Executive Summary: Tracking Telehealth Changes State-by-State in Response to COVID-19 – December 2023 | Manatt, Phelps & Phillips, LLP

Bill/Activity Key Proposed Actions Activity  

In June 2023, MedPAC issued a report entitled “Medicare and the Health Care Delivery System.

This report included a chapter that addresses the use of telehealth services during the public health emergency (PHE) and the impact of expanded telehealth coverage on quality and access to care, among other topics. Based on their analysis, the commission made following recommendations:

  • CMS should prevent to its pre-PHE telehealth payment methodology, paying the facility rate for telehealth services;
  • If CMS decides to permanently cover distant-site telehealth services delivered by Federally Qualified Health Centers (FQHCs) and Rural Health Centers (RHCs), those services should be paid at comparable Medicare Physician Fee Schedule (PFS) rates;
  • Continued program integrity activities (e.g., medical record review) are recommended to ensure clinicians are accurately billing; and
  • Policymakers should monitor the impact of telehealth on access, quality, and cost to inform telehealth policy.
Introduced Legislation  

H.B. 6364: A bill to amend title XVIII of the Social Security Act to maintain certain telehealth flexibilities relating to provider privacy under the Medicare program. 

Introduced November 13, 2023

  • As of November 15, 2023, there is no bill text publicly available for H.R. 6364.

S. 3193: Telehealth Response for E-prescribing Addiction Therapy Services (TREATS) Act

Introduced November 1, 2023

  • This bill would permit synchronous telehealth evaluations, including those completed via audio-only technologies, to be used to prescribe schedule III, IV, or V controlled substances to treat opioid use disorder.

S. 3090 / H.R. 6004: Maximizing Outcomes for Moms through Medicaid Improvement and Enhancement of Services (MOMMIES) Act

S. 3090 Introduced October 19, 2023

H.R. 6004 Introduced October 25, 2023

  • This bill would require the Comptroller General of the United States to submit a report to Congress on State Medicaid programs’ use of telehealth to increase access to maternity care. This report would outline States’ approaches to utilizing telehealth, services provided through telehealth, patient demographics, health outcomes, and patient care quality metrics.

S. 2880: A bill to amend title XVIII of the Social Security Act to expand the scope of practitioners eligible for payment for telehealth services under the Medicare program, and for other purposes.

Introduced September 21, 2023

  • This bill would expand the types of providers eligible for reimbursement of telehealth services under the Medicare program; providers would include: audiologists, occupational therapists, physical therapists, and qualified speech-language pathologists, among others specified by the Secretary of Health and Human Services.

H.R. 5611: Helping Ensure Access to Local TeleHealth (HEALTH) Act of 2023

Introduced September 20, 2023

  • This bill relates to telehealth services furnished by Federally Qualified Health Centers (FQHCs) and Rural Health Centers (RHCs) under the Medicare program, and would:
    • Permanently extend Medicare coverage of telehealth services to FQHCs and RHCs;
    • Establish coverage for audio-only telehealth services;
    • Permit prospective payments for telehealth services;
    • Remove originating site requirements for telehealth services; and
    • Prohibit facility fee payments to originating sites for telehealth services, except for sites specifically noted in law.

H.R. 5541: Temporary Reciprocity to Ensure Access to Treatment (TREAT) Act

Introduced September 18, 2023

  • This bill would allow mental health care providers with a valid license to provide telehealth services in any U.S. state, territory, or D.C. during an emergency period.

H.Res. 676 / S. Res. 368: Supporting the designation of the week of September 17 through September 23, 2023, as “Telehealth Awareness Week”

Introduced September 12, 2023

  • This resolution would designate September 17 – 23, 2023 as “Telehealth Awareness Week.”

H.R. 5163: Telehealth Response for E-prescribing Addiction Therapy Services Act

Introduced August 4, 2023

  • This bill would permit synchronous telehealth evaluations, including those completed via audio-only technologies, to be used to prescribe schedule III, IV, or V controlled substances (other than methadone) to treat opioid use disorder.

S. 2447: Strengthening Telehealth and Education for Rural Communities Act of 2023

Introduced July 20, 2023

  • This bill would reauthorize the distance learning and telemedicine grant program through 2028.

