This bill expands Medicare coverage to include mental and behavioral health services provided via telehealth, removing geographic restrictions that previously limited these services to rural areas. It directly affects Medicare beneficiaries seeking remote mental or behavioral health care and healthcare providers billing Medicare for these services. The key change amends the Social Security Act to replace "mental health services" with "mental and behavioral health services furnished through telehealth" and eliminates outdated geographic limitations. This ensures Medicare beneficiaries in all areas can access covered telehealth mental/behavioral health services without location-based restrictions. The policy change takes effect retroactively as if implemented in 2021.
This bill allows states to waive the 35-mile rule for certain rural hospitals seeking Critical Access Hospital (CAH) designation under Medicare. It targets hospitals that are sole community hospitals, Medicare-dependent small rural hospitals, low-volume hospitals, or subsection (d) hospitals located in high-poverty or health professional shortage areas, with two consecutive years of negative margins. To qualify, hospitals must commit to adding high-demand services like obstetrics or behavioral health and submit annual reports on these services. The bill caps total CAH designations at 120 nationwide (5 per state) and requires transition to new payment models after 9 years. It also mandates studies by GAO and MedPAC to evaluate impacts on access and costs.
This bill amends Medicare rules to temporarily waive distance requirements for certain rural hospitals seeking critical access hospital designation. Specifically, it allows rural community hospitals participating in a Medicare demonstration program (as of the bill's enactment date) to qualify as critical access hospitals without meeting standard distance criteria during a one-year window starting six months after the bill becomes law. The change directly affects eligible rural hospitals in the Medicare demonstration program, enabling them to maintain or gain critical access status without strict geographic proximity rules. This adjustment updates existing Medicare regulations to provide flexibility for these facilities during a defined transition period.
HR 7064, the AI in Health Care Efficiency and Study Act, requires the U.S. Department of Health and Human Services (HHS) to study how artificial intelligence can streamline administrative tasks in healthcare while protecting patient privacy. The study will examine AI applications for scheduling, claims processing, electronic health records, and cybersecurity threats like ransomware, involving healthcare providers, health plans, AI developers, and privacy experts. HHS must report findings and recommendations to Congress within 6 months of completing the study, focusing on reducing provider workload, improving data security, and ensuring compliance with health privacy laws. This bill does not create new regulations but directs a federal study to inform future policy on AI in healthcare administration.
This bill requires Medicare to cover "prescription digital therapeutics" (software-based treatments for medical conditions, like apps for diabetes management or mental health) starting January 1, 2026. It mandates Medicare to establish payment rules for manufacturers - considering actual costs and usage - and create specific billing codes for these tools. Manufacturers must annually report pricing, distribution volume, and user data to Medicare, with penalties for noncompliance. The bill directly affects Medicare beneficiaries, digital therapeutic developers, and healthcare providers who prescribe these digital health tools.
This bill amends IRS rules to require health insurance plans to cover telehealth services without applying deductibles, preventing plans from being disqualified as high-deductible health plans (HDHPs) solely because they waive deductibles for telehealth. It directly affects health insurance plans and employers offering HDHPs by changing how telehealth services are treated under IRS regulations. Key provisions include creating a specific exemption for telehealth services in the Internal Revenue Code and clarifying that such coverage does not disqualify plans from HDHP status. The changes take effect for plan years starting after December 31, 2024.
