CONNECT for Health Act of 2025

[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[H.R. 4206 Introduced in House (IH)]
<DOC>
119th CONGRESS
1st Session
H. R. 4206
To amend title XVIII of the Social Security Act to expand access to
telehealth services, and for other purposes.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
June 26, 2025
Mr. Thompson of California (for himself, Mr. Schweikert, Ms. Matsui,
and Mr. Balderson) introduced the following bill; which was 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
_______________________________________________________________________
A BILL
To amend title XVIII of the Social Security Act to expand access to
telehealth services, and for other purposes.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,

3d9d062fc8eb05aa0e0c267f32e8a8328d4796a013e12142491af2f897800f6b

(a) Short Title.--This Act may be cited as the ``Creating
Opportunities Now for Necessary and Effective Care Technologies
(CONNECT) for Health Act of 2025'' or the ``CONNECT for Health Act of
2025''.
(b) Table of Contents.--The table of contents of this Act is as
follows:

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efb0d1a570b5aba50e5d5f9cdafc51409597a9f95264070d7517c53542679edf

TITLE I

-REMOVING BARRIERS TO TELEHEALTH COVERAGE

ddd82928dede0d3607deca79e7e17d5da67e77f68e2d175a4c6d2df06216b5b5

848d0e6842d29dba8b2d5f0fda4a968e6729201d53d339aa87b274272d72df42

ef55a181b3d2bae466cfc906b88982292f8cceabc310c14a9dfc6672e29e322f

TITLE II

-PROGRAM INTEGRITY

1724d9de5a7a688261dc16072af582c6c275989ffb2008f5dbb08ceba77b6244

TITLE III

-BENEFICIARY AND PROVIDER SUPPORTS, QUALITY OF CARE, AND DATA

(a) Findings.--Congress finds the following:
(1) The use of technology in health care and coverage of
telehealth services are rapidly evolving.
(2) Research has found that telehealth services can expand
access to care, improve the quality of care, and reduce
spending.
(3) In 2023, 90 percent of patients receiving telehealth
services were satisfied with their experiences.
(4) Health care workforce shortages are a significant
problem in many areas and for many types of health care
clinicians.
(5) Telehealth increases access to care in areas with
workforce shortages and for individuals who live far away from
health care facilities, have limited mobility or
transportation, or have other barriers to accessing care.
(6) The use of health technologies can strengthen the
expertise of the health care workforce, including by connecting
clinicians to specialty consultations.
(7) Prior to the COVID-19 pandemic, the utilization of
telehealth services in the Medicare program under title XVIII
of the Social Security Act (42 U.S.C. 1395 et seq.) was low,
accounting for 0.1 percent of Medicare Part B visits in 2019.
(8) Telehealth now represents a critical component of care
delivery. In 2023, 24 percent of Medicare fee-for-service
beneficiaries received a telehealth service.
(9) Long-term certainty about coverage of telehealth
services under the Medicare program is necessary to fully
realize the benefits of telehealth.
(b) Sense of Congress.--It is the sense of Congress that--
(1) health care providers can furnish safe, effective, and
high-quality health care services through telehealth;
(2) the Secretary of Health and Human Services should
promptly take all necessary measures to ensure that providers
and beneficiaries can continue to furnish and utilize,
respectively, telehealth services in the Medicare program, and
support recent modifications to the definition of ``interactive
telecommunications system'' in regulations and program
instruction under the Medicare program to ensure that providers
can utilize all appropriate means and types of technology,
including audio-visual, audio-only, and other types of
technologies, to furnish telehealth services; and
(3) barriers to the use of telehealth should be removed.

