text: SECTION 1. SHORT TITLE.
  
      This Act may be cited as the ``Medicare Telemedicine and Medical 
  Informatics Demonstration Act of 1996''.
  
  SEC. 2. INFORMATICS, TELEMEDICINE, AND EDUCATION DEMONSTRATION PROJECT.
  
      (a) Purpose and Authorization.--
              (1) In general.--Under section 1142 of the Social Security 
          Act and consistent with this section, the Secretary of Health 
          and Human Services, through the Agency for Health Care Policy 
          and Research, shall make a grant to an eligible grantee to 
          provide for a project to demonstrate the application of high-
          capacity computing and advanced networks to the provision of 
          health care to both residents of medically underserved rural 
          areas and residents of medically underserved inner-city areas.
              (2) Focus.--The project shall focus on--
                      (A) improvements in primary care (and prevention of 
                  complications) for those residents with diabetes 
                  (mellitus), and
                      (B) those residents who are Medicare beneficiaries.
              (3) Duration of project.--The project shall be conducted 
          over a 4-year period.
              (4) Authorization of appropriations; medicare and medicaid 
          waiver authority.--The total amount of Federal expenditures 
          that may be provided pursuant to this section under the project 
          shall not exceed $30,000,000. Subject to such limitation, the 
          Secretary may waive such provisions of title XVIII and XIX of 
          the Social Security Act as may be appropriate in order to 
          permit and demonstrate the provision of Medicare and Medicaid 
          funding under the project.
      (b) Objectives of Project.--The objectives of the project include 
  the following:
              (1) Improving patient access to and compliance with 
          appropriate care guidelines for chronic diseases through direct 
          telecommunications link with information networks in order to 
          improve patient quality-of-life and reduce overall health care 
          costs.
              (2) Developing a curriculum to train, and providing 
          standards for credentialing and licensure of, health 
          professionals (particularly primary care health professionals) 
          in the use of medical informatics and telecommunciations.
              (3) Demonstrating the application of advanced technologies, 
          such as video-conferencing from a patient's home, remote 
          monitoring of a patient's medical condition, interventional 
          informatics, and applying individualized, automated care 
          guidelines, to assist primary care providers in assisting 
          patients with chronic illnesses in a home setting.
              (4) Application of medical informatics to residents with 
          limited English language skills.
              (5) Developing standards in the application of telemedicine 
          and medical informatics.
              (6) Developing a model for the cost-effective delivery of 
          primary and related care both in a managed care environment and 
          in a fee-for-service environment.
      (c) Eligible Grantee.--For purposes of this section, the term 
  ``eligible grantee'' means a consortium that includes at least one 
  tertiary care hospital, at least one medical school, and at least one 
  regional telecommunications provider and that meets the following 
  requirements:
              (1) The consortium is located in an area with a high 
          concentration of medical schools and tertiary care facilities 
          and has appropriate arrangements (within or outside the 
          consortium) with such schools and facilities, universities, and 
          telecommunications providers, in order to conduct the project.
              (2) The consortium submits to the Secretary an application 
          at such time, in such manner, and containing such information 
          as the Secretary may require, including a description of the 
          use to which the consortium would apply any amounts received 
          under the project and the source and amount of non-Federal 
          contribution towards the project.
              (3) The consortium demonstrates that it will provide for a 
          contribution toward the project from non-Federal funds or 
          resources in an amount that is not less than 50 percent of the 
          total amount to be expended in carrying out the project.
      (d) Use of Funds.--
              (1) In general.--Federal payments made available to an 
          eligible grantee under this section shall be used for the 
          development and operation of telemedicine and medical 
          informatics systems and related activities under the project.
              (2) Specific uses permitted.--Such payments may be used for 
          any of the following:
                      (A) The acquisition of telemedicine equipment for 
                  use in patients' homes (but only in the case of 
                  patients located in medically underserved areas).
                      (B) Curriculum development and training of health 
                  professionals in medical informatics and telemedicine.
                      (C) Payment of telecommunications costs (including 
                  salaries and maintenance of equipment), including costs 
                  of telecommunications between patients' homes and the 
                  eligible grantee and between the grantee and other 
                  entities under the arrangements described in subsection 
                  (c)(1).
                      (D) Payments to practitioners and providers under 
                  the Medicare and Medicaid programs.
              (3) Prohibited uses.--Such payments may not be used for any 
          of the following:
                      (A) The purchase or installation of transmission 
                  equipment (other than such equipment used by health 
                  professionals to deliver medical informatics services 
                  under the project).
                      (B) The establishment or operation of a 
                  telecommunications common carrier network.
                      (C) Construction (except for minor renovations 
                  related to the installation of reimbursable equipment) 
                  or the acquisition or building of real property.
      (e) Reports.--The Secretary shall submit to the Committees on Ways 
  and Means and Commerce of the House of Representatives and the 
  Committees on Finance and Labor and Human Resources of the Senate 
  interim reports on the project and a final report on the project within 
  6 months after the conclusion of the project. The final report shall 
  include an evaluation of the impact of the use of telemedicine and 
  medical informatics on improving access of medicare and medicaid 
  beneficiaries to health care services, on reducing the costs of such 
  services, and on improving the quality of life of such beneficiaries.
      (f) Definitions.--For purposes of this section:
              (1) Interventional informatics.--The term ``interventional 
          informatics'' means using information technology and virtual 
          reality technology to intervene in patient care.
              (2) Medical informatics.--The term ``medical informatics'' 
          means the storage, retrieval, and use of biomedical and related 
          information for problem solving and decision-making through 
          computing and communications technologies.
              (3) Project.--The term ``project'' means the demonstration 
          project under this section.
              (4) Secretary.--The term ``Secretary'' means the Secretary 
          of Health and Human Services.
target: Medicare Telemedicine and Medical Informatics Demonstration Act of 1996 - Directs the Secretary of Health and Human Services, through the Agency for Health Care Policy and Research, to make a grant to a consortium meeting specified criteria to provide for a project for the development and operation of telemedicine and medical informatics systems to demonstrate the application of high-capacity computing and advanced networks to the provision of health care to residents of medically underserved rural and inner-city areas.  Requires the project to focus on Medicare beneficiaries and on improvements in primary care (and prevention of complications) for residents with diabetes (mellitus).  Lists project objectives, which include improving patient access to and compliance with appropriate care guidelines for chronic diseases through direct telecommunications link with information networks in order to improve patient quality-of-life and reduce overall health care costs. Authorizes appropriations.
feat_title: Medicare Telemedicine and Medical Informatics Demonstration Act of 1996