text: SECTION 1. SHORT TITLE.
  
      This Act may be cited as the ``Rural Telemedicine Enhancing 
  Community Health (TECH) Act of 2009''.
  
  SEC. 2. TELEHEALTH PILOT PROJECTS.
  
      (a) In General.--The Secretary of Health and Human Services 
  (referred to in this section as the ``Secretary'') shall establish 3-
  year telehealth pilot projects for the purpose of analyzing the 
  clinical outcomes and cost effectiveness associated with telehealth 
  services in a variety of geographic areas. The Secretary shall provide 
  evaluation and treatment services to entities participating in the 
  pilot projects.
      (b) Eligible Entities.--
              (1) In general.--The Secretary shall select eligible 
          entities to participate in the pilot projects under this 
          section.
              (2) Priority.--In selecting eligible entities to 
          participate in the pilot projects under this section, the 
          Secretary shall give priority to such entities located in 
          medically underserved areas and facilities of the Indian Health 
          Service.
      (c) Evaluation.--The Secretary shall, through the pilot projects, 
  evaluate--
              (1) the effective and economic delivery of care in treating 
          behavioral health issues (including post-traumatic stress 
          disorder) with the use of telehealth services in medically 
          underserved and tribal areas, including collaborative uses of 
          health professionals, integration of the range of telehealth 
          and other technologies, and exploration of appropriate 
          reimbursement methods for third party payers;
              (2) the effectiveness of improving the capacity of non-
          medical providers and non-specialized medical providers to 
          provide health services for chronic complex diseases in 
          medically underserved and tribal areas; and
              (3) the effectiveness of using telehealth services to 
          provide acute stroke evaluation and treatment, occupational 
          therapy, physical therapy, and speech language pathology 
          services to treat cerebrovascular disease in medically 
          underserved and tribal areas.
      (d) Report.--Not later than 3 years after the pilot projects are 
  established under subsection (a), the Secretary shall submit to 
  Congress a report describing the outcomes of such pilot projects and 
  providing recommendations for expanding the use of telehealth services.
      (e) Expansion of Project.--If the Secretary determines that the 
  pilot projects under this section enhance outcomes for patients and 
  reduce expenditures for participating entities, the Secretary may 
  initiate similar projects for additional medical conditions and 
  geographic areas.
      (f) Authorization of Appropriations.--To carry out this section, 
  there is authorized to be appropriated $13,500,000 for fiscal years 
  2011 through 2014.
  
  SEC. 3. EXPANDING ACCESS TO STROKE TELEHEALTH SERVICES.
  
      (a) Expansion of Originating Sites for Stroke Telehealth 
  Services.--Section 1834(m)(4) of the Social Security Act (42 U.S.C. 
  1395m(m)(4)) is amended--
              (1) in subparagraph (C)--
                      (A) in clause (i), in the matter preceding 
                  subclause (I), by striking ``The term'' and inserting 
                  ``Subject to clause (iii), the term''; and
                      (B) by adding at the end the following new clause:
                              ``(iii) Expansion of originating sites for 
                          stroke telehealth services.--In the case of 
                          stroke telehealth services, the term 
                          `originating site' means any site described in 
                          clause (ii) at which the eligible telehealth 
                          individual is located at the time the service 
                          is furnished via a telecommunications system, 
                          regardless of where the site is located.''; and
              (2) by adding at the end the following new subparagraph:
                      ``(G) Stroke telehealth services.--The term `stroke 
                  telehealth services' means a telehealth service used 
                  for the evaluation or treatment of individuals with 
                  acute stroke, occupational therapy, physical therapy, 
                  and speech language pathology services furnished 
                  subsequent to a stroke, and stroke prevention and 
                  education services.''.
      (b) Effective Date.--The amendments made by subsection (a) shall 
  apply to telehealth services furnished on or after the date that is 6 
  months after the date of enactment of this Act.
  
  SEC. 4. IMPROVING ACCESS TO TELEHEALTH SERVICES AT IHS FACILITIES AND 
                FQHCS.
  
