Executive Summary: Tracking Telehealth Changes State-by-State in Response to COVID-19 (UPDATED) | Manatt, Phelps & Phillips, LLP

Bill/Activity Key Proposed Actions Activity  

In March 2021, MedPAC issued a report entitled “Medicare Payment Policy.”

The report included a chapter that proposes how Medicare may cover telehealth services for a limited duration of time after the end of the COVID-19 PHE; the commission noted that more time and data are needed prior to recommending permanent coverage and reimbursement changes. Specifically, MedPAC proposes temporarily continuing the following flexibilities for a limited duration of time after the end of the PHE:

  • Providing reimbursement for specific telehealth services to all beneficiaries, regardless of their location;
  • Covering certain telehealth services (in addition to those covered prior to the PHS), if there is potential clinical benefit; and,
  • Covering certain telehealth services delivered via audio-only modalities if there is potential clinical benefit.

After the PHE ends, MedPAC proposes: 1) returning to the fee schedule’s facility rate for telehealth services and collecting data on the cost to deliver telehealth services; and, 2) reintroducing cost sharing for telehealth services. In addition, MedPAC suggests implementing the following safeguards to prevent unnecessary spending and fraud:

  • Requiring clinicians to have an in-person visits with a patient prior to ordering high-cost durable medical equipment or laboratory tests;
  • Monitoring outlier clinicians who bill more telehealth services per beneficiary relative to other clinicians; and,
  • Prohibiting “incident to” billing for telehealth services provided by any clinician who can bill Medicare directly.

Notably, the path forward proposed by MedPAC in this report does not ensure long-term permanent coverage for telehealth for all Medicare members regardless of where they are located (e.g., patients in non-rural areas, patients located in their home), or for telehealth services delivered via audio-only modalities.

On March 5th, the House Energy & Commerce Health Subcommittee held a hearing, The Future of Telehealth: How COVID-19 is Changing the Delivery of Virtual Care to discuss the future of telehealth in Medicare.

Members of the sub-committee were not aligned on a timeline for adopting permanent telehealth reimbursement policies in Medicare, but generally voiced support for continuing many of the flexibilities that have been implemented during the public health emergency. While acknowledging the value that telehealth has demonstrated during the pandemic, many members continue to express long-standing concerns about the potential for increased fraud and abuse of telehealth services.

On January 14th, MedPAC hosted a meeting to discuss whether and how to permanently expand telehealth in fee-for-service Medicare.

The Commissioners largely supported the policy options outlined by MedPAC staff to maintain on a permanent basis some of the temporary policy changes made during the PHE. Several commissioners noted that given the pace of change with respect to telehealth adoption during the COVID-19 pandemic and the lack of concrete evidence to support permanent expansion of certain policies, they would be more comfortable supporting expansion on a more time-limited basis (e.g. 1-2 years) than permanently. In addition, the Commissioners identified several areas that will require continued discussion in order to balance access, cost and quality imperatives.

The policy options will be incorporated into MedPAC’s upcoming report to Congress expected in March 2021.

For more information regarding the MedPAC meeting, please see our Manatt Insights Newsletter.

On November 9, MedPac issued a report on the expansion of telehealth in Medicare.

The presentation highlights permanent (post-PHE) policy options that CMS may consider when expanding Medicare telehealth coverage.

For more information, please see our Manatt Newsletter.

Introduced Legislation  

S. 237: To preserve access to abortion medications.

Introduced 2/02/23

  • This bill would ensure that the FDA risk evaluation and mitigation strategies applied to mifepristone:
    • Do not have an in-person dispensing requirement;
    • Allow for patient access via telehealth; and,
    • Allow all pharmacies that are certified to dispense mifepristone to, at a minimum, dispense and mail the medication to patients.

H.R. 635: Expanding Access to Mental Health Services Act

Introduced 1/20/23

  • This bill would allow certain HCPCS codes for behavioral health counseling and other services to covered via audio-only telehealth within the Medicare program.

H.R. 134: To amend title XVIII of the Social Security Act to remove geographic requirements and expand originating sites for telehealth services.

Introduced January 9, 2023

  • This bill would extend COVID-19 PHE Medicare geographic flexibilities for originating sites permanently.

H.R. 197: Rural Telehealth Expansion Act

Introduced January 9, 2023

  • This bill would enable coverage and reimbursement for store-and-forward telehealth under the Medicare program.

