Health Care at Home Act of 2020
This bill requires private health insurance plans to cover certain services provided via telecommunications systems (i.e., telehealth) during the COVID-19 (i.e., coronavirus disease 2019) public health emergency. Specifically, the telehealth services must be deemed medically necessary by a health care provider and covered under the plan if provided in person. Plans must apply the same cost-sharing and reimbursement amounts that would otherwise apply to such services and may waive cost-sharing requirements for any services to diagnose or treat COVID-19, including via telehealth.
[Congressional Bills 116th Congress]
[From the U.S. Government Publishing Office]
[S. 3741 Introduced in Senate (IS)]
<DOC>
116th CONGRESS
2d Session
S. 3741
To require group health plans and health insurance issuers offering
group or individual health insurance coverage to provide coverage for
services furnished via telehealth if such services would be covered if
furnished in person during the COVID-19 emergency.
_______________________________________________________________________
IN THE SENATE OF THE UNITED STATES
May 14, 2020
Ms. Smith (for herself, Ms. Stabenow, Mr. Cardin, Mr. Casey, Mr. Udall,
Mrs. Shaheen, Ms. Harris, Ms. Klobuchar, and Mr. Markey) introduced the
following bill; which was read twice and referred to the Committee on
Health, Education, Labor, and Pensions
_______________________________________________________________________
A BILL
To require group health plans and health insurance issuers offering
group or individual health insurance coverage to provide coverage for
services furnished via telehealth if such services would be covered if
furnished in person during the COVID-19 emergency.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Health Care at Home Act of 2020''.
SEC. 2. REQUIRING GROUP HEALTH PLANS AND HEALTH INSURANCE ISSUERS
OFFERING GROUP OR INDIVIDUAL HEALTH INSURANCE COVERAGE TO
PROVIDE COVERAGE FOR SERVICES FURNISHED VIA TELEHEALTH IF
SUCH SERVICES WOULD BE COVERED IF FURNISHED IN PERSON
DURING THE COVID-19 EMERGENCY.
(a) In General.--During any portion of the emergency period
described in section 1135(g)(1)(B) of the Social Security Act (42
U.S.C. 1320b-5(g)(1)(B)), notwithstanding sections 2703 and 2715(d)(4)
of the Public Health Service Act (42 U.S.C. 300gg-2, 300gg-15(d)(4)), a
group health plan and a health insurance issuer offering group health
insurance coverage, including a grandfathered health plan (as defined
in section 1251(e) of the Patient Protection and Affordable Care Act
(42 U.S.C. 18011(e)))--
(1) shall--
(A) provide benefits under such plan or such
coverage for any eligible service (as defined in
subsection (c)), including a mental health and
substance use disorder service, furnished via a
qualifying telecommunications system (as defined in
subsection (c)) by a health care provider to an
individual who is a participant, beneficiary, or
enrollee under such plan or such coverage,
notwithstanding that such provider furnishing such
service is not at the same location as the individual;
(B) so provide such benefits for such service under
the same terms and with application of the same cost-
sharing requirements (including a deductible,
copayment, or coinsurance) as would apply if such
service were furnished by such provider to such
individual in person;
(C) reimburse such provider for such service in an
amount equal to the amount of reimbursement for such
service had such service been furnished by such
provider to such individual in person;
(D) not impose any requirement under such plan or
coverage that such provider have a prior relationship
with such individual; and
(E) not restrict the ability of any health care
provider with a contractual relationship for furnishing
an eligible service under such plan or coverage from
furnishing such service via a qualifying
telecommunications system, and shall not establish
incentives or penalties under such plan or coverage for
receiving such an eligible service from such a provider
via such a system; and
(2) may waive any cost-sharing requirement (including
application of a deductible, copayment, or coinsurance) for an
item or service furnished for purposes of diagnosing or
treating COVID-19, including any such service that is an
eligible service furnished via a qualifying telecommunications
system.
(b) Application.--The provisions of this section shall be applied
by the Secretary of Health and Human Services, Secretary of Labor, and
Secretary of the Treasury to group health plans and health insurance
issuers offering group or individual health insurance coverage as if
included in the provisions of part A of title XXVII of the Public
Health Service Act, part 7 of the Employee Retirement Income Security
Act of 1974, and subchapter B of chapter 100 of the Internal Revenue
Code of 1986, as applicable.
(c) Definitions.--In this section:
(1) Eligible service.--The term ``eligible service'' means,
with respect to a group health plan and a health insurance
issuer offering group or individual health insurance coverage,
a service--
(A) for which benefits are provided under such plan
or such coverage when such service is furnished in
person;
(B) that is medically necessary (as determined by
the health care provider furnishing such service); and
(C) that is able to be safely and effectively
furnished via a telecommunications system.
(2) Health insurance terms.--The terms ``group health
plan'', ``health insurance issuer'', ``group health insurance
coverage'', and ``individual health insurance coverage'' have
the meanings given such terms in section 2791 of the Public
Health Service Act (42 U.S.C. 300gg-91), section 733 of the
Employee Retirement Income Security Act of 1974 (29 U.S.C.
1191b), and section 9832 of the Internal Revenue Code of 1986,
as applicable.
(3) Qualifying telecommunications system.--The term
``qualifying telecommunications system'' means a
telecommunications system that includes, at a minimum, audio
capabilities permitting two-way, real-time interactive
communication between the individual receiving an eligible
service via such system and the health care provider furnishing
such system, including a telephone, videoconferencing system,
internet communications system, streaming media communications
system, and such other systems as specified by the Secretary of
Health and Human Services.
(d) Effective Date.--This section shall apply with respect to items
and services furnished on or after the first day of the emergency
period described in subsection (a).
<all>
Introduced in Senate
Read twice and referred to the Committee on Health, Education, Labor, and Pensions.
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