Us Congress 2025-2026 Regular Session

Us Congress Senate Bill SB1261 Compare Versions

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Old	New	Differences
1	1	II
2	2	119THCONGRESS
3	3	1
4	4	STSESSION S. 1261
5	5	To amend title XVIII of the Social Security Act to expand access to telehealth
6	6	services, and for other purposes.
7	7	IN THE SENATE OF THE UNITED STATES
8	8	APRIL2, 2025
9	9	Mr. S
10	10	CHATZ(for himself, Mr. WICKER, Mr. WARNER, Mrs. HYDE-SMITH, Mr.
11	11	W
12	12	ELCH, Mr. BARRASSO, Mr. PADILLA, Mr. THUNE, Ms. SMITH, Mr.
13	13	L
14	14	ANKFORD, Ms. CANTWELL, Mr. TUBERVILLE, Mr. HICKENLOOPER, Mr.
15	15	C
16	16	OTTON, Ms. KLOBUCHAR, Mr. SULLIVAN, Mr. FETTERMAN, Mrs. CAP-
17	17	ITO, Mr. MERKLEY, Ms. LUMMIS, Mr. KAINE, Mr. CRAMER, Mrs. SHA-
18	18	HEEN, Mrs. BRITT, Mr. GALLEGO, Mr. MORAN, Mr. LUJA´N, Mr. CAS-
19	19	SIDY, Mr. BLUMENTHAL, Mr. TILLIS, Mr. KING, Mr. JUSTICE, Mr.
20	20	C
21	21	OONS, Mr. SCHMITT, Mr. WHITEHOUSE, Ms. MURKOWSKI, Ms. ROSEN,
22	22	Mr. H
23	23	OEVEN, Mr. BOOKER, Mr. GRASSLEY, Ms. DUCKWORTH, Mr.
24	24	R
25	25	OUNDS, Mr. SANDERS, Mr. MARSHALL, Mr. KELLY, Mrs. FISCHER,
26	26	Mrs. G
27	27	ILLIBRAND, Mr. YOUNG, Mr. HEINRICH, Ms. COLLINS, Mr.
28	28	P
29	29	ETERS, Mr. RICKETTS, Mr. SCHIFF, Mr. MULLIN, Ms. WARREN, Mr.
30	30	G
31	31	RAHAM, Mr. VANHOLLEN, Mr. DAINES, Mr. WARNOCK, and Mr. BOOZ-
32	32	MAN) introduced the following bill; which was read twice and referred to
33	33	the Committee on Finance
34	34	A BILL
35	35	To amend title XVIII of the Social Security Act to expand
36	36	access to telehealth services, and for other purposes.
37	37	Be it enacted by the Senate and House of Representa-1
38	38	tives of the United States of America in Congress assembled, 2
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42	42	SECTION 1. SHORT TITLE; TABLE OF CONTENTS. 1
43	43	(a) S
44	44	HORTTITLE.—This Act may be cited as the 2
45	45	‘‘Creating Opportunities Now for Necessary and Effective 3
46	46	Care Technologies (CONNECT) for Health Act of 2025’’ 4
47	47	or the ‘‘CONNECT for Health Act of 2025’’. 5
48	48	(b) T
49	49	ABLE OFCONTENTS.—The table of contents of 6
50	50	this Act is as follows: 7
51	51	Sec. 1. Short title; table of contents.
52	52	Sec. 2. Findings and sense of Congress.
53	53	TITLE I—REMOVING BARRIERS TO TELEHEALTH COVERAGE
54	54	Sec. 101. Removing geographic requirements for telehealth services.
55	55	Sec. 102. Expanding originating sites.
56	56	Sec. 103. Expanding authority for practitioners eligible to furnish telehealth
57	57	services.
58	58	Sec. 104. Federally qualified health centers and rural health clinics.
59	59	Sec. 105. Native American health facilities.
60	60	Sec. 106. Repeal of six-month in-person visit requirement for telemental health
61	61	services.
62	62	Sec. 107. Waiver of telehealth requirements during public health emergencies.
63	63	Sec. 108. Use of telehealth in recertification for hospice care.
64	64	TITLE II—PROGRAM INTEGRITY
65	65	Sec. 201. Clarification for fraud and abuse laws regarding technologies pro-
66	66	vided to beneficiaries.
67	67	Sec. 202. Additional resources for telehealth oversight.
68	68	Sec. 203. Addressing significant outlier billing patterns for telehealth services.
69	69	TITLE III—BENEFICIARY AND PROVIDER SUPPORTS, QUALITY OF
70	70	CARE, AND DATA
71	71	Sec. 301. Beneficiary engagement on telehealth.
72	72	Sec. 302. Provider supports on telehealth.
73	73	Sec. 303. Ensuring the inclusion of telehealth in measuring quality of care.
74	74	Sec. 304. Posting of information on telehealth services.
75	75	SEC. 2. FINDINGS AND SENSE OF CONGRESS.