H.R. 207: Advanced Safe Testing at Residence Telehealth Act of 2023

Introduced January 9, 2023

  • This bill would amend Title XVII of the Social Security act to provide payment for cover certain tests (e.g., serology tests for COVID-19, diagnostic tests or screenings for certain types of cancer, Haptoglobin genetic tests, prediabetes and diabetes screenings, etc.)  and assistive telehealth consultations (e.g., an evaluation and management service; the ordering of a diagnostic test or screening; an assessment of an individual succeeding the delivery of a diagnostic test or screening; etc.) under state programs.

S. 4965: A bill to amend title XCIII of the Social Security Act to remove in-person requirements under Medicare for mental health services furnished through telehealth and telecommunications technology.

Introduced September 27, 2022

  • This bill would permanently remove in-person requirements for mental health services delivered via telehealth to Medicare beneficiaries after the end of the COVID-19 public health emergency.

H.R. 8976: Protecting Reproductive Freedom Act

Introduced September 22, 2022

  • This bill would prevent states from placing restrictions on the prescription of mifepristone and misoprostol, two abortifacient medications, via telehealth.

S. 4747: Investing in Kids’ Mental Health Now Act of 2022

Introduced August 2, 2022

  • This bill would direct the Secretary of Health and Human Services to provide states with guidance to improve the availability of mental, emotional, and behavioral telehealth services covered by Medicaid State Plans.

HR.R. 8650 / S. 4723: Let Doctors Provide Reproductive Health Care Act

Introduced August 2, 2022

  • This bill would prevent states and other entities from placing restrictions on the provision of reproductive health care services, including abortion services, through telehealth.

H.R. 8588: Fair Care Act of 2022

Introduced July 28, 2022

  • This bill would:
    • Expand Medicare coverage to include remote patient monitoring and additional telehealth services;
    • Allow the Secretary of Health and Human Services to waive Medicare telehealth requirements, including those related to originating sites, technology, and allowed services, to reduce spending or improve access to services in high-needs areas;
    • Remove Medicare restrictions on originating sites for mental health services and emergency medical care provided through telehealth;
    • Remove Medicare restrictions on originating/distant sites for federally qualified health centers, rural health clinics, and facilities operated by the Indian Health Service;
    • Allow under Medicare the use of telehealth to conduct face-to-face encounters prior to recertification of eligibility for hospice care;
    • Direct MedPAC to conduct a study on the use of telehealth in the home by Medicare beneficiaries; and,
    • Allow the Secretary of Health and Human Services to test models of telehealth use and delivery under Medicare.

H.R. 4040: Advancing Telehealth Beyond COVID-19 Act of 2022

Engrossed July 27, 2022

  • This legislation seeks to extend many of the key Medicare telehealth flexibilities associated with the COVID-19 public health emergency (PHE) included in the Consolidated Appropriations Act, 2022 (CAA), enacted in March (for more on the CAA, see the Manatt on Health analysis).  The House-passed legislation would further extend the following flexibilities through December 31, 2024:
    • Removing geographic requirements and expanding originating sites for telehealth services to enable beneficiaries in both rural and non-rural communities to receive telehealth services from their home or any other location;
    • Expanding the list of telehealth eligible providers include qualified occupational therapists, physical therapists, speech-language therapists, and audiologists.
    • Delaying in-person visit requirements for the delivery of mental health services via telehealth, including those furnished by rural health clinics and federally qualified health clinics;
    • Including audio-only as a covered telehealth modality; and,
    • Allowing the use of telehealth to conduct a face-to-face encounter prior to recertification of eligibility for hospice care.

H.R. 8489: Greater Access to Telehealth Act

Introduced July 26, 2022

  • This bill would:
    • Remove geographic requirements and expand originating sites for telehealth services;
    • Expand practitioners eligibility to furnish telehealth services through December 31, 2026;
    • Extend telehealth services for federally qualified Health Centers and Rural Health Clinics to end before December 31, 2026;
    • Delay the in-person requirements under Medicare for mental health services furnished through telehealth and telecommunications technology;
    • Allow for the furnishing of Audio-Only telehealth services through December 31, 2026; and,
    • Allow the use of telehealth to conduct face-to-face encounter prior to recertification of eligibility for hospice care during the emergency period through December 31, 2026.

H.R. 8506: To amend title XVIII of the Social Security Act to extend telehealth services for federally qualified health centers and rural health clinics.

Introduced July 26, 2022

  • This bill would permanently extend Medicare coverage for telehealth services provided by federally qualified health centers and rural health clinics beyond the end of the COVID-19 public health emergency.

H.R. 8505: To amend title XVIII of the Social Security Act to permit the use of telehealth for purposes of recertification of eligibility for hospice care.

