3. REQUIRING MODIFIER FOR USE OF TELEHEALTH TO CONDUCT FACE-TO-
FACE ENCOUNTER PRIOR TO RECERTIFICATION OF ELIGIBILITY
FOR HOSPICE CARE.
Section 1814(a)(7)(D)(i)(II) of the Social Security Act (42 U.S.C.
1395f(a)(7)(D)(i)(II)), as amended by section 2(f), is further amended
by inserting ``, but only if, in the case of such an encounter
occurring on or after January 1, 2026, any hospice claim includes 1 or
more modifiers or codes (as specified by the Secretary) to indicate
that such encounter was conducted via telehealth'' after ``as
determined appropriate by the Secretary''.
SEC. 4. EXTENDING ACUTE HOSPITAL CARE AT HOME WAIVER FLEXIBILITIES.
Section 1866G(a)(1) of the Social Security Act (42 U.S.C. 1395cc-
7(a)(1)) is amended by striking ``during the period'' and all that
follows through ``March 31, 2025'' and inserting ``on or after the
first day after the end of the emergency period described in section
1135(g)(1)(B)''.
SEC. 5. GUIDANCE ON FURNISHING SERVICES VIA TELEHEALTH TO INDIVIDUALS
WITH LIMITED ENGLISH PROFICIENCY.
(a) In General.--Not later than 1 year after the date of the
enactment of this section, the Secretary of Health and Human Services,
in consultation with 1 or more entities from each of the categories
described in paragraphs (1) through (7) of subsection (b), shall issue
and disseminate, or update and revise as applicable, guidance for the
entities described in such subsection on the following:
(1) Best practices on facilitating and integrating use of
interpreters during a telemedicine appointment.
(2) Best practices on providing accessible instructions on
how to access telecommunications systems (as such term is used
for purposes of section 1834(m) of the Social Security Act (42
U.S.C. 1395m(m)) for individuals with limited English
proficiency.
(3) Best practices on improving access to digital patient
portals for individuals with limited English proficiency.
(4) 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 proficiency.
(5) Best practices for providing patient materials,
communications, and instructions in multiple languages,
including text message appointment reminders and prescription
information.
(b) Entities Described.--For purposes of subsection (a), an entity
described in this subsection is an entity in 1 or more of the following
categories:
(1) Health information technology service providers,
including--
(A) electronic medical record companies;
(B) remote patient monitoring companies; and
(C) telehealth or mobile health vendors and
companies.
(2) Health care providers, including--
(A) physicians; and
(B) hospitals.
(3) Health insurers.
(4) Language service companies.
(5) Interpreter or translator professional associations.
(6) Health and language services quality certification
organizations.
(7) Patient and consumer advocates, including such
advocates that work with individuals with limited English
proficiency.
SEC. 6. IN-HOME CARDIOPULMONARY REHABILITATION FLEXIBILITIES.
(a) In General.--Section 1861(eee)(2) of the Social Security Act
(42 U.S.C. 1395x(eee)(2)) is amended--
(1) in subparagraph (A)(ii), by inserting ``(including,
with respect to items and services furnished through audio and
video real-time communications technology (excluding audio-
only) on or after March 31, 2025, in the home of an individual
who is an outpatient of the hospital)'' after ``outpatient
basis''; and
(2) in subparagraph (B), by inserting ``(including, with
respect to items and services furnished through audio and video
real-time communications technology on or after March 31, 2025,
the virtual presence of such physician, physician assistant,
nurse practitioner, or clinical nurse specialist)'' after
``under the program''.
(b) Program Instruction Authority.--Notwithstanding any other
provision of law, the Secretary of Health and Human Services may
implement the amendments made by this section by program instruction or
otherwise.
SEC. 7. INCLUSION OF VIRTUAL DIABETES PREVENTION PROGRAM SUPPLIERS IN
MDPP EXPANDED MODEL.
(a) In General.--Not later than January 1, 2026, the Secretary
shall revise the regulations under parts 410 and 424 of title 42, Code
of Federal Regulations, to provide that, beginning January 1, 2026--
(1) 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 (as specified in section
424.205(b) of title 42, Code of Federal Regulations (or a
successor regulation));
(2) if an entity participates in the MDPP in the manner
described in paragraph (1)--
(A) the administrative location of such entity
shall be the address of the entity on file under the
Diabetes Prevention Recognition Program; and
(B) 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 furnished, 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 time; and
(3) no limit is applied on the number of times an
individual may enroll in the MDPP.
(b) Definitions.--In this section:
(1) MDPP.--The term ``MDPP'' means the Medicare Diabetes
Prevention Program conducted under section 1115A of the Social
Security Act (42 U.S.C. 1315a), as described in the final rule
published in the Federal Register entitled ``Medicare and
Medicaid Programs; CY 2024 Payment Policies Under the Physician
Fee Schedule and Other Changes to Part B Payment and Coverage
Policies; Medicare Shared Savings Program Requirements;
Medicare Advantage; Medicare and Medicaid Provider and Supplier
Enrollment Policies; and Basic Health Program'' (88 Fed. Reg.
78818 (November 16, 2023)) (or a successor regulation).
(2) Regulatory terms.--The terms ``Diabetes Prevention
Recognition Program'', ``full CDC DPRP recognition'', ``MDPP
beneficiary'', ``MDPP services'', and ``MDPP supplier'' have
the meanings given each such term in section 410.79(b) of title
42, Code of Federal Regulations.
(3) Secretary.--The term ``Secretary'' means the Secretary
of Health and Human Services.
SEC. 8. MEDICATION-INDUCED MOVEMENT DISORDER OUTREACH AND EDUCATION.
Not later than January 1, 2026, 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
(42 U.S.C. 1395 et seq.) with respect to periodic screening for
medication-induced movement disorders that are associated with the
treatment of mental health disorders in at-risk patients, as well as
resources related to clinical guidelines and best practices for
furnishing such screening services through telehealth. Such education
and outreach shall include information on how to account for such
screening services in evaluation and management code selection. The
Secretary shall, to the extent practicable, seek input from relevant
stakeholders to inform such education and outreach. Such education and
outreach may also address other relevant screening services furnished
through telehealth, as the Secretary determines appropriate.
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