7f9d00bf71ffbd800ea5b3e4caa36b5e91b27cd232e55ee6230ad5a6c6e5c07b

Section 1834(m)(4)(C) of the Social Security Act (42 U.S.C.
1395m(m)(4)(C)) is amended--
(1) in clause (i), in the matter preceding subclause (I),
by striking ``clause (iii)'' and inserting ``clauses (iii) and
(iv)''; and
(2) by adding at the end the following new clause:
``(iv) Removal of geographic
requirements.--The geographic requirements
described in clause (i) shall not apply with
respect to telehealth services furnished on or
after October 1, 2025.''.

c957d97b56cf86ce26fbb19871d7c2b9123cc469af1859c2ffff1dfcfc79c61c

(a) In General.--Section 1834(m)(4)(C)(iii) of the Social Security
Act (42 U.S.C. 1395m(m)(4)(C)(iii)) is amended by striking ``In the
case that'' and all that follows through ``September 30, 2025,'' and
inserting ``Beginning on the date of the enactment of the CONNECT for
Health Act of 2025,''.
(b) Conforming Amendments.--Section 1834(m) of the Social Security
Act (42 U.S.C. 1395m(m)) is amended--
(1) in paragraph (2)(B)(iii), by striking ``In the case
that'' and all that follows through ``September 30, 2025,'' and
inserting ``With respect to telehealth services furnished on or
after the date of the enactment of the CONNECT for Health Act
of 2025,''; and
(2) in paragraph (4)(C)(ii)(X), by striking ``, but only
for purposes of section 1881(b)(3)(B) or telehealth services
described in paragraph (7)''.

588e412b5b0032c774db156a9ebc43037cd36ba49086fd5bdd54434798207e40

TELEHEALTH SERVICES.
Section 1834(m)(4)(E) of the Social Security Act (42 U.S.C.
1395m(m)(4)(E)) is amended--
(1) by striking ``Practitioner.--The term'' and inserting
``Practitioner.--
``(i) In general.--Subject to clause (ii),
the term''; and
(2) by adding at the end the following new clause:
``(ii) Expanding practitioners eligible to
furnish telehealth services.--
``(I) In general.--Notwithstanding
any other provision of this subsection,
in the case of telehealth services
furnished on or after October 1, 2025,
the Secretary may waive any limitation
on the types of practitioners who are
eligible to furnish telehealth services
if the Secretary determines that such
waiver is clinically appropriate.
``(II) Implementation.--In
implementing a waiver under this
clause, the Secretary may establish
requirements, as appropriate, for
practitioners under such waiver,
including with respect to beneficiary
and program integrity protections.
``(III) Public comment.--The
Secretary shall establish a process by
which stakeholders may (on at least an
annual basis) provide public comment on
such waiver under this clause.
``(IV) Periodic review.--The
Secretary shall periodically, but not
more frequently than every 3 years,
reassess the waiver under this clause
to determine whether such waiver
continues to be clinically appropriate.
The Secretary shall terminate any
waiver that the Secretary determines is
no longer clinically appropriate.''.

c15f68b575d6f2ab40cf498561f058f260dafea663812950ea8731da966de7f9

Section 1834(m) of the Social Security Act (42 U.S.C. 1395m(m)) is
amended--
(1) in paragraph (4)(C)(i), in the matter preceding
subclause (I), by striking ``and (7)'' and inserting ``(7), and
(8)''; and
(2) in paragraph (8)--
(A) in subparagraph (A)--
(i) in the matter preceding clause (i), by
striking ``During'' and all that follows
through ``September 30, 2025'' and inserting
the following: ``Beginning on the first day of
the emergency period described in section
1135(g)(1)(B)'';
(ii) in clause (ii), by striking ``and'' at
the end;
(iii) by redesignating clause (iii) as
clause (iv); and
(iv) by inserting after clause (ii) the
following new clause:
``(iii) the geographic requirements
described in paragraph (4)(C)(i) shall not
apply with respect to such a telehealth
service; and'';
(B) in subparagraph (B)--
(i) in the subparagraph heading, by
inserting ``during initial period'' after
``rule'';
(ii) in the first sentence of clause (i) by
striking ``during the periods for which
subparagraph (A) applies'' and inserting
``during the period beginning on the first day
of the emergency period and ending on September
30, 2025''; and
(iii) in clause (ii), by striking ``Costs
associated'' and inserting ``During the period
for which clause (i) applies, costs
associated''; and
(C) by adding at the end the following new
subparagraph:
``(C) Payment after initial period.--
``(i) In general.--A telehealth service
furnished by a Federally qualified health
center or a rural health clinic to an
individual pursuant to this paragraph on or
after October 1, 2025, 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 Federally
qualified health center service or rural health
clinic service (as applicable) under the
prospective payment system established under
section 1834(o) or under section 1833(a)(3),
respectively.
``(ii) Treatment of costs for fqhc pps
calculations and rhc air calculations.--Costs
associated with the furnishing of telehealth
services by a Federally qualified health center
or rural health clinic serving as a distant
site pursuant to this paragraph on or after
October 1, 2025, 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.''.