76	76	8
77	77	(a) F
78	78	INDINGS.—Congress finds the following: 9
79	79	(1) The use of technology in health care and 10
80	80	coverage of telehealth services are rapidly evolving. 11
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84	84	(2) Research has found that telehealth services 1
85	85	can expand access to care, improve the quality of 2
86	86	care, and reduce spending. 3
87	87	(3) In 2023, 90 percent of patients receiving 4
88	88	telehealth services were satisfied with their experi-5
89	89	ences. 6
90	90	(4) Health care workforce shortages are a sig-7
91	91	nificant problem in many areas and for many types 8
92	92	of health care clinicians. 9
93	93	(5) Telehealth increases access to care in areas 10
94	94	with workforce shortages and for individuals who 11
95	95	live far away from health care facilities, have limited 12
96	96	mobility or transportation, or have other barriers to 13
97	97	accessing care. 14
98	98	(6) The use of health technologies can strength-15
99	99	en the expertise of the health care workforce, includ-16
100	100	ing by connecting clinicians to specialty consulta-17
101	101	tions. 18
102	102	(7) Prior to the COVID–19 pandemic, the utili-19
103	103	zation of telehealth services in the Medicare program 20
104	104	under title XVIII of the Social Security Act (42 21
105	105	U.S.C. 1395 et seq.) was low, accounting for 0.1 22
106	106	percent of Medicare Part B visits in 2019. 23
107	107	(8) Telehealth now represents a critical compo-24
108	108	nent of care delivery. In 2023, 24 percent of Medi-25
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112	112	care fee-for-service beneficiaries received a telehealth 1
113	113	service. 2
114	114	(9) Long-term certainty about coverage of tele-3
115	115	health services under the Medicare program is nec-4
116	116	essary to fully realize the benefits of telehealth. 5
117	117	(b) S
118	118	ENSE OFCONGRESS.—It is the sense of Con-6
119	119	gress that— 7
120	120	(1) health care providers can furnish safe, effec-8
121	121	tive, and high-quality health care services through 9
122	122	telehealth; 10
123	123	(2) the Secretary of Health and Human Serv-11
124	124	ices should promptly take all necessary measures to 12
125	125	ensure that providers and beneficiaries can continue 13
126	126	to furnish and utilize, respectively, telehealth serv-14
127	127	ices in the Medicare program, and support recent 15
128	128	modifications to the definition of ‘‘interactive tele-16
129	129	communications system’’ in regulations and program 17
130	130	instruction under the Medicare program to ensure 18
131	131	that providers can utilize all appropriate means and 19
132	132	types of technology, including audio-visual, audio- 20
133	133	only, and other types of technologies, to furnish tele-21
134	134	health services; and 22
135	135	(3) barriers to the use of telehealth should be 23
136	136	removed. 24
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140	140	TITLE I—REMOVING BARRIERS 1
141	141	TO TELEHEALTH COVERAGE 2
142	142	SEC. 101. REMOVING GEOGRAPHIC REQUIREMENTS FOR 3
143	143	TELEHEALTH SERVICES. 4
144	144	Section 1834(m)(4)(C) of the Social Security Act (42 5
145	145	U.S.C. 1395m(m)(4)(C)) is amended— 6
146	146	(1) in clause (i), in the matter preceding sub-7
147	147	clause (I), by striking ‘‘clause (iii)’’ and inserting 8
148	148	‘‘clauses (iii) and (iv)’’; and 9
149	149	(2) by adding at the end the following new 10
150	150	clause: 11
151	151	‘‘(iv) R
152	152	EMOVAL OF GEOGRAPHIC RE -12
153	153	QUIREMENTS.—The geographic require-13
154	154	ments described in clause (i) shall not 14
155	155	apply with respect to telehealth services 15
156	156	furnished on or after October 1, 2025.’’. 16
157	157	SEC. 102. EXPANDING ORIGINATING SITES. 17
158	158	(a) I
159	159	NGENERAL.—Section 1834(m)(4)(C)(iii) of the 18
160	160	Social Security Act (42 U.S.C. 1395m(m)(4)(C)(iii)) is 19
161	161	amended by striking ‘‘In the case that’’ and all that fol-20
162	162	lows through ‘‘September 30, 2025,’’ and inserting ‘‘Be-21
163	163	ginning on the date of the enactment of the CONNECT 22
164	164	for Health Act of 2025,’’. 23
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168	168	(b) CONFORMINGAMENDMENTS.—Section 1834(m) 1
169	169	of the Social Security Act (42 U.S.C. 1395m(m)) is 2
170	170	amended— 3
171	171	(1) in paragraph (2)(B)(iii), by striking ‘‘In the 4
172	172	case that’’ and all that follows through ‘‘September 5
173	173	30, 2025,’’ and inserting ‘‘With respect to telehealth 6
174	174	services furnished on or after the date of the enact-7
175	175	ment of the CONNECT for Health Act of 2025,’’; 8
176	176	and 9
177	177	(2) in paragraph (4)(C)(ii)(X), by striking ‘‘, 10
178	178	but only for purposes of section 1881(b)(3)(B) or 11
179	179	telehealth services described in paragraph (7)’’. 12
180	180	SEC. 103. EXPANDING AUTHORITY FOR PRACTITIONERS EL-13
