Tele-Mental Health Improvement Act
This bill requires private health insurance plans that cover in-person mental health or substance use disorder services to cover such services on equal terms via telehealth (i.e., information technology used to aid treatment and diagnosis at a physical distance) during and shortly after the COVID-19 (i.e., coronavirus disease 2019) public health emergency. Specifically, this bill requires plans to, among other things, cover these services at the same rate as in-person services, exclude charges for facility fees, and provide information about how to access these services. Additionally, providers of these services may not charge facility fees to plan enrollees.
[Congressional Bills 117th Congress]
[From the U.S. Government Publishing Office]
[H.R. 2264 Introduced in House (IH)]
<DOC>
117th CONGRESS
1st Session
H. R. 2264
To require parity in the coverage of mental health and substance use
disorder services provided to enrollees in private insurance plans,
whether such services are provided in-person or through telehealth.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
March 26, 2021
Mr. Trone (for himself and Mr. Fitzpatrick) introduced the following
bill; which was referred to the Committee on Energy and Commerce, and
in addition to the Committees on Ways and Means, and Education and
Labor, for a period to be subsequently determined by the Speaker, in
each case for consideration of such provisions as fall within the
jurisdiction of the committee concerned
_______________________________________________________________________
A BILL
To require parity in the coverage of mental health and substance use
disorder services provided to enrollees in private insurance plans,
whether such services are provided in-person or through telehealth.
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 ``Tele-Mental Health Improvement
Act''.
SEC. 2. COVERAGE OF TELEHEALTH MENTAL HEALTH AND SUBSTANCE USE DISORDER
SERVICES.
(a) In General.--
(1) Insurer requirements.--During the applicable period
described in subsection (g), if a group health plan or group or
individual health insurance coverage provides coverage of a
mental health or substance use disorder service provided in-
person the group health plan or health insurance issuer
offering such group or individual health insurance coverage--
(A) shall provide coverage of the service provided
through telehealth at the same rate as the coverage for
the same service provided in-person (with the same
cost-sharing for enrollees and the same reimbursement
rates for providers);
(B) shall ensure that providers not charge
enrollees facility fees for such services provided
through telehealth;
(C) may not impose additional barriers to obtaining
such coverage for such services through telehealth,
compared to coverage for such services provided in-
person, such as a prior authorization requirement that
is more rigorous than for in-person visits; and
(D) shall provide notice to enrollees, informing
such enrollees of how to access in-network telehealth
mental health and substance use disorder services and
the scope of their coverage.
(2) Provider requirements.--During the applicable period
described in subsection (g), if a provider of a mental health
or substance use disorder service provides such services via
telehealth to an enrollee in a group health plan or group or
individual health insurance coverage, the provider shall not
charge such enrollee, such group health plan, or a health
insurance issuer of such coverage facility fees for such
services.
(b) Enforcement.--
(1) Insurer requirements.--The provisions of subsection
(a)(1) shall be applied by the Secretary of Health and Human
Services, the Secretary of Labor, and the 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 (42 U.S.C. 300gg et seq.), part 7 of
subtitle B of title I of the Employee Retirement Income
Security Act of 1974 (29 U.S.C. 1181 et seq.), and subchapter B
of chapter 100 of the Internal Revenue Code of 1986, as
applicable.
(2) Provider requirements.--Subsection (a)(2) shall be
applied by the Secretary of Health and Human Services and the
Secretary of Labor to providers as if included in the
provisions of part E of title XXVII of the Public Health
Service Act.
(c) Implementation.--The Secretary of Health and Human Services,
Secretary of Labor, and Secretary of the Treasury may implement the
provisions of this section through sub-regulatory guidance, program
instruction, or otherwise.
(d) Definitions.--In this section--
(1) the terms ``group health plan'', ``health insurance
issuer'', and ``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; and
(2) the term ``telehealth services'' has the meaning given
such term in section 330I(a) of the Public Health Service Act
(42 U.S.C. 254c-14(a)), and includes 2-way video communication,
and audio-only communication.
(e) Rule of Construction.--Nothing in this section shall prevent
the application of any State law that is not inconsistent with this
section.
(f) Report to Congress.--Not later than 180 days after the
conclusion of the public health emergency described in subsection (a),
the Secretary of Health and Human Services shall submit to the
Committee on Health, Education, Labor, and Pensions of the Senate, the
Committee on Education and Labor of the House of Representatives, and
the Committee on Energy and Commerce of the House of Representatives on
the impacts the requirement under subsection (a) has on the use of both
telehealth services and health services provided in-person.
(g) Applicable Period.--The applicable period described in
subsection (a) is the period beginning on the date of enactment of this
Act and ending on the date that is 90 days after the public health
emergency declared by the Secretary of Health and Human Services under
section 319 of the Public Health Service Act (42 U.S.C. 247d) on
January 31, 2020, with respect to COVID-19, expires.
<all>
Introduced in House
Introduced in House
Referred to the Subcommittee on Health.
Referred to the Committee on Energy and Commerce, and in addition to the Committees on Ways and Means, and Education and Labor, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
Referred to the Committee on Energy and Commerce, and in addition to the Committees on Ways and Means, and Education and Labor, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
Referred to the Committee on Energy and Commerce, and in addition to the Committees on Ways and Means, and Education and Labor, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
Referred to the Subcommittee on Health.
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