Sec. 304. Providing accountable care organizations the ability to expand the use of telehealth
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Section 1899 of the Social Security Act ( 42 U.S.C. 1395jjj ) is amended by adding at the end the following new subsection: In the case of telehealth services for which payment would otherwise be made under this title furnished on or after January 1, 2020, for purposes of this subsection only, the following shall apply with respect to such services furnished by a physician or practitioner participating in an applicable ACO (as defined in paragraph (2)) to a Medicare fee-for-service beneficiary assigned to the applicable ACO:
Subject to paragraph (3), the home of a beneficiary shall be treated as an originating site described in section 1834(m)(4)(C)(ii). The geographic limitation under section 1834(m)(4)(C)(i) shall not apply with respect to an originating site described in section 1834(m)(4)(C)(ii) (including the home of a beneficiary under subparagraph (A)), subject to State licensing requirements. In this subsection: The term applicable ACO means an ACO participating in a model tested or expanded under section 1115A or under this section— that operates under a two-sided model— described in section 425.600(a) of title 42, Code of Federal Regulations; or tested or expanded under section 1115A; and for which Medicare fee-for-service beneficiaries are assigned to the ACO using a prospective assignment method, as determined appropriate by the Secretary.
The term home means, with respect to a Medicare fee-for-service beneficiary, the place of residence used as the home of the beneficiary. In the case of telehealth services described in paragraph
(1)where the home of a Medicare fee-for-service beneficiary is the originating site, the following shall apply: There shall be no facility fee paid to the originating site under section 1834(m)(2)(B). No payment may be made for such services that are inappropriate to furnish in the home setting such as services that are typically furnished in inpatient settings such as a hospital. . The Secretary of Health and Human Services (in this subsection referred to as the Secretary ) shall conduct a study on the implementation of section 1899(l) of the Social Security Act, as added by subsection (a). Such study shall include an analysis of the utilization of, and expenditures for, telehealth services under such section. The Secretary may collect such data as the Secretary determines necessary to carry out the study under this paragraph. Not later than January 1, 2026, the Secretary shall submit to Congress a report containing the results of the study conducted under paragraph (1), together with recommendations for such legislation and administrative action as the Secretary determines appropriate.
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Sec. 304
Providing accountable care organizations the ability to expand the use of telehealth
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