      (a) Inclusion of IHS Facilities as Originating Sites.--Section 
  1834(m)(4)(C)(ii) of the Social Security Act (42 U.S.C. 
  1395m(m)(4)(C)(ii)) is amended by adding at the end the following new 
  subclause:
                                      ``(IX) A facility of the Indian 
                                  Health Service, whether operated by 
                                  such Service or by an Indian tribe or 
                                  tribal organization (as those terms are 
                                  defined in section 4 of the Indian 
                                  Health Care Improvement Act).''.
      (b) Access to Store-and-Forward and Videoconferencing 
  Technologies.--
              (1) In general.--Section 1834(m)(1) of such Act (42 U.S.C. 
          1395m(m)(1)) is amended by adding at the end the following 
          sentence: ``For purposes of the first sentence, in the case of 
          telehealth services described in subclause (I) of paragraph 
          (4)(F)(iii) that are furnished by a facility of the Indian 
          Health Service (whether operated by such Service or by an 
          Indian tribe or tribal organization (as those terms are defined 
          in section 4 of the Indian Health Care Improvement Act)) or a 
          federally qualified health center (as defined in section 
          1861(aa)(4)), the term `telecommunications system' includes 
          store-and-forward technologies described in the preceding 
          sentence and, in the case of telehealth services described in 
          subclause (II) of such paragraph that are furnished by such a 
          facility or federally qualified health center, such term 
          includes videoconferencing technologies.''
              (2) Conforming amendment.--Section 1834(m)(4)(F) of such 
          Act (42 U.S.C. 1395m(m)(4)(F)) is amended by adding at the end 
          the following new clauses:
                              ``(iii) Telehealth services described.--For 
                          purposes of paragraph (1):
                                      ``(I) The telehealth services 
                                  described in this subclause include 
                                  consultations related to neurosurgery, 
                                  neurology, cardiology, dermatology, 
                                  pediatric specialty, and orthopedic (as 
                                  specified by the Secretary).
                                      ``(II) The telehealth services 
                                  described in this subclause are 
                                  services related to hepatitis and other 
                                  chronic conditions and behavioral 
                                  health services (as specified by the 
                                  Secretary).''.
      (c) Effective Date.--The amendments made by this section shall 
  apply to telehealth services furnished on or after the date that is 6 
  months after the date of enactment of this Act.
  
  SEC. 5. IMPROVING CREDENTIALING AND PRIVILEGING STANDARDS FOR 
                TELEHEALTH SERVICES.
  
      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:
              ``(5) Establishment of remote credentialing and privileging 
          standards.--
                      ``(A) In general.--Not later than 2 years after the 
                  date of the enactment of this paragraph, the Secretary 
                  shall establish reasonable regulations for considering 
                  the remote credentialing and privileging standards 
                  applicable to telehealth services, including 
                  interpretative services, for originating sites under 
                  this subsection. Such regulations shall allow an 
                  originating site to accept, and not duplicate, the 
                  credentialing and privileging processes and decisions 
                  made by another site.
                      ``(B) Clarification regarding acceptance of 
                  processes and decisions prior to enactment of 
                  regulations.--During the period beginning on such date 
                  of enactment and ending on the effective date of the 
                  regulations under subparagraph (A), the Secretary shall 
                  not take any punitive action under any rule or 
                  regulation against an originating site on the basis of 
                  that site's acceptance, for purposes of receiving 
                  telehealth services (including interpretive services), 
                  the credentialing and privileging processes and 
                  decisions made by another site that is accredited by a 
                  national accreditation body recognized by the Secretary 
                  under section 1865(a)(1) if the site accepting such 
                  credentialing and privileging processes is also so 
                  accredited and complies with the applicable 
                  requirements for such acceptance.''.
target: Rural Telemedicine Enhancing Community Health (TECH) Act of 2009 - Directs the Secretary of Health and Human Services (HHS) to establish telehealth pilot projects for the purpose of analyzing the clinical outcomes and cost effectiveness associated with telehealth services in a variety of geographic areas.
  
  Amends title XVIII (Medicare) of the Social Security Act to: (1) provide for expansion of originating telehealth sites for stroke telehealth services; (2) provide access to store-and-forward telehealth services in facilities of the Indian Health Service and federally qualified health centers; and (3) direct the Secretary to establish reasonable regulations to consider the remote credentialing and privileging standards for originating sites with respect to telehealth services.
feat_title: A bill to establish telehealth pilot projects, expand access to stroke telehealth services under the Medicare program, improve access to "store-and-forward" telehealth services in facilities of the Indian Health Service and Federally qualified health centers, reimburse facilities of the Indian Health Service as originating sites, establish regulations to consider credentialing and privileging standards for originating sites with respect to receiving telehealth services, and for other purposes.