Telehealth flexibilities for critical access hospitals

Section 1834(m) of the Social Security Act (42 U.S.C. 1395m(m)) is amended— (1) in the first sentence of paragraph (1), by striking and (9) and inserting (9), and (10); (2) in paragraph (2)(A), by striking paragraph (8) and inserting paragraphs (8) and (10); (3) in paragraph (4)— (A) in subparagraph (A), by striking paragraph (8) and inserting paragraphs (8) and (10); and (B) in subparagraph (F)(i), by striking paragraph (8) and inserting paragraphs (8) and (10); and (4) by adding at the end the following new paragraph: (10) Telehealth flexibilities for critical access hospitals (A) In general On or after the date of the enactment of this paragraph— (i) the Secretary shall pay for telehealth services that are furnished via a telecommunications system by a critical access hospital, including any practitioner authorized to provide such services within the facility, that is a qualified provider (as defined in subparagraph (B)) to an eligible telehealth individual enrolled under this part notwithstanding that the critical access hospital providing the telehealth service is not at the same location as the beneficiary, if such services complement a plan of care that includes in-person care at some point, as may be appropriate; (ii) the amount of payment to a critical access hospital that serves as a distant site for such a telehealth service shall be determined under subparagraph (C); and (iii) for purposes of this subsection— (I) the term distant site includes a critical access hospital that furnishes a telehealth service to an eligible telehealth individual; and (II) the term telehealth services includes behavioral health services and any other outpatient critical access hospital service that is furnished using telehealth to the extent that payment codes corresponding to services identified by the Secretary under clause (i) or (ii) of paragraph (4)(F) are listed on the corresponding claim for such critical access hospital service. (B) Definition of qualified provider For purposes of this subsection, the term qualified provider means, with respect to a telehealth service described in subparagraph (A)(i) that is furnished to an eligible telehealth individual, a critical access hospital that has an established patient relationship with such individual as defined by the State in which the individual is located. (C) Payment The amount of payment to a critical access hospital that serves as a distant site that furnishes a telehealth service to an eligible telehealth individual under this paragraph shall be equal to 101 percent of the reasonable costs of the hospital in providing such services, unless the hospital makes an election under paragraph (2) of section 1834(g) to be paid for such services based on the methodology described in such paragraph. Telehealth services furnished by a critical access hospital shall be counted for purposes of determining the provider productivity rate of the critical access hospital for purposes of payment under such section. (D) Implementation Notwithstanding any other provision of law, the Secretary may implement this paragraph through program instruction, interim final rule, or otherwise..