ADVANCING TELEHEALTH BEYOND COVID–19.

SEC. 4113. ADVANCING TELEHEALTH BEYOND COVID–19.(a) Removing Geographic Requirements and Expanding Originating Sites for Telehealth Services.—Section 1834(m) of the Social Security Act (42 U.S.C. 1395m(m)) is amended—(1) in paragraph (2)(B)(iii)—(A) by striking “With” and inserting “In the case that the emergency period described in section 1135(g)(1)(B) ends before December 31, 2024, with”; and (B) by striking “that are furnished during the 151-day period beginning on the first day after the end of the emergency period described in section 1135(g)(1)(B)” and inserting “that are furnished during the period beginning on the first day after the end of such emergency period and ending December 31, 2024”; and (2) in paragraph (4)(C)(iii)—(A) by striking “With” and inserting “In the case that the emergency period described in section 1135(g)(1)(B) ends before December 31, 2024, with”; and (B) by striking “that are furnished during the 151-day period beginning on the first day after the end of the emergency period described in section 1135(g)(1)(B)” and inserting “that are furnished during the period beginning on the first day after the end of such emergency period and ending on December 31, 2024”. (b) Expanding 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 “and, for the 151-day period beginning on the first day after the end of the emergency period described in section 1135(g)(1)(B)” and inserting “and, in the case that the emergency period described in section 1135(g)(1)(B) ends before December 31, 2024, for the period beginning on the first day after the end of such emergency period and ending on December 31, 2024”. (c) Extending Telehealth Services for 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 151-day period beginning on the first day after the end of such emergency period” and inserting “in the case that such emergency period ends before December 31, 2024, during the period beginning on the first day after the end of such emergency period and ending on December 31, 2024”. (d) Delaying the In-person Requirements Under Medicare for Mental Health Services Furnished Through Telehealth and Telecommunications Technology.—(1) Delay in requirements for mental health services furnished through telehealth.—Section 1834(m)(7)(B)(i) of 136 STAT. 5899 the Social Security Act (42 U.S.C. 1395m(m)(7)(B)(i)) is amended, in the matter preceding subclause (I), by striking “on or after the day that is the 152nd day after the end of the period at the end of the emergency sentence described in section 1135(g)(1)(B))” and inserting “on or after January 1, 2025 (or, if later, the first day after the end of the emergency period described in section 1135(g)(1)(B))”. (2) Mental health visits furnished by rural health clinics.—Section 1834(y) of the Social Security Act (42 U.S.C. 1395m(y)) is amended—(A) in the heading, by striking “to hospice patients”; and (B) in paragraph (2), by striking “prior to the day that is the 152nd day after the end of the emergency period described in section 1135(g)(1)(B))” and inserting “prior to January 1, 2025 (or, if later, the first day after the end of the emergency period described in section 1135(g)(1)(B))”. (3) Mental health visits furnished by federally qualified health centers.—Section 1834(o)(4) of the Social Security Act (42 U.S.C. 1395m(o)(4) is amended—(A) in the heading, by striking “to hospice patients”; and (B) in subparagraph (B), by striking “prior to the day that is the 152nd day after the end of the emergency period described in section 1135(g)(1)(B))” and inserting “prior to January 1, 2025 (or, if later, the first day after the end of the emergency period described in section 1135(g)(1)(B))”. (e) Allowing for the Furnishing of Audio-only Telehealth Services.—Section 1834(m)(9) of the Social Security Act (42 U.S.C. 1395m(m)(9)) is amended by striking “The Secretary shall continue to provide coverage and payment under this part for telehealth services identified in paragraph (4)(F)(i) as of the date of the enactment of this paragraph that are furnished via an audio-only telecommunications system during the 151-day period beginning on the first day after the end of the emergency period described in section 1135(g)(1)(B)” and inserting “In the case that the emergency period described in section 1135(g)(1)(B) ends before December 31, 2024, the Secretary shall continue to provide coverage and payment under this part for telehealth services identified in paragraph (4)(F)(i) as of the date of the enactment of this paragraph that are furnished via an audio-only communications system during the period beginning on the first day after the end of such emergency period and ending on December 31, 2024”. (f) Use of Telehealth to Conduct Face-to-face Encounter Prior to Recertification of Eligibility for Hospice Care During Emergency Period.—Section 1814(a)(7)(D)(i)(II) of the Social Security Act (42 U.S.C. 1395f(a)(7)(D)(i)(II)) is amended by striking “and during the 151-day period beginning on the first day after the end of such emergency period” and inserting “and, in the case that such emergency period ends before December 31, 2024, during the period beginning on the first day after the end of such emergency period described in such section 1135(g)(1)(B) and ending on December 31, 2024”. (g) Study on Telehealth and Medicare Program Integrity.—136 STAT. 5900 (1) In general.—(A) Study.—The Secretary shall conduct a study using medical record review, as described in subparagraph (C), on program integrity related to telehealth services under part B of title XVIII of the Social Security Act (42 U.S.C. 1395j et seq.). (B) Scope of study.—In conducting the study under subparagraph (A), the Secretary shall review and analyze information (to the extent that such information is available) on the duration of telehealth services furnished, the types of telehealth services furnished, and, to the extent feasible, the impact of the telehealth services furnished on future utilization of health care services by Medicare beneficiaries, such as the utilization of additional telehealth services or in-person services, including hospitalizations and emergency department visits. The Secretary may also review and analyze information on—(i) any geographic differences in utilization of telehealth services; (ii) documentation of the care and methods of delivery associated with telehealth services; and (iii) other areas, as determined appropriate by the Secretary. (C) Medical record review.—In conducting the study under subparagraph (A), the Secretary shall conduct medical record review of a sample of claims for telehealth services with dates of service during the period beginning on January 1, 2022, and ending on December 31, 2024. For such claims with a date of service during the emergency period described in section 1135(g)(1)(B) of the Social Security Act (42 U.S.C. 1320b–5(g)(1)(B)), the Secretary shall only conduct medical record review of those claims that have undergone standard program integrity review (as defined in paragraph (2)(B)), as determined appropriate by the Secretary. (D) Reports.—(i) Interim report.—Not later than October 1, 2024, the Secretary shall submit to the Committee on Finance of the Senate and the Committee on Energy and Commerce and the Committee on Ways and Means of the House of Representatives an interim report on the study conducted under subparagraph (A). (ii) Final report.—Not later than April 1, 2026, the Secretary shall submit to the Committee on Finance of the Senate and the Committee on Energy and Commerce and the Committee on Ways and Means of the House of Representatives a final report on the study conducted under subparagraph (A). (2) Definitions.—In this subsection:(A) Secretary.—The term “Secretary” means the Secretary of Health and Human Services. (B) Standard program integrity review.—The term “standard program integrity review” refers to the review of any claim that requires a review of the associated medical record by the Secretary to determine the medical necessity of the services furnished or to identify potential fraud.136 STAT. 5901 (C) Telehealth service.—The term “telehealth service” has the meaning given that term in section 1834(m)(4)(F) of the Social Security Act (42 U.S.C. 1395(m)(4)(F)). (3) Funding.—In addition to amounts otherwise available, there is appropriated to the Centers for Medicare & Medicaid Services Program Management Account for fiscal year 2023, out of any amounts in the Treasury not otherwise appropriated, $10,000,000, to remain available until expended, for purposes of carrying out this subsection. (h) Program Instruction Authority.—Notwithstanding any other provision of law, the Secretary of Health and Human Services may implement the provisions of, including amendments made by, this section through program instruction or otherwise.