[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[S. 1261 Introduced in Senate (IS)]
<DOC>
119th CONGRESS
1st Session
S. 1261
To amend title XVIII of the Social Security Act to expand access to
telehealth services, and for other purposes.
_______________________________________________________________________
IN THE SENATE OF THE UNITED STATES
April 2, 2025
Mr. Schatz (for himself, Mr. Wicker, Mr. Warner, Mrs. Hyde-Smith, Mr.
Welch, Mr. Barrasso, Mr. Padilla, Mr. Thune, Ms. Smith, Mr. Lankford,
Ms. Cantwell, Mr. Tuberville, Mr. Hickenlooper, Mr. Cotton, Ms.
Klobuchar, Mr. Sullivan, Mr. Fetterman, Mrs. Capito, Mr. Merkley, Ms.
Lummis, Mr. Kaine, Mr. Cramer, Mrs. Shaheen, Mrs. Britt, Mr. Gallego,
Mr. Moran, Mr. Lujan, Mr. Cassidy, Mr. Blumenthal, Mr. Tillis, Mr.
King, Mr. Justice, Mr. Coons, Mr. Schmitt, Mr. Whitehouse, Ms.
Murkowski, Ms. Rosen, Mr. Hoeven, Mr. Booker, Mr. Grassley, Ms.
Duckworth, Mr. Rounds, Mr. Sanders, Mr. Marshall, Mr. Kelly, Mrs.
Fischer, Mrs. Gillibrand, Mr. Young, Mr. Heinrich, Ms. Collins, Mr.
Peters, Mr. Ricketts, Mr. Schiff, Mr. Mullin, Ms. Warren, Mr. Graham,
Mr. Van Hollen, Mr. Daines, Mr. Warnock, and Mr. Boozman) introduced
the following bill; which was read twice and referred to the Committee
on Finance
_______________________________________________________________________
A BILL
To amend title XVIII of the Social Security Act to expand access to
telehealth services, and for other purposes.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE; TABLE OF CONTENTS.
(a) Short Title.--This Act may be cited as the ``Creating
Opportunities Now for Necessary and Effective Care Technologies
(CONNECT) for Health Act of 2025'' or the ``CONNECT for Health Act of
2025''.
(b) Table of Contents.--The table of contents of this Act is as
follows:
Sec. 1. Short title; table of contents.
Sec. 2. Findings and sense of Congress.
TITLE I--REMOVING BARRIERS TO TELEHEALTH COVERAGE
Sec. 101. Removing geographic requirements for telehealth services.
Sec. 102. Expanding originating sites.
Sec. 103. Expanding authority for practitioners eligible to furnish
telehealth services.
Sec. 104. Federally qualified health centers and rural health clinics.
Sec. 105. Native American health facilities.
Sec. 106. Repeal of six-month in-person visit requirement for
telemental health services.
Sec. 107. Waiver of telehealth requirements during public health
emergencies.
Sec. 108. Use of telehealth in recertification for hospice care.
TITLE II--PROGRAM INTEGRITY
Sec. 201. Clarification for fraud and abuse laws regarding technologies
provided to beneficiaries.
Sec. 202. Additional resources for telehealth oversight.
Sec. 203. Addressing significant outlier billing patterns for
telehealth services.
TITLE III--BENEFICIARY AND PROVIDER SUPPORTS, QUALITY OF CARE, AND DATA
Sec. 301. Beneficiary engagement on telehealth.
Sec. 302. Provider supports on telehealth.
Sec. 303. Ensuring the inclusion of telehealth in measuring quality of
care.
Sec. 304. Posting of information on telehealth services.
SEC. 2. FINDINGS AND SENSE OF CONGRESS.
(a) Findings.--Congress finds the following:
(1) The use of technology in health care and coverage of
telehealth services are rapidly evolving.
(2) Research has found that telehealth services can expand
access to care, improve the quality of care, and reduce
spending.
(3) In 2023, 90 percent of patients receiving telehealth
services were satisfied with their experiences.
(4) Health care workforce shortages are a significant
problem in many areas and for many types of health care
clinicians.
(5) Telehealth increases access to care in areas with
workforce shortages and for individuals who live far away from
health care facilities, have limited mobility or
transportation, or have other barriers to accessing care.
(6) The use of health technologies can strengthen the
expertise of the health care workforce, including by connecting
clinicians to specialty consultations.
(7) Prior to the COVID-19 pandemic, the utilization of
telehealth services in the Medicare program under title XVIII
of the Social Security Act (42 U.S.C. 1395 et seq.) was low,
accounting for 0.1 percent of Medicare Part B visits in 2019.
(8) Telehealth now represents a critical component of care
delivery. In 2023, 24 percent of Medicare fee-for-service
beneficiaries received a telehealth service.
(9) Long-term certainty about coverage of telehealth
services under the Medicare program is necessary to fully
realize the benefits of telehealth.