Introduced July 26, 2022

  • This bill would allow under Medicare the use of telehealth to conduct face-to-face encounters prior to recertification of eligibility for hospice care.

H.R. 8515: To amend title XVIII of the Social Security Act to allow for the furnishing of audio-only telehealth services.

Introduced July 26, 2022

  • This bill would permanently extend Medicare coverage of audio-only telehealth services beyond the end of the COVID-19 public health emergency.

H.R. 8493: To amend title XVIII of the Social Security Act to remove geographic requirements and expand originating sites for telehealth services.

Introduced July 26, 2022

  • This bill would permanently expand Medicare flexibilities regarding originating sites and geographic requirements beyond the end of the COVID-19 public health emergency.

H.R. 8491:To amend title XVIII of the Social Security Act to expand eligible practitioners to furnish telehealth services.

Introduced July 26, 2022

  • This bill would permanently allow occupational therapists, physical therapists, speech-language pathologists, and audiologists to practice via telehealth beyond the end of the COVID-19 public health emergency.

H.R. 8497: To amend title XVIII of the Social Security Act to remove in-person requirements under Medicare for mental health services furnished through telehealth and telecommunications technology.

Introduced July 26, 2022

  • This bill would permanently remove in-person requirements for telehealth services provided to Medicare beneficiaries beyond the end of the COVID-19 public health emergency.

H.R. 8405 / S. 4467: Protecting Access to Medication Abortion Act

H.R. 8405 Introduced July 18, 2022

S.4467 Introduced June 23, 2022

  • This bill would protect access to medication abortion via telehealth and certified pharmacies, including mail-order pharmacies, by codifying current the current FDA mifepristone Risk Evaluation and Mitigation Strategy (REMS).

H.R. 8296: Women’s Health Protection Act of 2022

Engrossed July 15, 2022

  • This bill would limit government restrictions on the provision of abortion services, including medication abortion services delivered via telehealth.  

H.R.7900: National Defense Authorization Act for Fiscal Year 2023

Engrossed July 14, 2022

  • This bill will expand access to behavioral health care under the military health system using telehealth.
  • This bill will also introduce the Telehealth Pilot Program on Sexual Health, which would:
    • Direct the Defense Health Agency to carry out a five-year telehealth pilot program for sexual health for members of the uniformed services on active duty enrolled in TRICARE Prime; and,
    • Extend telehealth screenings and assessment of the participant’s sexual health, comprehensive counseling on a full range of methods of contraception, diagnostic services, prescription medications as appropriate, laboratory diagnostic services, and follow up remote appointments.

S. 4498: Kids’ Mental Health Improvement Act

Introduced June 23, 2022

  • This bill would direct the Secretary of Health and Human Services to publish guidance for states to improve the availability of telehealth services covered by Medicaid State Plans.

S. 4486: Health Equity and Accountability Act of 2022

Introduced June 23, 2022

  • This bill would direct the Secretary of Health and Human Services to:
    • Work with state representatives, physician and non-physician health care practitioners, and advocates to promote telehealth provisions that allow practitioners to provide services across state lines; and,
    • Publish guidance for states to improve telehealth accessibility under Medicaid and CHIP.
  • This bill would also:
    • Direct the Comptroller General to report to Congress on the use of telehealth by State Medicaid programs to improve maternity care access;
    • Direct the Secretary of Veterans Affairs to develop pilot projects to evaluate the cost-effectiveness of telehealth and how it impacts health outcomes in rural areas and those with medically underserved populations; and,
  • Amend the Social Security Act to remove restrictions on and allow the home and other locations to be considered geographic originating sites for telehealth.

H.R. 8169: Rural Telehealth Access Task Force Act

Introduced June 22, 2022

  • This bill would create a Rural Telehealth Access Task Force for the purpose of improving access to broadband internet and the use of telehealth services in rural areas.

H.R. 8180: Undertaking Needed Investments in Therapy, Education, and De-Escalation Act of 2022

Introduced June 22, 2022

  • This bill would extend authorized emergency telehealth services two years following the end of the COVID-19 emergency.

H.R. 7878: Kidney Health Connect Act of 2022

Introduced May 24, 2022

  • This bill would allow for renal dialysis facilities to serve as originating sites for telehealth services under the Medicare program.

H.R.7876: Connecting Rural Telehealth to the Future Act

Introduced May 24, 2022

  • This bill would extend Medicare telehealth flexibilities implemented during the COVID-19 Public Health Emergency and would:
    • Extend all temporary telehealth provisions included in the FY2022 omnibus through December 31, 2024
    • Permanently allow the use of audio-only telehealth flexibilities for two years
  • Permanently allow audio-only technologies when providers are evaluating or managing patient health or providing behavioral health services

H.R. 7666: Restoring Hope for Mental Health and Well-Being Act of 2022

Introduced May 6, 2022

  • This bill would provide grant support to schools and emergency departments to establish or expand existing pediatric mental health care telehealth access programs.