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(a) In General.--Section 1834(m)(4)(C) of the Social Security Act
(42 U.S.C. 1395m(m)(4)(C)), as amended by section 101, is amended--
(1) in clause (i), by striking ``and (iv)'' and inserting
``, (iv), and (v)''; and
(2) by adding at the end the following new clause:
``(v) Native american health facilities.--
With respect to telehealth services furnished
on or after January 1, 2026, the originating
site requirements described in clauses (i) and
(ii) shall not apply with respect to a facility
of the Indian Health Service, whether operated
by such Service, or by an Indian tribe (as that
term is defined in section 4 of the Indian
Health Care Improvement Act (25 U.S.C. 1603))
or a tribal organization (as that term is
defined in section 4 of the Indian Self-
Determination and Education Assistance Act (25
U.S.C. 5304)), or a facility of the Native
Hawaiian health care systems authorized under
the Native Hawaiian Health Care Improvement Act
(42 U.S.C. 11701 et seq.).''.
(b) No Originating Site Facility Fee for Certain Native American
Facilities.--Section 1834(m)(2)(B)(i) of the Social Security Act (42
U.S.C. 1395m(m)(2)(B)(i)) is amended, in the matter preceding subclause
(I), by inserting ``(other than an originating site that is only
described in clause (v) of paragraph (4)(C), and does not meet the
requirement for an originating site under clauses (i) and (ii) of such
paragraph)'' after ``the originating site''.

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TELEMENTAL HEALTH SERVICES.
(a) In General.--Section 1834(m)(7) of the Social Security Act (42
U.S.C. 1395m(m)(7)(B)) is amended--
(1) in subparagraph (A), by striking ``, subject to
subparagraph (B),'';
(2) by striking ``(A) In general.--The geographic'' and
inserting ``The geographic''; and
(3) by striking subparagraph (B).
(b) Rural Health Clinics.--Section 1834(y)(2) of the Social
Security Act (42 U.S.C. 1395m(y)(2)) is amended by striking ``prior to
October 1, 2025''.
(c) Federally Qualified Health Centers.--Section 1834(o)(4)(B) of
the Social Security Act (42 U.S.C. 1395m(o)(4)(B)) is amended by
striking ``prior to October 1, 2025''.

1f47f1fbe2211a83265f16810ce0dcb2d4c6095d17531514ab8e0b2f8a962f4d

EMERGENCIES.
Section 1135(g)(1) of the Social Security Act (42 U.S.C. 1320b-
5(g)(1)) is amended--
(1) in subparagraph (A), in the matter preceding clause
(i), by striking ``subparagraph (B)'' and inserting
``subparagraphs (B) and (C)''; and
(2) by adding at the end the following new subparagraph:
``(C) Exception for waiver of telehealth
requirements during public health emergencies.--For
purposes of subsection (b)(8), in addition to the
emergency period described in subparagraph (B), an
`emergency area' is a geographical area in which, and
an `emergency period' is the period during which, there
exists a public health emergency declared by the
Secretary pursuant to section 319 of the Public Health
Service Act on or after the date of enactment of this
subparagraph.''.

35f4a7929b6bfd89bb1af8d6e532e4e212d50941daad448e3bb8cb94986db83e

(a) In General.--Section 1814(a)(7)(D)(i)(II) of the Social
Security Act (42 U.S.C. 1395f(a)(7)(D)(i)(II)) is amended by striking
``during the emergency period'' and all that follows through
``September 30, 2025'' and inserting the following: ``during and after
the emergency period described in section 1135(g)(1)(B)''.
(b) GAO Report.--Not later than 3 years after the date of enactment
of this Act, the Comptroller General of the United States shall submit
to Congress a report evaluating the impact of section
1814(a)(7)(D)(i)(II) of the Social Security Act (42 U.S.C.
1395f(a)(7)(D)(i)(II)), as amended by subsection (a), on--
(1) the number and percentage of beneficiaries recertified
for the Medicare hospice benefit at 180 days and for subsequent
benefit periods, to the extent such data is available;
(2) Federal oversight of the appropriateness for hospice
care of the patients recertified through the use of telehealth;
and
(3) any other factors determined appropriate by the
Comptroller General.

