HR 8261 — Preserving Telehealth, Hospital, and Ambulance Access Act

8261 IntroducedReported in House (IH)](RH)] <DOC> 118thUnion CONGRESSCalendar 2dNo. Session H.

786 118th CONGRESS 2d Session H.

8261 To[Report amendNo. title XVIII of the Social Security Act to extend certain flexibilities and payment adjustments under the Medicare program, and for other purposes.

118-891, Part I] To amend title XVIII of the Social Security Act to extend certain flexibilities and payment adjustments under the Medicare program, and for other purposes.

which was referred to the Committee on Ways and Means, and in addition to the Committee on Energy and Commerce, 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 _______________________________________________________________________December A17, BILL2024 ToReported amendfrom titlethe XVIIICommittee ofon theWays Socialand SecurityMeans Actwith toan extendamendment certain[Strike flexibilitiesout all after the enacting clause and paymentinsert adjustmentsthe underpart printed in italic] December 17, 2024 Referral to the MedicareCommittee program,on Energy and Commerce extended for othera purposes.period ending not later than December 19, 2024 December 19, 2024 Committee on Energy and Commerce discharged;

committed to the Committee of the Whole House on the State of the Union and ordered to be printed [For text of introduced bill, see copy of bill as introduced on May 7, 2024] _______________________________________________________________________ A BILL To amend title XVIII of the Social Security Act to extend certain flexibilities and payment adjustments under the Medicare program, and for other purposes.

1395m)1395m(m)) is amended-- (1) in paragraph (2)(B)(iii), by striking ``ending December 31, 2024'' and inserting ``ending December 31, 2026'';

(d) Delaying the In-PersonIn-person Requirements Under Medicare for Mental Health Services Furnished Through Telehealth and Telecommunications Technology.-- (1) Delay in requirements for mental health services furnished through telehealth.--Section 1834(m)(7)(B)(i) of the Social Security Act (42 U.S.C.

(e) Allowing for the Furnishing of Audio-OnlyAudio-only Telehealth Services.--Section 1834(m)(9) of the Social Security Act (42 U.S.C.

(f) Extending Use of Telehealth Toto Conduct Face-to-FaceFace-to-face Encounter Prior to Recertification of Eligibility for Hospice Care.--Section 1814(a)(7)(D)(i)(II) of the Social Security Act (42 U.S.C.

(ii) in clause (vi),(iv), by striking ``and'' at the end;

(iii) in clause (vii),(v), by striking the period and inserting ``;

``(viii)``(vi) in the case of the second study conducted under this paragraph, the quality of care, outcomes, costs, quantity and intensity of services, and other relevant metrics between individuals who entered into the Acute Hospital Care at Home initiative directly from an emergency department compared with individuals who entered into the Acute Hospital Care at Home initiative directly from an existing inpatient stay in a hospital.'';

``(23) Master list inclusion and claim review for certain items.-- ``(A) Master list inclusion.--Beginning January 1, 2026,2027, for purposes of the Master List described in section 414.234(b) of title 42, Code of Federal Regulations (or any successor regulation), an item for which payment may be made under this subsection shall be treated as having aberrant billing patterns (as such term is used for purposes of such section) if the Secretary determines that, without explanatory contributing factors (such as furnishing emergent care services), a substantial number of writtenclaims orders for such items under this subsection are from an ordering physician or applicable practitioner with whom the individual involved does not have a prior relationship, as determined on the basis of priorclaims. payment experience.

``(B) Claim review.--With respect to items furnished on or after January 1, 20262027 that are included on the Master List pursuant to subparagraph (A), if such an item is not subject to a determination of coverage in advance pursuant to paragraph (15)(C), the Secretary may conduct prepayment review of claims for payment for such item.''.

(a) Revised Phase-InPhase-in of Reductions From Private Payor Rate Implementation.--Section 1834A(b)(3) of the Social Security Act (42 U.S.C.

<all>Union Calendar No.

786 118th CONGRESS 2d Session H.

R.

8261 [Report No.

118-891, Part I] _______________________________________________________________________ A BILL To amend title XVIII of the Social Security Act to extend certain flexibilities and payment adjustments under the Medicare program, and for other purposes.

_______________________________________________________________________ December 19, 2024 Committee on Energy and Commerce discharged;

committed to the Committee of the Whole House on the State of the Union and ordered to be printed