H.R. 7585: Health Equity and Accountability Act of 2022

Introduced April 26, 2022

  • This bill would direct the Secretary of Health and Human Services to:
    • Work with state representatives, physician and non-physician health care practitioners, and advocates to promote telehealth provisions that allow practitioners to provide services across state lines; and,
    • Publish guidance for states to improve telehealth accessibility under Medicaid and CHIP.
  • This bill would also:
    • Direct the Comptroller General to report to Congress on the use of telehealth by State Medicaid programs to improve maternity care access;
    • Direct the Secretary of Veterans Affairs to develop pilot projects to evaluate the cost-effectiveness of telehealth and how it impacts health outcomes in rural areas and those with medically underserved populations; and,
    • Amend the Social Security Act to remove restrictions on and allow the home and other locations to be considered geographic originating sites for telehealth.

H.R. 7573: Telehealth Extension and Evaluation Act

Introduced April 26, 2022

  • This bill aims to extend certain telehealth flexibilities enabled by Medicare for two years following the COVID-19 pandemic. It would allow:
    • Limitation on payment for high-cost medical equipment via telehealth
    • Limitation on payment for high-cost laboratory tests via telehealth
    • A telehealth service provided by a Federally Qualified Health Center or Rural Clinic to be reimbursed as an outpatient service
    • Telehealth flexibilities at critical access hospitals, including payment for telehealth services that are furnished via a telecommunications system
    • The use of telehealth for the dispensing of controlled substances by means of the internet
  • This act would also fund a study on the effects of changes to telehealth under the Medicare and Medicaid programs during the COVID–19 emergency.

S. 4132: Women’s Health Protection Act of 2022

Introduced May 4, 2022

(Note: Failed to pass the Senate on May 11, 2022)

  • This bill would protect a provider’s ability to perform and a patients ability to receive abortion services, including via telehealth.

Telehealth Extension and Evaluation Act

Introduced on Feb. 7, 2022

  • This bill would allow Centers for Medicare and Medicaid Services (CMS) to extend Medicare payments for a variety of telehealth services, and commission a study on the impact of the pandemic telehealth flexibilities.

S. 150: Ensuring Parity in MA for Audio-Only Telehealth Act of 2021

Reintroduced Feb. 2, 2021

  • Requires Medicare to factor certain qualifying diagnosis obtained through telehealth during the PHE when setting risk adjustment payments in Medicare Advantage plans in future years
  • Requires any payment made for a telehealth service during the PHE under the new risk adjust to be the same as the in-person rate

S. 155: Equal Access to Care Act

Reintroduced Feb. 2, 2021

  • Allows licensed health care providers to provide health care services in a secondary state under the rules and regulations that govern them in their primary state
  • If passed, the bill would remain in effect for up to 180 days after the PHE ends

S. 340: Telehealth Response for E-prescribing Addiction Therapy Services (TREATS) Act

Reintroduced Feb. 22, 2021

  • Extends ability to prescribe Medication Assisted Therapies (MAT) and other necessary drugs without needing a prior in-person visit
  • Enables Medicare to cover audio-only telehealth services for substance use disorder services in a case where a provider has already conducted an in-person or telehealth evaluation

S. 368: Telehealth Modernization Act

Reintroduced Feb. 23, 2021

  • Remove geographic barriers for originating site
  • Require telehealth services to be covered by Medicare at FQHCs and RHCs
  • Direct HHS to permanently expand the telehealth services covered by Medicare during the PHE
  • Require Medicare to cover additional telehealth services for hospice and home dialysis care

S. 445: Mainstreaming Addiction Treatment Act of 2021

Reintroduced Feb. 25, 2021

  • Allows community health practitioners to dispense narcotic drugs in schedule III, IV, or V, to an individual for maintenance treatment or detoxification through the practice of telemedicine

S. 620: KEEP Telehealth Options Act of 2021

Reintroduced Mar. 9, 2021

  • Directs the HHS Secretary and the Comptroller General of the United States to conduct studies and report to Congress on actions taken to expand access to telehealth services under the Medicare, Medicaid, and Children’s Health Insurance programs during the COVID-19 emergency

S. 660: Tele-Mental Health Improvement Act

Introduced March 10, 2021

  • A bill to require parity in the coverage of mental health and substance use disorder services provided to enrollees in private insurance plans, whether such services are provided in-person or through telehealth.