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PROVIDED TO BENEFICIARIES.
Section 1128A(i)(6) of the Social Security Act (42 U.S.C. 1320a-
7a(i)(6)) is amended--
(1) in subparagraph (I), by striking ``; or'' and inserting
a semicolon;
(2) in subparagraph (J), by striking the period at the end
and inserting ``; or''; and
(3) by adding at the end the following new subparagraph:
``(K) the provision of technologies (as defined by
the Secretary) on or after the date of the enactment of
this subparagraph, by a provider of services or
supplier (as such terms are defined for purposes of
title XVIII) directly to an individual who is entitled
to benefits under part A of title XVIII, enrolled under
part B of such title, or both, for the purpose of
furnishing telehealth services, remote patient
monitoring services, or other services furnished
through the use of technology (as defined by the
Secretary), if--
``(i) the technologies are not offered as
part of any advertisement or solicitation; and
``(ii) the provision of the technologies
meets any other requirements set forth in
regulations promulgated by the Secretary.''.

66895b7174db3ddb80a78cfb0b579065b8f9c4667c000fd699830b86e9886030

In addition to amounts otherwise available, there are authorized to
be appropriated to the Inspector General of the Department of Health
and Human Services for each of fiscal years 2026 through 2030, out of
any money in the Treasury not otherwise appropriated, $3,000,000, to
remain available until expended, for purposes of conducting audits,
investigations, and other oversight and enforcement activities with
respect to telehealth services, remote patient monitoring services, or
other services furnished through the use of technology (as defined by
the Secretary).