181	181	IGIBLE TO FURNISH TELEHEALTH SERVICES. 14
182	182	Section 1834(m)(4)(E) of the Social Security Act (42 15
183	183	U.S.C. 1395m(m)(4)(E)) is amended— 16
184	184	(1) by striking ‘‘P
185	185	RACTITIONER.—The term’’ 17
186	186	and inserting ‘‘P
187	187	RACTITIONER.— 18
188	188	‘‘(i) I
189	189	N GENERAL.—Subject to clause 19
190	190	(ii), the term’’; and 20
191	191	(2) by adding at the end the following new 21
192	192	clause: 22
193	193	‘‘(ii) E
194	194	XPANDING PRACTITIONERS ELI -23
195	195	GIBLE TO FURNISH TELEHEALTH SERV -24
196	196	ICES.— 25
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200	200	‘‘(I) IN GENERAL .—Notwith-1
201	201	standing any other provision of this 2
202	202	subsection, in the case of telehealth 3
203	203	services furnished on or after October 4
204	204	1, 2025, the Secretary may waive any 5
205	205	limitation on the types of practitioners 6
206	206	who are eligible to furnish telehealth 7
207	207	services if the Secretary determines 8
208	208	that such waiver is clinically appro-9
209	209	priate. 10
210	210	‘‘(II) I
211	211	MPLEMENTATION.—In im-11
212	212	plementing a waiver under this clause, 12
213	213	the Secretary may establish require-13
214	214	ments, as appropriate, for practi-14
215	215	tioners under such waiver, including 15
216	216	with respect to beneficiary and pro-16
217	217	gram integrity protections. 17
218	218	‘‘(III) P
219	219	UBLIC COMMENT .—The 18
220	220	Secretary shall establish a process by 19
221	221	which stakeholders may (on at least 20
222	222	an annual basis) provide public com-21
223	223	ment on such waiver under this 22
224	224	clause. 23
225	225	‘‘(IV) P
226	226	ERIODIC REVIEW.—The 24
227	227	Secretary shall periodically, but not 25
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231	231	more frequently than every 3 years, 1
232	232	reassess the waiver under this clause 2
233	233	to determine whether such waiver con-3
234	234	tinues to be clinically appropriate. The 4
235	235	Secretary shall terminate any waiver 5
236	236	that the Secretary determines is no 6
237	237	longer clinically appropriate.’’. 7
238	238	SEC. 104. FEDERALLY QUALIFIED HEALTH CENTERS AND 8
239	239	RURAL HEALTH CLINICS. 9
240	240	Section 1834(m) of the Social Security Act (42 10
241	241	U.S.C. 1395m(m)) is amended— 11
242	242	(1) in paragraph (4)(C)(i), in the matter pre-12
243	243	ceding subclause (I), by striking ‘‘and (7)’’ and in-13
244	244	serting ‘‘(7), and (8)’’; and 14
245	245	(2) in paragraph (8)— 15
246	246	(A) in subparagraph (A)— 16
247	247	(i) in the matter preceding clause (i), 17
248	248	by striking ‘‘During’’ and all that follows 18
249	249	through ‘‘September 30, 2025’’ and insert-19
250	250	ing the following: ‘‘Beginning on the first 20
251	251	day of the emergency period described in 21
252	252	section 1135(g)(1)(B)’’; 22
253	253	(ii) in clause (ii), by striking ‘‘and’’ at 23
254	254	the end; 24
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258	258	(iii) by redesignating clause (iii) as 1
259	259	clause (iv); and 2
260	260	(iv) by inserting after clause (ii) the 3
261	261	following new clause: 4
262	262	‘‘(iii) the geographic requirements de-5
263	263	scribed in paragraph (4)(C)(i) shall not 6
264	264	apply with respect to such a telehealth 7
265	265	service; and’’; 8
266	266	(B) in subparagraph (B)— 9
267	267	(i) in the subparagraph heading, by 10
268	268	inserting ‘‘
269	269	DURING INITIAL PERIOD’’ after 11
270	270	‘‘
271	271	RULE’’; 12
272	272	(ii) in the first sentence of clause (i) 13
273	273	by striking ‘‘during the periods for which 14
274	274	subparagraph (A) applies’’ and inserting 15
275	275	‘‘during the period beginning on the first 16
276	276	day of the emergency period and ending on 17
277	277	September 30, 2025’’; and 18
278	278	(iii) in clause (ii), by striking ‘‘Costs 19
279	279	associated’’ and inserting ‘‘During the pe-20
280	280	riod for which clause (i) applies, costs as-21
281	281	sociated’’; 22
282	282	(C) by adding at the end the following new 23
283	283	subparagraph: 24
284	284	‘‘(C) P
285	285	AYMENT AFTER INITIAL PERIOD .— 25
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289	289	‘‘(i) IN GENERAL.—A telehealth serv-1
290	290	ice furnished by a Federally qualified 2
291	291	health center or a rural health clinic to an 3
292	292	individual pursuant to this paragraph on 4
293	293	or after October 1, 2025, shall be deemed 5
294	294	to be so furnished to such individual as an 6
295	295	outpatient of such clinic or facility (as ap-7
296	296	plicable) for purposes of paragraph (1) or 8
297	297	(3), respectively, of section 1861(aa) and 9
298	298	payable as a Federally qualified health cen-10
299	299	ter service or rural health clinic service (as 11
300	300	applicable) under the prospective payment 12
301	301	system established under section 1834(o) 13
302	302	or under section 1833(a)(3), respectively. 14