H.R. 4189 / S. 2016: Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act

Introduced June 15, 2023

  • This bill would:
    • Permanently remove Medicare geographic restrictions and allow the home and other sites to be originating sites for telehealth services;
    • Permanently allow federally qualified health centers (FQHCs) and rural health clinics (RHCs) to provide telehealth services;
    • Expand which practitioners are eligible to provide telehealth services;
    • Remove in-person visit requirements for telemental health services.

H.R. 3875: Expanded Telehealth Access Act

Introduced June 6, 2023

  • This bill would expand the types of providers eligible for reimbursement of telehealth services under the Medicare program; providers would include: audiologists, occupational therapists, physical therapists, and qualified speech-language pathologists, among others specified by the Secretary of Health and Human Services.

S. 1699: Tech to Save Moms Act

Introduced May 18, 2023

  • This bill would require 1) the Center for Medicare and Medicaid Innovation to test payment and delivery models regarding the adoption and use of telehealth tools for screening, monitoring, and managing health complications during the pregnancies of Medicaid beneficiaries, and 2) the Secretary of Health and Human Services to submit a report to Congress that includes recommendations related to maternal telehealth services reimbursement, barriers to maternal telehealth service provision and access, and lessons learned from expanded access to telehealth maternity care during the COVID-19 Public Health Emergency (PHE).

H.R. 3440 / S. 1636: Protecting Rural Telehealth Access Act

Introduced May 17, 2023

  • This bill would amend title XVIII of the Social Security Act, related to the delivery of telehealth services under the Medicare program:
    • Eliminate geographic requirements for originating sites
    • Permit store-and-forward technologies in all states
    • Require reimbursement for telehealth services provided in a critical access hospital
    • Require a telehealth payment rate for telehealth services furnished by a FQHC or RHC
    • Allow the use of audio-only technology for certain telehealth services including: E/M services, behavioral health counseling and education services, and other services determined appropriate by the secretary

H.R. 3432: Telemental Health Care Access Act of 2023

Introduced May 17, 2023

  • This bill would remove the statutory requirement that Medicare members be seen in-person within six months of being treated for mental and behavioral health services through telehealth.

H.R. 3129: Health Care Fairness for All Act

Introduced May 9, 2023

  • This bill would permanently extend Medicare’s telehealth flexibilities that are otherwise slated to end on the final day of the COVID-19 Public Health Emergency (PHE) period or December 1, 2024.

S.B. 1315: Veterans’ Health Empowerment, Access, Leadership, and Transparency for our Heroes (HEALTH) Act of 2023

Introduced April 26, 2023

  • This bill requires the Secretary to ensure that veterans are informed of the availability of telehealth services, and disallows the Secretary from taking into consideration the availability of telehealth appointments when determining a veteran’s community care program eligibility.

H.R. 2907 / S. 1297: Let Doctors Provide Reproductive Health Care Act

Introduced April 26, 2023

  • This bill would prevent states and other entities from restricting the provision of reproductive health care services, including through telehealth.

H.R. 2573: To express the Sense of Congress with respect to Federal preemption of State restrictions on dispensing medication abortion, and for other purposes.

Introduced April 10, 2023

  • This bill would express that it is the sense of Congress that:
    • Medication abortion was appropriately approved, and regulated, under the Food, Drug, and Cosmetic Act; and,
    • Approval of medication abortion under the Food, Drug, and Cosmetic Act preempts any state law establishing, implementing, or enforcing: (1) any requirement that medication abortion be dispensed in-person; (2) any prohibition or restriction on prescribing or dispensing medication abortion via telehealth. 

H.R. 12: Women’s Health Protection Act of 2023

Introduced March 30, 2023

  • This bill would prohibit limitations on a provider’s ability to deliver or a patient’s ability to receive telemedication abortion services that are not otherwise applied to other “medically comparable services via telemedicine.

H.R. 1843 / S. 1001: Telehealth Expansion Act of 2023

Introduced March 28, 2023

  • This bill would amend the Internal Revenue Code of 1986 to ensure that “a plan shall not fail to be treated as a high deductible health plan by reason of failing to have a deductible for telehealth and other remote care services”.