(b) Sense of Congress.--It is the sense of Congress that--
(1) health care providers can furnish safe, effective, and
high-quality health care services through telehealth;
(2) the Secretary of Health and Human Services should
promptly take all necessary measures to ensure that providers
and beneficiaries can continue to furnish and utilize,
respectively, telehealth services in the Medicare program, and
support recent modifications to the definition of ``interactive
telecommunications system'' in regulations and program
instruction under the Medicare program to ensure that providers
can utilize all appropriate means and types of technology,
including audio-visual, audio-only, and other types of
technologies, to furnish telehealth services; and
(3) barriers to the use of telehealth should be removed.
TITLE I--REMOVING BARRIERS TO TELEHEALTH COVERAGE
SEC. 101. REMOVING GEOGRAPHIC REQUIREMENTS FOR TELEHEALTH SERVICES.
Section 1834(m)(4)(C) of the Social Security Act (42 U.S.C.
1395m(m)(4)(C)) is amended--
(1) in clause (i), in the matter preceding subclause (I),
by striking ``clause (iii)'' and inserting ``clauses (iii) and
(iv)''; and
(2) by adding at the end the following new clause:
``(iv) Removal of geographic
requirements.--The geographic requirements
described in clause (i) shall not apply with
respect to telehealth services furnished on or
after October 1, 2025.''.
SEC. 102. EXPANDING ORIGINATING SITES.
(a) In General.--Section 1834(m)(4)(C)(iii) of the Social Security
Act (42 U.S.C. 1395m(m)(4)(C)(iii)) is amended by striking ``In the
case that'' and all that follows through ``September 30, 2025,'' and
inserting ``Beginning on the date of the enactment of the CONNECT for
Health Act of 2025,''.
(b) Conforming Amendments.--Section 1834(m) of the Social Security
Act (42 U.S.C. 1395m(m)) is amended--
(1) in paragraph (2)(B)(iii), by striking ``In the case
that'' and all that follows through ``September 30, 2025,'' and
inserting ``With respect to telehealth services furnished on or
after the date of the enactment of the CONNECT for Health Act
of 2025,''; and
(2) in paragraph (4)(C)(ii)(X), by striking ``, but only
for purposes of section 1881(b)(3)(B) or telehealth services
described in paragraph (7)''.
SEC. 103. EXPANDING AUTHORITY FOR 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--
(1) by striking ``Practitioner.--The term'' and inserting
``Practitioner.--
``(i) In general.--Subject to clause (ii),
the term''; and
(2) by adding at the end the following new clause:
``(ii) Expanding practitioners eligible to
furnish telehealth services.--
``(I) In general.--Notwithstanding
any other provision of this subsection,
in the case of telehealth services
furnished on or after October 1, 2025,
the Secretary may waive any limitation
on the types of practitioners who are
eligible to furnish telehealth services
if the Secretary determines that such
waiver is clinically appropriate.
``(II) Implementation.--In
implementing a waiver under this
clause, the Secretary may establish
requirements, as appropriate, for
practitioners under such waiver,
including with respect to beneficiary
and program integrity protections.
``(III) Public comment.--The
Secretary shall establish a process by
which stakeholders may (on at least an
annual basis) provide public comment on
such waiver under this clause.
``(IV) Periodic review.--The
Secretary shall periodically, but not
more frequently than every 3 years,
reassess the waiver under this clause
to determine whether such waiver
continues to be clinically appropriate.
The Secretary shall terminate any
waiver that the Secretary determines is
no longer clinically appropriate.''.
SEC. 104. FEDERALLY QUALIFIED HEALTH CENTERS AND RURAL HEALTH CLINICS.
Section 1834(m) of the Social Security Act (42 U.S.C. 1395m(m)) is
amended--
(1) in paragraph (4)(C)(i), in the matter preceding
subclause (I), by striking ``and (7)'' and inserting ``(7), and
(8)''; and
(2) in paragraph (8)--
(A) in subparagraph (A)--
(i) in the matter preceding clause (i), by
striking ``During'' and all that follows
through ``September 30, 2025'' and inserting
the following: ``Beginning on the first day of
the emergency period described in section
1135(g)(1)(B)'';
(ii) in clause (ii), by striking ``and'' at
the end;
(iii) by redesignating clause (iii) as
clause (iv); and
(iv) by inserting after clause (ii) the
following new clause:
``(iii) the geographic requirements
described in paragraph (4)(C)(i) shall not
apply with respect to such a telehealth
service; and'';
(B) in subparagraph (B)--
(i) in the subparagraph heading, by
inserting ``during initial period'' after
``rule'';
(ii) in the first sentence of clause (i) by
striking ``during the periods for which
subparagraph (A) applies'' and inserting
``during the period beginning on the first day
of the emergency period and ending on September
30, 2025''; and
(iii) in clause (ii), by striking ``Costs
associated'' and inserting ``During the period
for which clause (i) applies, costs
associated'';
(C) by adding at the end the following new
subparagraph:
``(C) Payment after initial period.--
``(i) In general.--A telehealth service
furnished by a Federally qualified health
center or a rural health clinic to an
individual pursuant to this paragraph on or
after October 1, 2025, shall be deemed to be so
furnished to such individual as an outpatient
of such clinic or facility (as applicable) for
purposes of paragraph (1) or (3), respectively,
of section 1861(aa) and payable as a Federally
qualified health center service or rural health
clinic service (as applicable) under the
prospective payment system established under
section 1834(o) or under section 1833(a)(3),
respectively.