303	303	‘‘(ii) T
304	304	REATMENT OF COSTS FOR 15
305	305	FQHC PPS CALCULATIONS AND RHC AIR 16
306	306	CALCULATIONS.—Costs associated with the 17
307	307	furnishing of telehealth services by a Fed-18
308	308	erally qualified health center or rural 19
309	309	health clinic serving as a distant site pur-20
310	310	suant to this paragraph on or after Octo-21
311	311	ber 1, 2025, shall be considered allowable 22
312	312	costs for purposes of the prospective pay-23
313	313	ment system established under section 24
314	314	1834(o) and any payment methodologies 25
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318	318	developed under section 1833(a)(3), as ap-1
319	319	plicable.’’. 2
320	320	SEC. 105. NATIVE AMERICAN HEALTH FACILITIES. 3
321	321	(a) I
322	322	NGENERAL.—Section 1834(m)(4)(C) of the So-4
323	323	cial Security Act (42 U.S.C. 1395m(m)(4)(C)), as amend-5
324	324	ed by section 101, is amended— 6
325	325	(1) in clause (i), by striking ‘‘and (iv)’’ and in-7
326	326	serting ‘‘, (iv), and (v)’’; and 8
327	327	(2) by adding at the end the following new 9
328	328	clause: 10
329	329	‘‘(v) N
330	330	ATIVE AMERICAN HEALTH FA -11
331	331	CILITIES.—With respect to telehealth serv-12
332	332	ices furnished on or after January 1, 2026, 13
333	333	the originating site requirements described 14
334	334	in clauses (i) and (ii) shall not apply with 15
335	335	respect to a facility of the Indian Health 16
336	336	Service, whether operated by such Service, 17
337	337	or by an Indian tribe (as that term is de-18
338	338	fined in section 4 of the Indian Health 19
339	339	Care Improvement Act (25 U.S.C. 1603)) 20
340	340	or a tribal organization (as that term is 21
341	341	defined in section 4 of the Indian Self-De-22
342	342	termination and Education Assistance Act 23
343	343	(25 U.S.C. 5304)), or a facility of the Na-24
344	344	tive Hawaiian health care systems author-25
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348	348	ized under the Native Hawaiian Health 1
349	349	Care Improvement Act (42 U.S.C. 11701 2
350	350	et seq.).’’. 3
351	351	(b) N
352	352	OORIGINATINGSITEFACILITYFEE FORCER-4
353	353	TAIN NATIVE AMERICAN FACILITIES.—Section 5
354	354	1834(m)(2)(B)(i) of the Social Security Act (42 U.S.C. 6
355	355	1395m(m)(2)(B)(i)) is amended, in the matter preceding 7
356	356	subclause (I), by inserting ‘‘(other than an originating site 8
357	357	that is only described in clause (v) of paragraph (4)(C), 9
358	358	and does not meet the requirement for an originating site 10
359	359	under clauses (i) and (ii) of such paragraph)’’ after ‘‘the 11
360	360	originating site’’. 12
361	361	SEC. 106. REPEAL OF SIX-MONTH IN-PERSON VISIT RE-13
362	362	QUIREMENT FOR TELEMENTAL HEALTH 14
363	363	SERVICES. 15
364	364	(a) I
365	365	NGENERAL.—Section 1834(m)(7) of the Social 16
366	366	Security Act (42 U.S.C. 1395m(m)(7)(B)) is amended— 17
367	367	(1) in subparagraph (A), by striking ‘‘, subject 18
368	368	to subparagraph (B),’’; 19
369	369	(2) by striking ‘‘(A) I
370	370	N GENERAL.—The geo-20
371	371	graphic’’ and inserting ‘‘The geographic’’; and 21
372	372	(3) by striking subparagraph (B). 22
373	373	(b) R
374	374	URALHEALTHCLINICS.—Section 1834(y)(2) of 23
375	375	the Social Security Act (42 U.S.C. 1395m(y)(2)) is 24
376	376	amended by striking ‘‘prior to October 1, 2025’’. 25
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380	380	(c) FEDERALLYQUALIFIEDHEALTHCENTERS.— 1
381	381	Section 1834(o)(4)(B) of the Social Security Act (42 2
382	382	U.S.C. 1395m(o)(4)(B)) is amended by striking ‘‘prior to 3
383	383	October 1, 2025’’. 4
384	384	SEC. 107. WAIVER OF TELEHEALTH REQUIREMENTS DUR-5
385	385	ING PUBLIC HEALTH EMERGENCIES. 6
386	386	Section 1135(g)(1) of the Social Security Act (42 7
387	387	U.S.C. 1320b–5(g)(1)) is amended— 8
388	388	(1) in subparagraph (A), in the matter pre-9
389	389	ceding clause (i), by striking ‘‘subparagraph (B)’’ 10
390	390	and inserting ‘‘subparagraphs (B) and (C)’’; and 11
391	391	(2) by adding at the end the following new sub-12
392	392	paragraph: 13
393	393	‘‘(C) E
394	394	XCEPTION FOR WAIVER OF TELE -14
395	395	HEALTH REQUIREMENTS DURING PUBLIC 15
396	396	HEALTH EMERGENCIES .—For purposes of sub-16
397	397	section (b)(8), in addition to the emergency pe-17
398	398	riod described in subparagraph (B), an ‘emer-18
399	399	gency area’ is a geographical area in which, and 19
400	400	an ‘emergency period’ is the period during 20
401	401	which, there exists a public health emergency 21
402	402	declared by the Secretary pursuant to section 22
403	403	319 of the Public Health Service Act on or 23
404	404	after the date of enactment of this subpara-24
405	405	graph.’’. 25
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409	409	SEC. 108. USE OF TELEHEALTH IN RECERTIFICATION FOR 1
410	410	HOSPICE CARE. 2
411	411	(a) I
412	412	NGENERAL.—Section 1814(a)(7)(D)(i)(II) of 3
