Sponsors (18)
The bill expands telehealth specialty access and builds nonprofit regional safety‑net networks for rural Medicare/Medicaid populations and improves data-driven coordination, but its reach and effectiveness may be constrained by connectivity gaps, nonprofit-only and large-network requirements, and limited funding.
Medicare, Medicaid, and CHIP enrollees in rural and underserved communities gain increased access to specialty care through telehealth coordinated with their primary care providers.
Expansion of nonprofit regional networks (with a requirement for 50+ safety-net sites and multi-region experience) builds specialty service capacity across multiple rural regions and safety-net systems.
The model promotes better care coordination and quality improvement by requiring participating networks to collect, exchange, and evaluate program data.
Rural patients without reliable broadband or internet-capable devices may still be unable to use telehealth services, limiting the real-world access gains for many target beneficiaries.
If implementation depends on limited appropriations constrained by PHS Act rules, the program could remain small in scale, reaching fewer beneficiaries while using taxpayer funds.
Restricting selected networks to 501(c)(3) nonprofit entities may exclude qualified for‑profit telehealth providers, reducing competition and potential innovation in service delivery.
Based on analysis of 2 sections of legislative text.
Requires CMMI to test nonprofit networks delivering specialty care via digital modalities to Medicare and Medicaid/CHIP beneficiaries in rural and underserved areas.
Introduced April 1, 2025 by Jodey Cook Arrington · Last progress April 1, 2025
Requires the CMS Innovation Center (CMMI) to test a Specialty Health Care Services Access Model that hires nonprofit provider networks to deliver specialty care through digital modalities (for example, telehealth) in coordination with primary care. The model must serve Medicare and Medicaid/CHIP beneficiaries who live in rural or underserved areas and select networks that meet size, rurality, nonprofit status, regional reach, and data/exchange capability requirements. Any funds used to implement the model are subject to requirements that apply to certain Public Health Service Act programs.