II
111th CONGRESS
1st Session
S. 2741
IN THE SENATE OF THE UNITED STATES
November 5, 2009
Mr. Udall of New Mexico introduced the following bill; which was read twice and referred to the Committee on Finance
A BILL
To establish telehealth pilot projects, expand access to
stroke telehealth services under the Medicare program, improve access to
store-and-forward
telehealth services in facilities of the
Indian Health Service and federally qualified health centers, reimburse
facilities of the Indian Health Service as originating sites, establish
regulations to consider credentialing and privileging standards for originating
sites with respect to receiving telehealth services, and for other
purposes.
Short title
This Act may be cited as the
Rural Telemedicine Enhancing Community
Health (TECH) Act of 2009
.
Telehealth pilot projects
In general
The Secretary of Health and Human Services (referred to
in this section as the Secretary
) shall establish 3-year
telehealth pilot projects for the purpose of analyzing the clinical outcomes
and cost effectiveness associated with telehealth services in a variety of
geographic areas. The Secretary shall provide evaluation and treatment services
to entities participating in the pilot projects.
Eligible entities
In general
The Secretary shall select eligible entities to participate in the pilot projects under this section.
Priority
In selecting eligible entities to participate in the pilot projects under this section, the Secretary shall give priority to such entities located in medically underserved areas and facilities of the Indian Health Service.
Evaluation
The Secretary shall, through the pilot projects, evaluate—
the effective and economic delivery of care in treating behavioral health issues (including post-traumatic stress disorder) with the use of telehealth services in medically underserved and tribal areas, including collaborative uses of health professionals, integration of the range of telehealth and other technologies, and exploration of appropriate reimbursement methods for third party payers;
the effectiveness of improving the capacity of non-medical providers and non-specialized medical providers to provide health services for chronic complex diseases in medically underserved and tribal areas; and
the effectiveness of using telehealth services to provide acute stroke evaluation and treatment, occupational therapy, physical therapy, and speech language pathology services to treat cerebrovascular disease in medically underserved and tribal areas.
Report
Not later than 3 years after the pilot projects are established under subsection (a), the Secretary shall submit to Congress a report describing the outcomes of such pilot projects and providing recommendations for expanding the use of telehealth services.
Expansion of project
If the Secretary determines that the pilot projects under this section enhance outcomes for patients and reduce expenditures for participating entities, the Secretary may initiate similar projects for additional medical conditions and geographic areas.
Authorization of appropriations
To carry out this section, there is authorized to be appropriated $13,500,000 for fiscal years 2011 through 2014.
Expanding access to stroke telehealth services
Expansion of originating sites for stroke telehealth services
Section 1834(m)(4) of the Social Security Act (42 U.S.C. 1395m(m)(4)) is amended—
in subparagraph (C)—
in clause (i), in
the matter preceding subclause (I), by striking The term
and
inserting Subject to clause (iii), the term
; and
by adding at the end the following new clause:
Expansion of originating sites for stroke telehealth services
In the case of stroke telehealth services, the term originating site means any site described in clause (ii) at which the eligible telehealth individual is located at the time the service is furnished via a telecommunications system, regardless of where the site is located.
; and
by adding at the end the following new subparagraph:
Stroke telehealth services
The term stroke telehealth services means a telehealth service used for the evaluation or treatment of individuals with acute stroke, occupational therapy, physical therapy, and speech language pathology services furnished subsequent to a stroke, and stroke prevention and education services.
.
Effective date
The amendments made by subsection (a) shall apply to telehealth services furnished on or after the date that is 6 months after the date of enactment of this Act.
Improving access to telehealth services at IHS facilities and FQHCs
Inclusion of IHS facilities as originating sites
Section 1834(m)(4)(C)(ii) of the Social Security Act (42 U.S.C. 1395m(m)(4)(C)(ii)) is amended by adding at the end the following new subclause:
A facility of the Indian Health Service, whether operated by such Service or by an Indian tribe or tribal organization (as those terms are defined in section 4 of the Indian Health Care Improvement Act).
.
Access to store-and-Forward and videoconferencing technologies
In general
Section 1834(m)(1) of such Act (42 U.S.C. 1395m(m)(1)) is
amended by adding at the end the following sentence: For purposes of the
first sentence, in the case of telehealth services described in subclause (I)
of paragraph (4)(F)(iii) that are furnished by a facility of the Indian Health
Service (whether operated by such Service or by an Indian tribe or tribal
organization (as those terms are defined in section 4 of the Indian Health Care
Improvement Act)) or a federally qualified health center (as defined in section
1861(aa)(4)), the term telecommunications system includes
store-and-forward technologies described in the preceding sentence and, in the
case of telehealth services described in subclause (II) of such paragraph that
are furnished by such a facility or federally qualified health center, such
term includes videoconferencing technologies.
Conforming amendment
Section 1834(m)(4)(F) of such Act (42 U.S.C. 1395m(m)(4)(F)) is amended by adding at the end the following new clauses:
Telehealth services described
For purposes of paragraph (1):
The telehealth services described in this subclause include consultations related to neurosurgery, neurology, cardiology, dermatology, pediatric specialty, and orthopedic (as specified by the Secretary).
The telehealth services described in this subclause are services related to hepatitis and other chronic conditions and behavioral health services (as specified by the Secretary).
.
Effective date
The amendments made by this section shall apply to telehealth services furnished on or after the date that is 6 months after the date of enactment of this Act.
Improving credentialing and privileging standards for telehealth services
Section 1834(m) of the Social Security Act (42 U.S.C. 1395m(m)) is amended by adding at the end the following new paragraph:
Establishment of remote credentialing and privileging standards
In general
Not later than 2 years after the date of the enactment of this paragraph, the Secretary shall establish reasonable regulations for considering the remote credentialing and privileging standards applicable to telehealth services, including interpretative services, for originating sites under this subsection. Such regulations shall allow an originating site to accept, and not duplicate, the credentialing and privileging processes and decisions made by another site.
Clarification regarding acceptance of processes and decisions prior to enactment of regulations
During the period beginning on such date of enactment and ending on the effective date of the regulations under subparagraph (A), the Secretary shall not take any punitive action under any rule or regulation against an originating site on the basis of that site’s acceptance, for purposes of receiving telehealth services (including interpretive services), the credentialing and privileging processes and decisions made by another site that is accredited by a national accreditation body recognized by the Secretary under section 1865(a)(1) if the site accepting such credentialing and privileging processes is also so accredited and complies with the applicable requirements for such acceptance.
.