413	413	the Social Security Act (42 U.S.C. 1395f(a)(7)(D)(i)(II)) 4
414	414	is amended by striking ‘‘during the emergency period’’ and 5
415	415	all that follows through ‘‘September 30, 2025’’ and insert-6
416	416	ing the following: ‘‘during and after the emergency period 7
417	417	described in section 1135(g)(1)(B)’’. 8
418	418	(b) GAO R
419	419	EPORT.—Not later than 3 years after the 9
420	420	date of enactment of this Act, the Comptroller General 10
421	421	of the United States shall submit to Congress a report 11
422	422	evaluating the impact of section 1814(a)(7)(D)(i)(II) of 12
423	423	the Social Security Act (42 U.S.C. 1395f(a)(7)(D)(i)(II)), 13
424	424	as amended by subsection (a), on— 14
425	425	(1) the number and percentage of beneficiaries 15
426	426	recertified for the Medicare hospice benefit at 180 16
427	427	days and for subsequent benefit periods, to the ex-17
428	428	tent such data is available; 18
429	429	(2) Federal oversight of the appropriateness for 19
430	430	hospice care of the patients recertified through the 20
431	431	use of telehealth; and 21
432	432	(3) any other factors determined appropriate by 22
433	433	the Comptroller General. 23
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437	437	TITLE II—PROGRAM INTEGRITY 1
438	438	SEC. 201. CLARIFICATION FOR FRAUD AND ABUSE LAWS 2
439	439	REGARDING TECHNOLOGIES PROVIDED TO 3
440	440	BENEFICIARIES. 4
441	441	Section 1128A(i)(6) of the Social Security Act (42 5
442	442	U.S.C. 1320a–7a(i)(6)) is amended— 6
443	443	(1) in subparagraph (I), by striking ‘‘; or’’ and 7
444	444	inserting a semicolon; 8
445	445	(2) in subparagraph (J), by striking the period 9
446	446	at the end and inserting ‘‘; or’’; and 10
447	447	(3) by adding at the end the following new sub-11
448	448	paragraph: 12
449	449	‘‘(K) the provision of technologies (as de-13
450	450	fined by the Secretary) on or after the date of 14
451	451	the enactment of this subparagraph, by a pro-15
452	452	vider of services or supplier (as such terms are 16
453	453	defined for purposes of title XVIII) directly to 17
454	454	an individual who is entitled to benefits under 18
455	455	part A of title XVIII, enrolled under part B of 19
456	456	such title, or both, for the purpose of furnishing 20
457	457	telehealth services, remote patient monitoring 21
458	458	services, or other services furnished through the 22
459	459	use of technology (as defined by the Secretary), 23
460	460	if— 24
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464	464	‘‘(i) the technologies are not offered 1
465	465	as part of any advertisement or solicita-2
466	466	tion; and 3
467	467	‘‘(ii) the provision of the technologies 4
468	468	meets any other requirements set forth in 5
469	469	regulations promulgated by the Sec-6
470	470	retary.’’. 7
471	471	SEC. 202. ADDITIONAL RESOURCES FOR TELEHEALTH 8
472	472	OVERSIGHT. 9
473	473	In addition to amounts otherwise available, there are 10
474	474	authorized to be appropriated to the Inspector General of 11
475	475	the Department of Health and Human Services for each 12
476	476	of fiscal years 2026 through 2030, out of any money in 13
477	477	the Treasury not otherwise appropriated, $3,000,000, to 14
478	478	remain available until expended, for purposes of con-15
479	479	ducting audits, investigations, and other oversight and en-16
480	480	forcement activities with respect to telehealth services, re-17
481	481	mote patient monitoring services, or other services fur-18
482	482	nished through the use of technology (as defined by the 19
483	483	Secretary). 20
484	484	SEC. 203. ADDRESSING SIGNIFICANT OUTLIER BILLING 21
485	485	PATTERNS FOR TELEHEALTH SERVICES. 22
486	486	(a) I
487	487	DENTIFICATION AND NOTIFICATION OF 23
488	488	O
489	489	UTLIERBILLERS OFTELEHEALTH.— 24
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493	493	(1) IN GENERAL.—The Secretary shall, using 1
494	494	standard unique health identifiers (described in sec-2
495	495	tion 1173(b) of the Social Security Act (42 U.S.C. 3
496	496	1320d–2) reported on claims for telehealth services 4
497	497	furnished to individuals under section 1834(m) of 5
498	498	such Act (42 U.S.C. 1395m(m)), identify physicians 6
499	499	and practitioners that demonstrate significant 7
500	500	outlier billing patterns (such as coding of telehealth 8
501	501	services for inappropriate length of time and inac-9
502	502	curate complexity and inappropriate or duplicate 10
503	503	billing) for telehealth services or items or services or-11
504	504	dered or prescribed concurrent to a telehealth service 12
505	505	over a period of time specified by the Secretary. 13
506	506	(2) E
507	507	STABLISHMENT OF THRESHOLDS .—For 14
508	508	purposes of this subsection, the Secretary shall es-15
509	509	tablish thresholds for outlier billing patterns to iden-16
510	510	tify whether a physician or practitioner is a signifi-17