S. 801: Connected MOM Act

Introduced Mar. 17, 2021

  • Requires Health and Human Services to identify and address barriers to coverage of remote physiologic devices under State Medicaid programs to improve maternal and child health outcomes for pregnant and postpartum women

S. 1309: Home Health Emergency Access to Telehealth (HEAT) Act

Introduced Apr. 28, 2021

  • Gives the Centers for Medicare & Medicaid Services (CMS) the authority to issues waivers to allow payments for home health services furnished via visual or audio telecommunication systems during an emergency period

S. 1704/H.R.5981: Telehealth Expansion Act

S. 1704 introduced May 19, 2021

H.R. 5981 introduced November 15, 2021

  • Permanently allows first-dollar coverage of virtual care under high-deductible health plans (HDHPs)
  • Allows access to a wider variety of telehealth services without first meeting a deductible

S. 2061: Telemental Healthcare Access Act of 2021

Introduced June 15, 2021

  • Expands access to telemental health services by removing statutory requirement that Medicare beneficiaries be seen in-person within six months of being treated for mental health services through telehealth

S. 2097: Telehealth Health Savings Account (HSA) Act

Introduced June 17, 2021

  • Allow employers to offer high-deductible health plans that include telehealth services without limiting employees’ ability to use health savings accounts.

S. 2110: Increasing Rural Telehealth Access Act of 2021

Introduced June 17, 2021

  • Expands access to health care by improving remote patient monitoring technology for individuals in rural areas

S. 2111: Audio-Only Telehealth for Emergencies Act

Introduced June 17, 2021

  • Allow physicians delivering care during a public health emergency or a major disaster declaration to receive the same compensation for audio-only telehealth visits as they would receive for in-person appointments

S. 2173: Promoting Responsible and Effective Virtual Experiences through Novel Technology to Deliver Improved Access and Better Engagement with Tested and Evidence-based Strategies (PREVENT DIABETES) Act

Reintroduced June 22, 2021

  • Enables Medicare coverage of connected health services in the MDPP (Medicare Diabetes Prevention Program)

S. 2197: Rural and Fronteir Telehealth Expansion Act

Introduced June 23, 2021

  • Amends title XIX of the Social Security Act to increase the Federal medical assistance percentage for States that provide Medicaid coverage for telehealth services.

H.R. 318: Safe Testing at Residence Telehealth Act of 2021

Reintroduced Jan. 13, 2021

  • Provides Medicare payment of telehealth assessments provided in relation to COVID-19
  • Requires Medicare payment of COVID-19 blood tests ordered via telehealth during the PHE
  • Requires practitioners to report demographic data with respects to tests and services ordered via telehealth

H.R. 341: Ensuring Telehealth Expansion Act of 2021

Reintroduced Jan. 15, 2021

  • Extend telehealth provisions in the CARES Act through December 31, 2025
  • Require payment parity for telehealth services furnished at FQHCs and RHCs
  • Allows the use of telehealth to conduct a face-to-face encounters for recertification of eligibility for hospice care

H.R. 366: Protecting Access to Post-COVID-19 Telehealth Act of 2021

Reintroduced Jan. 19, 2021

  • Eliminate most geographic and originating site restrictions in Medicare and establish the patient’s home as an eligible distant site
  • Authorize CMS to continue reimbursement for telehealth for 90 days beyond the end of the PHE
  • Allow HHS to expand telehealth in Medicare during all future emergencies
  • Require a study on the use of telehealth during COVID-19

H.R. 596: The Advancing Connectivity During the Coronavirus to Ensure Support for Seniors (ACCESS) Act

Reintroduced Jan. 28, 2021

  • Allows HHS Telehealth Resource Center to allocate $50 million to expand Medicare and Medicaid coverage of telehealth services in nursing facilities
  • Creates a grant for nursing homes to offer virtual visits

H.R. 708: Temporary Reciprocity to Ensure Access to Treatment Act (TREAT)

Reintroduced Jan. 19, 2021

  • Note: H.R. 708 is nearly identical in scope to the Equal Access to Care Act (see S.155 above), with the exception that H.R. 708 would grant HHS authority to unilaterally create similar temporary licensure regulations in the event of future public health or other emergencies

H.R. 726: COVID–19 Testing, Reaching, And Contacting Everyone (TRACE) Act

Introduced Feb. 2, 2021

  • Authorizes the Secretary of Health and Human Services to award grants to eligible entities to conduct diagnostic testing for COVID-19, and related activities