c6f086a3e05ae66d3c0da425d7598114d725581453c89b436700ea4cb4177370

TELEHEALTH SERVICES.
(a) Identification and Notification of Outlier Billers of
Telehealth.--
(1) In general.--The Secretary shall, using standard unique
health identifiers (described in section 1173(b) of the Social
Security Act (42 U.S.C. 1320d-2) reported on claims for
telehealth services furnished to individuals under section
1834(m) of such Act (42 U.S.C. 1395m(m))), identify physicians
and practitioners that demonstrate significant outlier billing
patterns (such as coding of telehealth services for
inappropriate length of time and inaccurate complexity and
inappropriate or duplicate billing) for telehealth services or
items or services ordered or prescribed concurrent to a
telehealth service over a period of time specified by the
Secretary.
(2) Establishment of thresholds.--For purposes of this
subsection, the Secretary shall establish thresholds for
outlier billing patterns to identify whether a physician or
practitioner is a significant outlier biller for telehealth
services or items or services ordered or prescribed concurrent
to a telehealth service as compared to other physicians or
practitioners within the same specialty and geographic area.
(b) Notification.--
(1) In general.--The Secretary shall notify physicians and
practitioners identified as a significant outlier biller for
telehealth services or items or services ordered or prescribed
concurrent to a telehealth service under subsection (a). Each
notification under the preceding sentence shall include the
following:
(A) Information on how the physician or
practitioner compares to physicians or practitioners
within the same specialty and geographic area with
respect to billing for telehealth services or items or
services ordered or prescribed concurrent to a
telehealth service under the Medicare program under
title XVIII of the Social Security Act (42 U.S.C. 1395
et seq.).
(B) Information on telehealth billing guidelines
under the Medicare program.
(C) Other information determined appropriate by the
Secretary.
(2) Clarification.--Nothing in this subsection or
subsection (a) shall be construed as directing the Centers for
Medicare & Medicaid Services to pursue further audits of
providers of services and suppliers outside of those permitted
or required under titles XI or XVIII of the Social Security
Act, or otherwise under applicable Federal law.
(c) Public Availability of Information.--The Secretary shall make
aggregate information on outlier billing patterns identified under
subsection (a) available on the internet website of the Centers for
Medicare & Medicaid Services. Such information shall be in a form and
manner determined appropriate by the Secretary and shall not identify
any specific physician or practitioner.
(d) Other Activities.--Nothing in this section shall preclude the
Secretary from conducting activities that provide physicians and
practitioners with information as to how they compare to other
physicians and practitioners that are in addition to the activities
under this section.
(e) Telehealth Resource Centers Education Activities.--Section
330I(j)(2) of the Public Health Service Act (42 U.S.C. 254c-14(j)(2))
is amended--
(1) in subparagraph (F), by striking ``and'' at the end;
(2) in subparagraph (G), by striking the period at the end
and inserting ``; and''; and
(3) by adding at the end the following new subparagraph:
``(H) providing technical assistance and education
to physicians and practitioners that the Secretary
identifies pursuant to section 203(a) of the CONNECT
for Health Act of 2025 as having significant levels of
outlier billing patterns with respect to telehealth
services or items or services ordered or prescribed
concurrent to a telehealth service under the Medicare
program under title XVIII of the Social Security Act,
including--
``(i) education on practices to ensure
coding of telehealth services for appropriate
length of time and accurate complexity;
``(ii) education on prevention of
inappropriate or duplicate billing; and
``(iii) information provided in the annual
physician fee schedule rulemaking regarding--
``(I) services specified in
paragraph (4)(F)(i) of section 1834(m)
of the Social Security Act (42 U.S.C.
1395m(m)) for authorized payment under
paragraph (1) of such section; and
``(II) the process used to update
such services under paragraph
(4)(F)(ii) of such section 1834(m); and
``(iv) referral to the appropriate medicare
administrative contractor for specific
questions that fall outside of the scope of
broad best practices.''.
(f) Definitions.--In this section:
(1) Secretary.--The term ``Secretary'' means the Secretary
of Health and Human Services.
(2) Telehealth service.--The term ``telehealth service''
has the meaning given that term in section 1834(m)(4)(F) of the
Social Security Act (42 U.S.C. 1395m(m)(4)(F)).
(3) Physician; practitioner.--The terms ``physician'' and
``practitioner'' have the meaning given those terms for
purposes of section 1834(m) of the Social Security Act (42
U.S.C. 1395m(m)).

f7d88806bd58d0e9a0feb46a1b659eabdb5f5decb5a9a13553cf0547efde0fa7

(a) Resources, Guidance, and Training Sessions.--Section 1834(m) of
the Social Security Act (42 U.S.C. 1395m(m)) is amended by adding at
the end the following new paragraph:
``(10) Resources, guidance, and training sessions.--
``(A) In general.--Not later than 6 months after
the date of the enactment of this paragraph, the
Secretary, in consultation with stakeholders, shall
issue resources, guidance, and training sessions for
beneficiaries, physicians, practitioners, and health
information technology software vendors on best
practices for ensuring telehealth services are
accessible for--
``(i) individuals with limited English
proficiency, including instructions on how to--
``(I) access telehealth platforms;
``(II) utilize interpreter
services; and
``(III) integrate telehealth and
virtual interpreter services; and
``(ii) individuals with disabilities,
including instructions on accessibility of the
telecommunications system being used for
telehealth services, engagement with
beneficiaries with disabilities prior to,
during, and after the furnishing of the
telehealth service, and training on captioning
and transcripts.
``(B) Accounting for age and other differences.--
Resources, guidance, and training sessions issued under
this paragraph shall account for age and
sociodemographic, geographic, literacy, cultural,
cognitive, and linguistic differences in how
individuals interact with technology.''.
(b) Study and Report on Tactics To Improve Beneficiary Engagement
on Telehealth.--
(1) Study.--The Secretary of Health and Human Services
shall, to the maximum extent feasible, collect and analyze
qualitative and quantitative data on strategies that
clinicians, payers, and other health care organizations use to
improve beneficiary engagement on telehealth services (as
defined in section 1834(m)(4)(F) of the Social Security Act (42
U.S.C. 1395m(m)(4)(F))), with an emphasis on underserved
communities, such as the use of digital navigators, providing
patients with pre-visit information on telehealth, caregiver
engagement, and training on telecommunications systems, and the
investments necessary for health care professionals to
effectively furnish telehealth services, including the costs of
necessary technology and of training staff.
(2) Report.--Not later than 2 years after the date of the
enactment of this Act, the Secretary shall submit to Congress
and make available on the internet website of the Secretary of
Health and Human Services a report containing the results of
the study under paragraph (1), together with recommendations
for such legislation and administrative action as the Secretary
determines appropriate.
(c) Funding.--There are authorized to be appropriated such sums as
necessary to carry out the provisions of, including the amendments made
by, this section.