511	511	cant outlier biller for telehealth services or items or 18
512	512	services ordered or prescribed concurrent to a tele-19
513	513	health service as compared to other physicians or 20
514	514	practitioners within the same specialty and geo-21
515	515	graphic area. 22
516	516	(b) N
517	517	OTIFICATION.— 23
518	518	(1) I
519	519	N GENERAL.—The Secretary shall notify 24
520	520	physicians and practitioners identified as a signifi-25
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524	524	cant outlier biller for telehealth services or items or 1
525	525	services ordered or prescribed concurrent to a tele-2
526	526	health service under subsection (a). Each notifica-3
527	527	tion under the preceding sentence shall include the 4
528	528	following: 5
529	529	(A) Information on how the physician or 6
530	530	practitioner compares to physicians or practi-7
531	531	tioners within the same specialty and geo-8
532	532	graphic area with respect to billing for tele-9
533	533	health services or items or services ordered or 10
534	534	prescribed concurrent to a telehealth service 11
535	535	under the Medicare program under title XVIII 12
536	536	of the Social Security Act (42 U.S.C. 1395 et 13
537	537	seq.). 14
538	538	(B) Information on telehealth billing guide-15
539	539	lines under the Medicare program. 16
540	540	(C) Other information determined appro-17
541	541	priate by the Secretary. 18
542	542	(2) C
543	543	LARIFICATION.—Nothing in this sub-19
544	544	section or subsection (a) shall be construed as di-20
545	545	recting the Centers for Medicare & Medicaid Serv-21
546	546	ices to pursue further audits of providers of services 22
547	547	and suppliers outside of those permitted or required 23
548	548	under titles XI or XVIII of the Social Security Act, 24
549	549	or otherwise under applicable Federal law. 25
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553	553	(c) PUBLICAVAILABILITY OFINFORMATION.—The 1
554	554	Secretary shall make aggregate information on outlier bill-2
555	555	ing patterns identified under subsection (a) available on 3
556	556	the internet website of the Centers for Medicare & Med-4
557	557	icaid Services. Such information shall be in a form and 5
558	558	manner determined appropriate by the Secretary and shall 6
559	559	not identify any specific physician or practitioner. 7
560	560	(d) O
561	561	THERACTIVITIES.—Nothing in this section 8
562	562	shall preclude the Secretary from conducting activities 9
563	563	that provide physicians and practitioners with information 10
564	564	as to how they compare to other physicians and practi-11
565	565	tioners that are in addition to the activities under this sec-12
566	566	tion. 13
567	567	(e) T
568	568	ELEHEALTHRESOURCECENTERSEDUCATION 14
569	569	A
570	570	CTIVITIES.—Section 330I(j)(2) of the Public Health 15
571	571	Service Act (42 U.S.C. 254c–14(j)(2)) is amended— 16
572	572	(1) in subparagraph (F), by striking ‘‘and’’ at 17
573	573	the end; 18
574	574	(2) in subparagraph (G), by striking the period 19
575	575	at the end and inserting ‘‘; and’’; and 20
576	576	(3) by adding at the end the following new sub-21
577	577	paragraph: 22
578	578	‘‘(H) providing technical assistance and 23
579	579	education to physicians and practitioners that 24
580	580	the Secretary identifies pursuant to section 25
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584	584	203(a) of the CONNECT for Health Act of 1
585	585	2025 as having significant levels of outlier bill-2
586	586	ing patterns with respect to telehealth services 3
587	587	or items or services ordered or prescribed con-4
588	588	current to a telehealth service under the Medi-5
589	589	care program under title XVIII of the Social 6
590	590	Security Act, including— 7
591	591	‘‘(i) education on practices to ensure 8
592	592	coding of telehealth services for appro-9
593	593	priate length of time and accurate com-10
594	594	plexity; 11
595	595	‘‘(ii) education on prevention of inap-12
596	596	propriate or duplicate billing; 13
597	597	‘‘(iii) information provided in the an-14
598	598	nual physician fee schedule rulemaking re-15
599	599	garding— 16
600	600	‘‘(I) services specified in para-17
601	601	graph (4)(F)(i) of section 1834(m) of 18
602	602	the Social Security Act (42 U.S.C. 19
603	603	1395m(m)) for authorized payment 20
604	604	under paragraph (1) of such section; 21
605	605	and 22
606	606	‘‘(II) the process used to update 23
607	607	such services under paragraph 24
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611	611	(4)(F)(ii) of such section 1834(m); 1
612	612	and 2
613	613	‘‘(iv) referral to the appropriate medi-3
614	614	care administrative contractor for specific 4
615	615	questions that fall outside of the scope of 5
616	616	broad best practices.’’. 6
617	617	(f) D
618	618	EFINITIONS.—In this section: 7
619	619	(1) S