H.R. 937: Tech To Save Moms Act

Introduced Feb. 8, 2021

  • Amends title XI of the Social Security Act to integrate telehealth models in maternity care services, and for other purposes

H.R. 1149: Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act of 2021
Reintroduced for fourth time on Apr. 29, 2021 with overwhelming support (sponsored by 50 bi-partisan senators)

  • Permanently removes the Medicare geographic restrictions and allow the home to be an originating site for mental telehealth services
  • Remove the geographic and distant site restrictions for federally qualified health centers (FQHCs) and rural health clinics (RHCs)
  • Allows the HHS secretary to waive telehealth restrictions
  • Encourages CMS Innovation Center to test more payment models that include telehealth

H.R. 1397: Telehealth Improvement for Kids’ Essential Services (TIKES) Act 

Reintroduced Feb. 26, 2021

  • Provide states with guidance and strategies to increase telehealth access for Medicaid and Children’s Health Insurance Program (CHIP) populations. Guidance and strategies will include:
    • Delivery of covered telehealth services
    • Recommended voluntary billing codes, modifiers, and place-of-service designations
    • Simplifications or alignment of provider licensing, credentialing, and enrollment
    • Existing strategies States can use to integrate telehealth into value-based health care models
    • Examples of States that have used waivers under the Medicaid program to test expanded access to telehealth
  • Require a Medicaid and CHIP Payment and Access Commission (MACPAC) study examining data and information on the impact of telehealth on the Medicaid population
  • Require a Government Accountability Office (GAO) study reviewing coordination among federal agency telehealth policies and examine opportunities for better collaboration, as well as opportunities for telehealth expansion into early care and education settings

H.R. 1406: COVID-19 Emergency Telehealth Impact Reporting Act

Reintroduced Feb. 26, 2021

  • Require HHS to study telehealth use during the pandemic and impact on care delivery

H.R. 2166: Ensuring Parity in MA and PACE for Audio-Only Telehealth Act

Bill text not yet available at the time of publication. Introduced Mar. 23, 2021

  • Requires the inclusion of certain audio-only diagnoses in the determination of risk adjustment for Medicare Advantage plans and PACE programs, and for other purposes.

H.R. 2168: Expanded Telehealth Access Act

Bill text not yet available at the time of publication. Introduced Mar. 23, 2021

  • Allows on a permanent basis the HHS Secretary to expand the list of healthcare providers who would be able to use the connected health program including: physical and occupational therapists, audiologists, and speech and language pathologists

H.R. 2228: Rural Behavioral Health Access Act

Bill text not yet available at the time of publication.
Introduced Mar. 26, 2021

  • Allows for payment of outpatient critical access hospital services furnished through telehealth under the Medicare program, including behavioral health services such as psychotherapy

H.R. 2903: CONNECT for Health Act

Introduced Apr. 28, 2021

  • Amends title XVIII of the Social Security Act to expand access to telehealth services

H.R. 3371: Home Health Emergency Access to Telehealth (HEAT) Act

Reintroduced May 20, 2021

  • Gives the Centers for Medicare & Medicaid Services (CMS) the authority to issues waivers to allow payments for home health services furnished via visual or audio telecommunication systems during an emergency period

H.R. 3447: Permanency for Audio-Only Telehealth Act

Introduced May 20, 2021

  • Allows Medicare coverage of audio-only telehealth services after the COVID-19 public health emergency

H.R. 3755: Women’s Health Protection Act of 2021

Reintroduced June 8, 2021

  • Allows health care providers to provide abortion services via telemedicine

H.R. 4012: Expanding Access to Mental Health Services Act
Introduced June 17, 2021

Bill text not yet available at the time of publication.

  • Permanently broadens mental health options, including intake examinations and therapy, via telehealth for Medicare members.

H.R. 4036/S.2112: Enhance Access to Support Essential Behavioral Health Services (EASE) Act
S. 2112 introduced June 17, 2021

H.R. 4036 Introduced June 22, 2021

  • Permanently allows Medicare and Medicaid to reimburse for all behavioral health services for children, seniors and those on disability.

H.R. 4058 / S.2061: Telemental Health Care Access Act of 2021
S. 2061 introduced June 15, 2021

H.R. 4058 introduced June 22, 2021

  • Expands access to telemental health services by removing statutory requirement that Medicare members be seen in-person within six months of being treated for mental health services through telehealth.

H.R. 4437: HEALTH Act of 2021

Introduced July 16, 2021

  • Amends title XVIII of the Social Security Act to permanently provide reimbursement to Federally qualified health centers (FQHCs) and rural health clinics (RHCs) under the Medicare program for services delivered via telehealth.

