S.Amdt. 2532

SA 2532. Mr. ALEXANDER submitted an amendment intended to be proposed
to amendment SA 2499 proposed by Mr. McConnell to the bill S. 178, to
condemn gross human rights violations of ethnic Turkic Muslims in
Xinjiang, and calling for an end to arbitrary detention, torture, and
harassment of these communities inside and outside China; which was
ordered to lie on the table; as follows:

At the appropriate place, insert the following:

SEC. __. EXTENDING MEDICARE TELEHEALTH FLEXIBILITIES.

(a) Expanding Access to Telehealth Services.--
(1) In general.--Section 1834(m)(4)(C) of the Social
Security Act (42 U.S.C. 1395m(m)(4)(C)) is amended by adding
at the end the following new clause:
``(iii) Expanding access to telehealth services.--With
respect to telehealth services furnished beginning on the
first day after the end of the emergency period described in
section 1135(g)(1)(B) of this clause, the term `originating
site' means any site at which the eligible telehealth
individual is located at the time the service is furnished
via a telecommunications system, including the home of an
individual.''.
(2) Conforming amendments.--Such section is amended--
(A) in paragraph (2)(B)--
(i) in clause (i), in the matter preceding subclause (I),
by striking ``clause (ii)'' and inserting ``clauses (ii) and
(iii)''; and
(ii) by adding at the end the following new clause:
``(iii) No facility fee for new sites.--With respect to
telehealth services furnished on or after the date of
enactment of this clause, a facility fee shall only be paid
under this subparagraph to an originating site that is
described in paragraph (4)(C)(ii) (other than subclause (X)
of such paragraph).''.
(B) in paragraph (4)(C)--
(i) in clause (i), in the matter preceding subclause (I),
by inserting ``and clause (iii)'' after ``and (7)''; and
(ii) in clause (ii)(X), by inserting ``prior to the first
day after the end of the emergency period described in
section 1135(g)(1)(B)'' before the period;
(C) in paragraph (5), by inserting ``and prior to the first
day after the end of the emergency period described in
section 1135(g)(1)(B)'' after ``January 1, 2019,'';
(D) in paragraph (6)(A), by inserting ``and prior to the
first day after the end of the emergency period described in
section 1135(g)(1)(B),'' after ``January 1, 2019,''; and
(E) in paragraph (7), by inserting ``and prior to the first
day after the end of the emergency period described in
section 1135(g)(1)(B),'' after ``July 1, 2019,''.
(b) Expanding Practitioners Eligible to Furnish Telehealth
Services.--Section 1834(m) of the Social Security Act (42
U.S.C. 1395m(m)) is amended--
(1) in paragraph (1), by striking ``(described in section
1842(b)(18)(C))'' and inserting ``(defined in paragraph
(4)(E))''; and
(2) in paragraph (4)(E)--
(A) by striking ``practitioner.--The term'' and inserting
``Practitioner.--
``(A) In general.--Subject to subparagraph (B), the term'';
and
(B) by adding at the end the following new subparagraph:
``(B) Expansion.--The Secretary, after consulting with
stakeholders regarding services that are clinically
appropriate, may expand the types of practitioners who may
furnish telehealth services to include any health care
professional that is eligible to bill the program under this
title for their professional services.''.
(c) Retention of Additional Services and Subregulatory
Process for Modifications Following Emergency Period.--
Section 1834(m)(4)(F) of the Social Security Act (42 U.S.C.
1395m(m)(4)(F)) is amended--
(1) in clause (i), by inserting ``and clause (iii)'' after
``paragraph (8)'';
(2) in clause (ii), by striking ``The Secretary'' and
inserting ``Subject to clause (iii), the Secretary''; and
(3) by adding at the end the following new clause:
``(iii) Retention of additional services and subregulatory
process for modifications following emergency period.--With
respect to telehealth services furnished after the last day
of the emergency period described in section 1135(g)(1)(B),
the Secretary may--

``(I) retain as appropriate the expanded list of telehealth
services specified in clause (i) pursuant to the waiver
authority under section 1135(b)(8) during such emergency
period; and
``(II) retain the subregulatory process used to modify the
services included on the list of such telehealth services
pursuant to clause (ii) during such emergency period.''.

(d) Enhancing Telehealth Services for Federally Qualified
Health Centers and Rural Health Clinics.--Section 1834(m)(8)
of the Social Security Act (42 U.S.C. 1395m(m)(8)) is
amended--
(1) in the paragraph heading by inserting ``and after''
after ``during '';
(2) in subparagraph (A), in the matter preceding clause
(i), by inserting ``and after'' after ``During''; and
(3) in the first sentence of subparagraph (B)(i), by
inserting ``and after'' after ``during''.
(e) Use of Telehealth, as Clinically Appropriate, to
Conduct Face-to-face Encounter for Hospice Care.--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 inserting ``and after
such emergency period as clinically appropriate'' after
``1135(g)(1)(B)''.
(f) Use of Telehealth, as Clinically Appropriate, to
Conduct Face-to-face Clinical Assessments for Home
Dialysis.--Clause (iii) of section 1881(b)(3)(B) of the
Social Security Act (42 U.S.C. 1395rr(b)(3)(B)) is amended--
(1) by moving such clause 4 ems to the left; and
(2) by inserting ``and after such emergency period as
clinically appropriate'' before the period.

[[Page S4809]]

(g) Implementation.--Notwithstanding any provision of law,
the Secretary may implement the provisions of, and amendments
made by, this section by interim final rule, program
instruction, or otherwise.
______