HR 5496 — HEALTH Act of 2025

Summary

Helping Ensure Access to Local TeleHealth Act of 2025 or the HEALTH Act of 2025 This bill modifies requirements relating to Medicare coverage of telehealth services, including services that are furnished by federally qualified health centers (FQHCs) and rural health clinics (RHCs).Specifically, the bill expands coverage to include audio-only telehealth services. It also permanently allows FQHCs and RHCs to serve as the distant site (i.e., the location of the health care practitioner) for telehealth services and excludes such services from certain geographic restrictions. Payment must be made in the same manner as for non-telehealth services, rather than in accordance with a separate methodology determined by the Centers for Medicare & Medicaid Services.

Bill Text

• Introduced Introduced in House Current html September 18, 2025

Compared against current U.S. Code AI-generated reading aid — verify against the official bill.

The bill establishes permanent payments for telehealth services provided by federally qualified health centers (FQHCs) and rural health clinics (RHCs), while also removing originating site requirements for distant site telehealth services.

• 42 U.S.C. 1395m(m)(4)

  (G) Telecommunications system.--Except as provided in paragraph (1), the term `telecommunications system' means a two-way, real-time interactive communications system, whether by audiovisual or audio-only communications.

  Defines telecommunications system to include audio-only communications.

• 42 U.S.C. 1395m(m)(8)

  During the emergency period → With respect to telehealth services furnished on or after the date of the beginning of the emergency period described in section 1135(g)(1)(B)--

  Changes the payment context for telehealth services to a permanent change based on the start of the emergency period.

• 42 U.S.C. 1395m(m)(8)

  subparagraph (B) → (B) Payment.-- (i) In general.--A telehealth service furnished by a rural health clinic or a federally qualified health center serving as a distant site to an individual shall be deemed to be so furnished to such individual as an outpatient of such clinic or facility (as applicable) for purposes of paragraph (1) or (3), respectively, of section 1861(aa) and payable as a rural health clinic service or federally qualified health center service (as applicable) under section 1833(a)(3) or under the prospective payment system established under section 1834(o), respectively. (ii) Treatment of costs for fqhc pps calculations and rhc air calculations.--Costs associated with the delivery of telehealth services by a federally qualified health center or rural health clinic serving as a distant site pursuant to this paragraph shall be considered allowable costs for purposes of the prospective payment system established under section 1834(o) and any payment methodologies developed under section 1833(a)(3), as applicable.

  Replaces the existing payment structure for telehealth services with new provisions ensuring payment as outpatient services.

• 42 U.S.C. 1395m(m)

  and (7) → (7), and (8)

  Includes telehealth services into the list of covered services under the specified paragraphs.

• 42 U.S.C. 1395m(m)(2)(B)

  clause (ii) → clauses (ii) and (iii)

  Expands the conditions under which facility fees are applicable for originating sites regarding telehealth services.

• 42 U.S.C. 1395m(m)(8)

  (C) Nonapplication of originating site requirements.--The geographic and site requirements described in paragraph (4)(C) shall not apply with respect to telehealth services furnished by a federally qualified health center or a rural health clinic serving as a distant site.

  Removes originating site geographic and site requirements for telehealth services provided by FQHCs and RHCs.

Action History

1. September 18, 2025

   Introduced in House

2. September 18, 2025

   Introduced in House

3. September 18, 2025

   Referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.

4. September 18, 2025

   Referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.

Sponsors

• Glenn Thompson · Primary
• Jill N. Tokuda · Cosponsor
• Eugene Simon Vindman · Cosponsor
• Melanie A. Stansbury · Cosponsor
• Chris Pappas · Cosponsor
• Marcy Kaptur · Cosponsor

Subjects