620	620	ECRETARY.—The term ‘‘Secretary’’ means 8
621	621	the Secretary of Health and Human Services. 9
622	622	(2) T
623	623	ELEHEALTH SERVICE .—The term ‘‘tele-10
624	624	health service’’ has the meaning given that term in 11
625	625	section 1834(m)(4)(F) of the Social Security Act 12
626	626	(42 U.S.C. 1395m(m)(4)(F)). 13
627	627	(3) P
628	628	HYSICIAN; PRACTITIONER.—The terms 14
629	629	‘‘physician’’ and ‘‘practitioner’’ have the meaning 15
630	630	given those terms for purposes of section 1834(m) of 16
631	631	the Social Security Act (42 U.S.C. 1395m(m)). 17
632	632	TITLE III—BENEFICIARY AND 18
633	633	PROVIDER SUPPORTS, QUAL-19
634	634	ITY OF CARE, AND DATA 20
635	635	SEC. 301. BENEFICIARY ENGAGEMENT ON TELEHEALTH. 21
636	636	(a) R
637	637	ESOURCES, GUIDANCE, ANDTRAININGSES-22
638	638	SIONS.—Section 1834(m) of the Social Security Act (42 23
639	639	U.S.C. 1395m(m)) is amended by adding at the end the 24
640	640	following new paragraph: 25
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644	644	‘‘(10) RESOURCES, GUIDANCE, AND TRAINING 1
645	645	SESSIONS.— 2
646	646	‘‘(A) I
647	647	N GENERAL.—Not later than 6 3
648	648	months after the date of the enactment of this 4
649	649	paragraph, the Secretary, in consultation with 5
650	650	stakeholders, shall issue resources, guidance, 6
651	651	and training sessions for beneficiaries, physi-7
652	652	cians, practitioners, and health information 8
653	653	technology software vendors on best practices 9
654	654	for ensuring telehealth services are accessible 10
655	655	for— 11
656	656	‘‘(i) individuals with limited English 12
657	657	proficiency, including instructions on how 13
658	658	to— 14
659	659	‘‘(I) access telehealth platforms; 15
660	660	‘‘(II) utilize interpreter services; 16
661	661	and 17
662	662	‘‘(III) integrate telehealth and 18
663	663	virtual interpreter services; and 19
664	664	‘‘(ii) individuals with disabilities, in-20
665	665	cluding instructions on accessibility of the 21
666	666	telecommunications system being used for 22
667	667	telehealth services, engagement with bene-23
668	668	ficiaries with disabilities prior to, during, 24
669	669	and after the furnishing of the telehealth 25
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672	672	•S 1261 IS
673	673	service, and training on captioning and 1
674	674	transcripts. 2
675	675	‘‘(B) A
676	676	CCOUNTING FOR AGE AND OTHER 3
677	677	DIFFERENCES.—Resources, guidance, and 4
678	678	training sessions issued under this paragraph 5
679	679	shall account for age and sociodemographic, ge-6
680	680	ographic, literacy, cultural, cognitive, and lin-7
681	681	guistic differences in how individuals interact 8
682	682	with technology.’’. 9
683	683	(b) S
684	684	TUDY ANDREPORT ONTACTICSTOIMPROVE 10
685	685	B
686	686	ENEFICIARYENGAGEMENT ON TELEHEALTH.— 11
687	687	(1) S
688	688	TUDY.—The Secretary of Health and 12
689	689	Human Services shall, to the maximum extent fea-13
690	690	sible, collect and analyze qualitative and quantitative 14
691	691	data on strategies that clinicians, payers, and other 15
692	692	health care organizations use to improve beneficiary 16
693	693	engagement on telehealth services (as defined in sec-17
694	694	tion 1834(m)(4)(F) of the Social Security Act (42 18
695	695	U.S.C. 1395m(m)(4)(F))), with an emphasis on un-19
696	696	derserved communities, such as the use of digital 20
697	697	navigators, providing patients with pre-visit informa-21
698	698	tion on telehealth, caregiver engagement, and train-22
699	699	ing on telecommunications systems, and the invest-23
700	700	ments necessary for health care professionals to ef-24
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704	704	fectively furnish telehealth services, including the 1
705	705	costs of necessary technology and of training staff. 2
706	706	(2) R
707	707	EPORT.—Not later than 2 years after the 3
708	708	date of the enactment of this Act, the Secretary 4
709	709	shall submit to Congress and make available on the 5
710	710	internet website of the Secretary of Health and 6
711	711	Human Services a report containing the results of 7
712	712	the study under paragraph (1), together with rec-8
713	713	ommendations for such legislation and administra-9
714	714	tive action as the Secretary determines appropriate. 10
715	715	(c) F
716	716	UNDING.—There are authorized to be appro-11
717	717	priated such sums as necessary to carry out the provisions 12
718	718	of, including the amendments made by, this section. 13
719	719	SEC. 302. PROVIDER SUPPORTS ON TELEHEALTH. 14
720	720	(a) E
721	721	DUCATIONALRESOURCES AND TRAININGSES-15
722	722	SIONS.—Not later than 6 months after the date of enact-16
723	723	ment of this Act, the Secretary of Health and Human 17
724	724	Services shall develop and make available to health care 18
725	725	professionals educational resources and training sessions 19