H.R. 4480

Introduced July 16, 2021

  • Requires group health plans and health insurance issuers offering group or individual health insurance coverage to provide coverage for services furnished via telehealth if such services would be covered if furnished in-person.

H.R. 4670: Advanced Safe Testing at Residence Telehealth Act (A-START)

Introduced July 22, 2021

  • Enables individuals who receive care through Medicare Advantage, Medicaid, and the Veterans Affairs to receive FDA-approved at-home tests at home in conjunction with an assistive telehealth consultations

H.R. 4748: Helping Every American Link To Healthcare Act of 2021

Introduced July 28, 2021

  • Allows providers to furnish telehealth services using any non-public facing audio or video communication product during the 7-year period beginning the last day of the public health emergency

H.R. 4770: Evaluating Disparities and Outcomes of Telehealth (EDOT) During the COVID-19 Emergency Act of 2021

Introduced July 28, 2021

Requires the Secretary of HHS to conduct a study evaluating the effects of changes to telehealth under Medicare and Medicaid during the COVID-19 emergency.

H.R. 4918: Rural Telehealth Expansion Act

Introduced Aug. 3, 2021

Amends the Social Security Act to include store-and- forward technologies as telecommunications systems through which telehealth services may be furnished for payment under the Medicare program.

H.R. 5248: Temporary Responders for Immediate Aid in Grave Emergencies Act of 2021

Introduced Sept. 14, 2021

Authorizes the HRSA Provider Bridge Program to:

  • Streamline the process for mobilizing health care professionals during the COVID-19 pandemic and future public health emergencies, including by utilization communications pathways and new technologies; and,
  • Connect health care professionals with state agencies and health care entities to quickly increase access to care for patients via telehealth.

H.R. 5425: Protecting Rural Telehealth Access Act

Introduced Sept. 29, 2021

  • Amends title XVIII of the Social Security Act to protect access to telehealth services under the Medicare program
  • Eliminates geographic requirements for originating sites
  • Requires reimbursement for telehealth services provided in a critical access hospital
  • Requires a telehealth payment rate for telehealth services furnished by a FQHC or RHC

Allows the use of audio-only technology for certain telehealth services including: E/M services, behavioral health counseling and education services, and other services determined appropriate by the secretary.

H.R. 5506: Rural Telehealth Access Task Force Act

Introduced October 8, 2021

  • Establishes a Rural Telehealth Access Task Force to determine how to address barriers to the adoption of telehealth technology and access to broadband internet access service in rural areas, and for other purposes

H.R. 5541: Primary and Virtual Care Affordability Act

Introduced October 8, 2021

  • Amends the Internal Revenue Code to extend the exemption for telehealth services from certain high deductible plan rules

H.R. 5837: To amend title XVIII of the Social Security Act to expand access to telehealth services relating to substance use disorder treatment, and for other purposes.

Introduced November 3, 2021

  • Eliminates requirement within Medicare for an in-person medical evaluation by a physician or practitioner prior to furnishing substance abuse disorder services through audio or telephone only technologies
  • Requires the Secretary of HHS to establish a task force to collect and assess data relating to the utilization rates of medications for opioid use disorder and the number of practitioners furnishing SUD prescriptions through telehealth

H.R. 6000: CURES Act 2.0

Introduced November 16, 2021

  • Requires HHS to disseminate guidance and strategies to states on effectively integrating telehealth into Medicaid and CHIP programs
  • Eliminates geographic and originating site restrictions within Medicare that require patients to live in a rural area and physically travel to a doctor’s office or clinic in order to receive care via telehealth.
  • Allows the HHS secretary to permanently expand the types of health providers who can offer telehealth and the scope of telehealth services that can be reimbursed under Medicare

H.R. 6202: Telehealth Extension Act

Introduced Dec. 9, 2021

  • Permanently eliminates geographic and site restrictions for telehealth services for Medicare beneficiaries
  • Extends select COVID-19 emergency telehealth waivers for two years, including (but not limited to) permitting Medicare coverage for telehealth services provided by specialty providers (e.g., speech language pathologists, occupational therapists, and physical therapists)
  • Allows critical access hospitals to keep providing behavioral therapy via telehealth and ensures proper reimbursement for audio-only telehealth services
Passed Legislation  

H.R. 2617: Consolidated Appropriations Act, 2023

Passed December 29, 2022

  • This bill will, among other provisions, extend the following COVID-19 PHE flexibilities for Medicare beneficiaries to December 31, 2024:
    • Removing specific telehealth geographic requirements and expanding originating sites;
    • Expanding practitioners allowed to practice telehealth;
    • Telehealth service provision by FQHCs;
    • Delaying in-person requirements for mental health services;
    • Allowing audio-only telehealth service provision; and,
    • Allowing the use of telehealth to conduct face-to-face encounters prior to recertification of eligibility for hospice care.