``(ii) Treatment of costs for fqhc pps
calculations and rhc air calculations.--Costs
associated with the furnishing of telehealth
services by a Federally qualified health center
or rural health clinic serving as a distant
site pursuant to this paragraph on or after
October 1, 2025, shall be considered allowable
costs for purposes of the prospective payment
system established under section 1834(o) and
any payment methodologies developed under
section 1833(a)(3), as applicable.''.
SEC. 105. NATIVE AMERICAN HEALTH FACILITIES.
(a) In General.--Section 1834(m)(4)(C) of the Social Security Act
(42 U.S.C. 1395m(m)(4)(C)), as amended by section 101, is amended--
(1) in clause (i), by striking ``and (iv)'' and inserting
``, (iv), and (v)''; and
(2) by adding at the end the following new clause:
``(v) Native american health facilities.--
With respect to telehealth services furnished
on or after January 1, 2026, the originating
site requirements described in clauses (i) and
(ii) shall not apply with respect to a facility
of the Indian Health Service, whether operated
by such Service, or by an Indian tribe (as that
term is defined in section 4 of the Indian
Health Care Improvement Act (25 U.S.C. 1603))
or a tribal organization (as that term is
defined in section 4 of the Indian Self-
Determination and Education Assistance Act (25
U.S.C. 5304)), or a facility of the Native
Hawaiian health care systems authorized under
the Native Hawaiian Health Care Improvement Act
(42 U.S.C. 11701 et seq.).''.
(b) No Originating Site Facility Fee for Certain Native American
Facilities.--Section 1834(m)(2)(B)(i) of the Social Security Act (42
U.S.C. 1395m(m)(2)(B)(i)) is amended, in the matter preceding subclause
(I), by inserting ``(other than an originating site that is only
described in clause (v) of paragraph (4)(C), and does not meet the
requirement for an originating site under clauses (i) and (ii) of such
paragraph)'' after ``the originating site''.
SEC. 106. REPEAL OF SIX-MONTH IN-PERSON VISIT REQUIREMENT FOR
TELEMENTAL HEALTH SERVICES.
(a) In General.--Section 1834(m)(7) of the Social Security Act (42
U.S.C. 1395m(m)(7)(B)) is amended--
(1) in subparagraph (A), by striking ``, subject to
subparagraph (B),'';
(2) by striking ``(A) In general.--The geographic'' and
inserting ``The geographic''; and
(3) by striking subparagraph (B).
(b) Rural Health Clinics.--Section 1834(y)(2) of the Social
Security Act (42 U.S.C. 1395m(y)(2)) is amended by striking ``prior to
October 1, 2025''.
(c) Federally Qualified Health Centers.--Section 1834(o)(4)(B) of
the Social Security Act (42 U.S.C. 1395m(o)(4)(B)) is amended by
striking ``prior to October 1, 2025''.
SEC. 107. WAIVER OF TELEHEALTH REQUIREMENTS DURING PUBLIC HEALTH
EMERGENCIES.
Section 1135(g)(1) of the Social Security Act (42 U.S.C. 1320b-
5(g)(1)) is amended--
(1) in subparagraph (A), in the matter preceding clause
(i), by striking ``subparagraph (B)'' and inserting
``subparagraphs (B) and (C)''; and
(2) by adding at the end the following new subparagraph:
``(C) Exception for waiver of telehealth
requirements during public health emergencies.--For
purposes of subsection (b)(8), in addition to the
emergency period described in subparagraph (B), an
`emergency area' is a geographical area in which, and
an `emergency period' is the period during which, there
exists a public health emergency declared by the
Secretary pursuant to section 319 of the Public Health
Service Act on or after the date of enactment of this
subparagraph.''.
SEC. 108. USE OF TELEHEALTH IN RECERTIFICATION FOR HOSPICE CARE.
(a) In General.--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
``during the emergency period'' and all that follows through
``September 30, 2025'' and inserting the following: ``during and after
the emergency period described in section 1135(g)(1)(B)''.
(b) GAO Report.--Not later than 3 years after the date of enactment
of this Act, the Comptroller General of the United States shall submit
to Congress a report evaluating the impact of section
1814(a)(7)(D)(i)(II) of the Social Security Act (42 U.S.C.
1395f(a)(7)(D)(i)(II)), as amended by subsection (a), on--
(1) the number and percentage of beneficiaries recertified
for the Medicare hospice benefit at 180 days and for subsequent
benefit periods, to the extent such data is available;
(2) Federal oversight of the appropriateness for hospice
care of the patients recertified through the use of telehealth;
and
(3) any other factors determined appropriate by the
Comptroller General.
TITLE II--PROGRAM INTEGRITY
SEC. 201. CLARIFICATION FOR FRAUD AND ABUSE LAWS REGARDING TECHNOLOGIES
PROVIDED TO BENEFICIARIES.
Section 1128A(i)(6) of the Social Security Act (42 U.S.C. 1320a-
7a(i)(6)) is amended--