726	726	on requirements relating to the furnishing of telehealth 20
727	727	services under section 1834(m) of the Social Security Act 21
728	728	(42 U.S.C. 1395m(m)) and topics including— 22
729	729	(1) requirements for payment for telehealth 23
730	730	services; 24
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734	734	(2) telehealth-specific health care privacy and 1
735	735	security training; 2
736	736	(3) utilizing telehealth services to engage and 3
737	737	support underserved, high-risk, and vulnerable pa-4
738	738	tient populations; and 5
739	739	(4) other topics as determined appropriate by 6
740	740	the Secretary. 7
741	741	(b) F
742	742	UNDING.—There are authorized to be appro-8
743	743	priated such sums as necessary to carry out this section. 9
744	744	SEC. 303. ENSURING THE INCLUSION OF TELEHEALTH IN 10
745	745	MEASURING QUALITY OF CARE. 11
746	746	Section 1890A of the Social Security Act (42 U.S.C. 12
747	747	1395aaa–1) is amended by adding at the end the following 13
748	748	new subsection: 14
749	749	‘‘(h) M
750	750	EASURINGQUALITY OFTELEHEALTHSERV-15
751	751	ICES.— 16
752	752	‘‘(1) I
753	753	N GENERAL.—Not later than 180 days 17
754	754	after the date of the enactment of this subsection, 18
755	755	the Secretary shall review quality measures to en-19
756	756	sure inclusion of measures relating to telehealth 20
757	757	services, including care, prevention, diagnosis, pa-21
758	758	tient experience, health outcomes, and treatment. 22
759	759	‘‘(2) C
760	760	ONSULTATION.—In conducting the review 23
761	761	and assessment under paragraph (1), the Secretary 24
762	762	shall consult external technical experts in quality 25
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766	766	measurement, including patient organizations, pro-1
767	767	viders, and experts in telehealth. 2
768	768	‘‘(3) R
769	769	EVIEW AND ASSESSMENT .—The review 3
770	770	and assessment under this subsection shall— 4
771	771	‘‘(A) include review of existing and under 5
772	772	development quality measures to identify meas-6
773	773	ures that are currently inclusive of, and meas-7
774	774	ures that fail to account for, telehealth services; 8
775	775	‘‘(B) identify gaps in areas of quality 9
776	776	measurement that relate to telehealth services, 10
777	777	including health outcomes and patient experi-11
778	778	ence of care; and 12
779	779	‘‘(C) assess how to effectively streamline, 13
780	780	implement, and assign accountability for health 14
781	781	outcomes for quality measures for telehealth 15
782	782	services across health care settings and pro-16
783	783	viders. 17
784	784	‘‘(4) T
785	785	ECHNICAL GUIDANCE .—The Secretary 18
786	786	shall issue technical guidance on the following for 19
787	787	health care providers and other stakeholders, as de-20
788	788	termined appropriate by the Secretary: 21
789	789	‘‘(A) How to stratify measures by care mo-22
790	790	dality and population to identify differences in 23
791	791	health outcomes. 24
792	792	‘‘(B) The use of uniform data elements. 25
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796	796	‘‘(C) How to identify and catalogue best 1
797	797	practices related to the use of quality measure-2
798	798	ment and quality improvement for telehealth 3
799	799	services. 4
800	800	‘‘(D) Other areas determined appropriate 5
801	801	by the Secretary. 6
802	802	‘‘(5) R
803	803	EPORT.—Not later than 2 years after the 7
804	804	date of the enactment of this subsection, the Sec-8
805	805	retary shall submit to Congress and post on the 9
806	806	internet website of the Centers for Medicare & Med-10
807	807	icaid Services a report on the review and assessment 11
808	808	conducted under this subsection.’’. 12
809	809	SEC. 304. POSTING OF INFORMATION ON TELEHEALTH 13
810	810	SERVICES. 14
811	811	Not later than 180 days after the date of the enact-15
812	812	ment of this Act, and quarterly thereafter, the Secretary 16
813	813	of Health and Human Services shall post on the internet 17
814	814	website of the Centers for Medicare & Medicaid Services 18
815	815	information on— 19
816	816	(1) the furnishing of telehealth services under 20
817	817	the Medicare program under title XVIII of the So-21
818	818	cial Security Act (42 U.S.C. 1395 et seq.), described 22
819	819	by patient population, type of service, geography, 23
820	820	place of service, and provider type; 24
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824	824	(2) the impact of telehealth services on expendi-1
825	825	tures and utilization under the Medicare program 2
826	826	for the most recent 4 quarters for which Medicare 3
827	827	claims data is available; and 4
828	828	(3) other outcomes related to the furnishing of 5
829	829	telehealth services under the Medicare program, as 6
830	830	determined appropriate by the Secretary. 7
831	831	Æ
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