S. 2938: Bipartisan Safer Communities Act

Passed June 25, 2022

  • This bill would direct the Secretary of Health and Human Services to publish guidance for states to improve telehealth accessibility under Medicaid and CHIP.

Omnibus FY 2022 Spending Bill
Passed March 15, 2022

  • Temporarily extends the following Medicare telehealth flexibilities, which are central to enabling Medicare beneficiaries to access a broad range of services via telehealth from any location, for 151 days beginning on the first day after the end of the public health emergency (PHE) period:
    • Any site in the United States, including a patient’s home, will be considered an eligible originating site for the delivery of telehealth services.
    • Facility fees will not be paid to newly covered originating sites (e.g., patient’s home).
    • Eligible telehealth practitioners will continue to include qualified occupational therapists, physical therapists, speech-language therapists, and audiologists.
    • Federally qualified health centers and rural health clinics may serve as originating or distant sites for the delivery of telehealth services.
    • Providers will not be required to meet in-person visit requirements in order to deliver mental health services via video or audio-only visit. This applies to all sites of care, including Federally Qualified Health Centers and Rural Health Clinics (except in the case of hospice patients).
    • Coverage of telehealth services delivered via audio-only format will continue for specific service codes identified by Medicare as being eligible for delivery via audio only.
    • Practitioners will be able to use telehealth to conduct face-to-face encounters prior to recertification of eligibility for hospice care.
    • Allows health savings account-eligible plans to provide pre-deductible coverage for telehealth services through the end of 2022. 
    • Establishes telehealth reporting requirements for the Medicare Payment Advisory Commission (MedPAC) and the HHS related to telehealth utilization under the Medicare program.

H.R. 6074: Coronavirus Preparedness and Response Supplemental Appropriations Act

  • Allows CMS to extend coverage of telehealth services to beneficiaries regardless of where they are located
  • Allows CMS to extend coverage to telehealth services provided by “telephone” but only those with “audio and video capabilities that are used for two-way, real-time interactive communication” (e.g., smartphones)

For more information on Medicare changes, see our March 17 Manatt newsletter.

H.R. 748: Coronavirus Aid, Relief, and Economic Security (CARES) Act

  • Telehealth Provisions include:
    • Telehealth Network and Telehealth Resource Centers Grant Programs
    • Exemption for Telehealth Services
    • Increasing Medicare Telehealth Flexibilities During Emergency
    • Enhancing Medicare Telehealth Services for Federally Qualified Health Centers and Rural Health Clinics During Emergency Periods
    • Temporary Waiver of Requirement for Face-to-Face Visits Between Home Dialysis Patients and Physicians
    • Use of Telehealth to Conduct Face-to-Face Encounter Prior to Recertification of Eligibility for Hospice Care During Emergency Period
    • Encouraging Use of Telecommunications Systems for Home Health Services Furnished During Emergency Period

For more information on the CARES Act, see our March 27 Manatt newsletter.

H.R. 133: Consolidated Appropriations Act, 2021

  • Telehealth provisions include:
    • Expanding Access to Mental Health Services Furnished through Telehealth
    • Funding for Telehealth and Broadband Programs including:
      • An additional $250M to the FCC COVID-19 Telehealth Program
      • $285M for a pilot program to award grants to Historically Black Colleges or Universities, tribal colleges and universities, and other minority-serving institutions
      • $3.2B to establish an Emergency Broadband Benefit program at the FCC
      • $1B at the NTIA support broadband connectivity on tribal lands to be used for broadband development, telehealth, distance learning, affordability and digital inclusion
      • $300M for broadband development program targeted towards rural areas to support broadband infrastructure development 

For more information on the Consolidated Appropriations Act, see our December 23 Manatt newsletter.

H.R. 1319: American Rescue Plan Act of 2021

  • Includes funding for the following opportunities that would expand access to telehealth, including:
    • Emergency Grants to help Rural Health Care facilities increase telehealth capabilities
    • Funding to support information technology infrastructure for telehealth at Indian Health Services Centers
    • Funding to support behavioral and mental health professionals who utilize telehealth to deliver care via telehealth
    • Support and training for home care visiting entities that conduct virtual home visits 
  • Assistance for rape crisis centers transitioning to virtual services

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