S. 731: TELEHEALTH HSA Act of 2023 / Telemedicine Everywhere Lifting Everyone’s Healthcare Experience And Long Term Health HSA Act of 2023

Introduced March 9, 2023

  • This bill removes restrictions that require the originating site (i.e., the location of the beneficiary) to be in a rural area, and allows the home of a beneficiary to serve as the originating site, for behavioral health telehealth services under Medicare. The bill applies to services provided on or after January 1, 2025.
  • The bill also expands the scope of required guidance, studies, and reports to address the provision of such services under Medicaid.

S. 730: Enhance Access to Support Essential (EASE) Behavioral Health Services Act

Introduced March 9, 2023

  • This bill would amend the Internal Revenue Code of 1986 to “make permanent the permissible first dollar coverage of telehealth services for purposes of health savings accounts.”

S. 729: Audio-Only Telehealth for Emergencies Act

Introduced March 9, 2023

  • This bill would ensure payment parity of audio-only services in Medicare during an emergency declaration.

S. 701: Women’s Health Protection Act of 2023

Introduced March 8, 2023

  • This bill would prohibit limitations on a provider’s ability to deliver or a patient’s ability to receive telemedication abortion services that are not otherwise applied to other “medically comparable services via telemedicine”.

H.R. 1114: Department of Veterans Affairs Telehealth Strategy Act

Introduced February 21, 2023

  • This bill would direct the Secretary of Veterans Affairs to develop a telehealth strategy for services furnished by the Veterans Health Administration and submit a report on end-user devices that facilitate telehealth services.

H.R. 1110: KEEP Telehealth Options Act of 2023 / Knowing the Efficiency and Efficacy of Permanent Telehealth Options Act of 2023

Introduced February 21, 2023

  • This bill would require the Secretary of Health and Human Services, the Medicare Payment Advisory Commission, and the Medicaid and CHIP Payment and Access Commission to conduct studies on actions to expand access to telehealth services under Medicare, Medicaid, and CHIP during the COVID-19 Public Health Emergency.

H.R. 833: Save America’s Rural Hospitals Act 

Introduced February 6, 2023

  • This bill would make permanent the Medicare telehealth service enhancements for federally qualified health centers and rural health clinics permanent listed under Paragraph (8) of section 1834(m) of the Social Security Act.

H.R. 824: Telehealth Benefit Expansion for Workers Act of 2023

Introduced February 2, 2023

  • This bill would treat telehealth services offered under a group health plan or other group health insurance coverage as excepted benefits.

H.R. 767: / S. 237: To preserve access to abortion medications.

Introduced February 2, 2023

  • This bill would ensure that the FDA risk evaluation and mitigation strategies applied to mifepristone:
    • Do not have an in-person dispensing requirement;
    • Allow for patient access via telehealth; and,
    • Allow all pharmacies that are certified to dispense mifepristone to, at a minimum, dispense and mail the medication to patients.

H.R. 635: Expanding Access to Mental Health Services Act

Introduced 1/20/23

  • This bill would allow certain HCPCS codes for behavioral health counseling and other services to covered via audio-only telehealth within the Medicare program.

H.R. 134: To amend title XVIII of the Social Security Act to remove geographic requirements and expand originating sites for telehealth services.

Introduced January 9, 2023

  • This bill would extend COVID-19 PHE Medicare geographic flexibilities for originating sites permanently.

H.R. 197: Rural Telehealth Expansion Act

Introduced January 9, 2023

  • This bill would enable coverage and reimbursement for store-and-forward telehealth under the Medicare program.

H.R. 207: Advanced Safe Testing at Residence Telehealth Act of 2023

Introduced January 9, 2023

  • This bill would amend Title XVII of the Social Security act to provide payment for cover certain tests (e.g., serology tests for COVID-19, diagnostic tests or screenings for certain types of cancer, Haptoglobin genetic tests, prediabetes and diabetes screenings, etc.)  and assistive telehealth consultations (e.g., an evaluation and management service; the ordering of a diagnostic test or screening; an assessment of an individual succeeding the delivery of a diagnostic test or screening; etc.) under state programs.
Passed Legislation    

N/A; No applicable passed legislation in 2023.

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