INFORMATICS, TELEMEDICINE, AND EDUCATION DEMONSTRATION PROJECT.

SEC. 4207. INFORMATICS, TELEMEDICINE, AND EDUCATION DEMONSTRATION PROJECT. (a) Purpose and Authorization.— (1) In general.—Not later than 9 months after the date of enactment of this section, the Secretary of Health and Human Services shall provide for a demonstration project described in paragraph (2). (2) Description of project.— (A) In general.—The demonstration project described in this paragraph is a single demonstration project to use eligible health care provider telemedicine networks to apply high-capacity computing and advanced networks to improve primary care (and prevent health care complications) to medicare beneficiaries with diabetes mellitus who are residents of medically underserved rural areas or residents of medically underserved inner-city areas. (B) Medically underserved defined.—As used in this paragraph, the term “medically underserved” has the meaning given such term in section 330(b)(3) of the Public Health Service Act (42 U.S.C. 254b(b)(3)). (3) Waiver.—The Secretary shall waive such provisions of title XVIII of the Social Security Act as may be necessary to provide for payment for services under the project in accordance with subsection (d). (4) Duration of project.—The project shall be conducted over a 4-year period. (b) Objectives of Project.—The objectives of the project include the following: (1) Improving patient access to and compliance with appropriate care guidelines for individuals with diabetes mellitus through direct telecommunications link with information networks in order to improve patient quality-of-life and reduce overall health care costs.111 STAT. 380 (2) Developing a curriculum to train health professionals (particularly primary care health professionals) in the use of medical informatics and telecommunications. (3) Demonstrating the application of advanced technologies, such as video-conferencing from a patient’s home, remote monitoring of a patient’s medical condition, interventional informatics, and applying individualized, automated care guidelines, to assist primary care providers in assisting patients with diabetes in a home setting. (4) Application of medical informatics to residents with limited English language skills. (5) Developing standards in the application of telemedicine and medical informatics. (6) Developing a model for the cost-effective delivery of primary and related care both in a managed care environment and in a fee-for-service environment. (c) Eligible Health Care Provider Telemedicine Network Defined.—For purposes of this section, the term “eligible health care provider telemedicine network” means a consortium that includes at least one tertiary care hospital (but no more than 2 such hospitals), at least one medical school, no more than 4 facilities in rural or urban areas, and at least one regional telecommunications provider and that meets the following requirements: (1) The consortium is located in an area with a high concentration of medical schools and tertiary care facilities in the United States and has appropriate arrangements (within or outside the consortium) with such schools and facilities, universities, and telecommunications providers, in order to conduct the project. (2) The consortium submits to the Secretary an application at such time, in such manner, and containing such information as the Secretary may require, including a description of the use to which the consortium would apply any amounts received under the project and the source and amount of non-Federal funds used in the project. (3) The consortium guarantees that it will be responsible for payment for all costs of the project that are not paid under this section and that the maximum amount of payment that may be made to the consortium under this section shall not exceed the amount specified in subsection (d)(3). (d) Coverage as Medicare Part B Services.— (1) In general.—Subject to the succeeding provisions of this subsection, services related to the treatment or management of (including prevention of complications from) diabetes for medicare beneficiaries furnished under the project shall be considered to be services covered under part B of title XVIII of the Social Security Act. (2) Payments.— (A) In general.—Subject to paragraph (3), payment for such services shall be made at a rate of 50 percent of the costs that are reasonable and related to the provision of such services. In computing such costs, the Secretary shall include costs described in subparagraph (B), but may not include costs described in subparagraph (C).111 STAT. 381 (B) Costs that may be included.—The costs described in this subparagraph are the permissible costs (as recognized by the Secretary) for the following: (i) The acquisition of telemedicine equipment for use in patients’ homes (but only in the case of patients located in medically underserved areas). (ii) Curriculum development and training of health professionals in medical informatics and telemedicine. (iii) Payment of telecommunications costs (including salaries and maintenance of equipment), including costs of telecommunications between patients’ homes and the eligible network and between the network and other entities under the arrangements described in subsection (c)(1). (iv) Payments to practitioners and providers under the medicare programs. (C) Costs not included.—The costs described in this subparagraph are costs for any of the following: (i) The purchase or installation of transmission equipment (other than such equipment used by health professionals to deliver medical informatics services under the project). (ii) The establishment or operation of a telecommunications common carrier network. (iii) Construction (except for minor renovations related to the installation of reimbursable equipment) or the acquisition or building of real property. (3) Limitation.—The total amount of the payments that may be made under this section shall not exceed $30,000,000 for the period of the project (described in subsection (a)(4)). (4) Limitation on cost-sharing.—The project may not impose cost sharing on a medicare beneficiary for the receipt of services under the project in excess of 20 percent of the costs that are reasonable and related to the provision of such services. (e) Reports.—The Secretary shall submit to the Committee on Ways and Means and the Committee Commerce of the House of Representatives and the Committee on Finance of the Senate interim reports on the project and a final report on the project within 6 months after the conclusion of the project. The final report shall include an evaluation of the impact of the use of telemedicine and medical informatics on improving access of medicare beneficiaries to health care services, on reducing the costs of such services, and on improving the quality of life of such beneficiaries. (f) Definitions.—For purposes of this section: (1) Interventional informatics.—The term “interventional informatics” means using information technology and virtual reality technology to intervene in patient care. (2) Medical informatics.—The term “medical informatics” means the storage, retrieval, and use of biomedical and related information for problem solving and decision-making through computing and communications technologies. (3) Project.—The term “project” means the demonstration project under this section.111 STAT. 382