e6d58fddafcd6ebb5e8bb82408ddfca137fbb9d2c73debca912d612a82c534b9

(a) Educational Resources and Training Sessions.--Not later than 6
months after the date of enactment of this Act, the Secretary of Health
and Human Services shall develop and make available to health care
professionals educational resources and training sessions on
requirements relating to the furnishing of telehealth services under
section 1834(m) of the Social Security Act (42 U.S.C. 1395m(m)) and
topics including--
(1) requirements for payment for telehealth services;
(2) telehealth-specific health care privacy and security
training;
(3) utilizing telehealth services to engage and support
underserved, high-risk, and vulnerable patient populations; and
(4) other topics as determined appropriate by the
Secretary.
(b) Funding.--There are authorized to be appropriated such sums as
necessary to carry out this section.

775c4aea98a4d48fe209b91c673fe6e43bfc4091821b73f72d3ccd7ab8470b0a

CARE.
Section 1890A of the Social Security Act (42 U.S.C. 1395aaa-1) is
amended by adding at the end the following new subsection:
``(h) Measuring Quality of Telehealth Services.--
``(1) In general.--Not later than 180 days after the date
of the enactment of this subsection, the Secretary shall review
quality measures to ensure inclusion of measures relating to
telehealth services, including care, prevention, diagnosis,
patient experience, health outcomes, and treatment.
``(2) Consultation.--In conducting the review and
assessment under paragraph (1), the Secretary shall consult
external technical experts in quality measurement, including
patient organizations, providers, and experts in telehealth.
``(3) Review and assessment.--The review and assessment
under this subsection shall--
``(A) include review of existing and under
development quality measures to identify measures that
are currently inclusive of, and measures that fail to
account for, telehealth services;
``(B) identify gaps in areas of quality measurement
that relate to telehealth services, including health
outcomes and patient experience of care; and
``(C) assess how to effectively streamline,
implement, and assign accountability for health
outcomes for quality measures for telehealth services
across health care settings and providers.
``(4) Technical guidance.--The Secretary shall issue
technical guidance on the following for health care providers
and other stakeholders, as determined appropriate by the
Secretary:
``(A) How to stratify measures by care modality and
population to identify differences in health outcomes.
``(B) The use of uniform data elements.
``(C) How to identify and catalogue best practices
related to the use of quality measurement and quality
improvement for telehealth services.
``(D) Other areas determined appropriate by the
Secretary.
``(5) Report.--Not later than 2 years after the date of the
enactment of this subsection, the Secretary shall submit to
Congress and post on the internet website of the Centers for
Medicare & Medicaid Services a report on the review and
assessment conducted under this subsection.''.

8e0ce8a9171d9933d8075c20a89b148b3546e109ceecba136de0eae1906db4db

Not later than 180 days after the date of the enactment of this
Act, and quarterly thereafter, the Secretary of Health and Human
Services shall post on the internet website of the Centers for Medicare
& Medicaid Services information on--
(1) the furnishing of telehealth services under the
Medicare program under title XVIII of the Social Security Act
(42 U.S.C. 1395 et seq.), described by patient population, type
of service, geography, place of service, and provider type;
(2) the impact of telehealth services on expenditures and
utilization under the Medicare program for the most recent 4
quarters for which Medicare claims data is available; and
(3) other outcomes related to the furnishing of telehealth
services under the Medicare program, as determined appropriate
by the Secretary.
<all>

8a5d54703b49c9dd4dcef4ae311af127ed40a8882995d80d85859102d916e147

CONNECT for Health Act of 2025 — HR. 4206

Other Sections

TITLE I

TITLE II

TITLE III

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