Tele-Mental Health Improvement Act

II 117TH CONGRESS 1ST SESSION S. 660 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 SENATE OF THE UNITED STATES MARCH 10, 2021 Ms. SMITH (for herself and Ms. MURKOWSKI) introduced the following bill; which was read twice and referred to the Committee on Health, Edu- cation, Labor, and Pensions A BILL To require parity in the coverage of mental health and sub- stance use disorder services provided to enrollees in pri- vate insurance plans, whether such services are provided in-person or through telehealth. Be it enacted by the Senate and House of Representa- 1 tives of the United States of America in Congress assembled, 2 SECTION 1. SHORT TITLE. 3 This Act may be cited as the ‘‘Tele-Mental Health 4 Improvement Act’’. 5 SEC. 2. COVERAGE OF TELEHEALTH MENTAL HEALTH AND 6 SUBSTANCE USE DISORDER SERVICES. 7 (a) IN GENERAL.— 8 VerDate Sep 11 2014 21:42 Apr 04, 2021 Jkt 019200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\S660.IS S660 kjohnson on DSK79L0C42PROD with BILLS 2 •S 660 IS (1) INSURER REQUIREMENTS.—During the ap- 1 plicable period described in subsection (g), if a group 2 health plan or group or individual health insurance 3 coverage provides coverage of a mental health or 4 substance use disorder service provided in-person the 5 group health plan or health insurance issuer offering 6 such group or individual health insurance cov- 7 erage— 8 (A) shall provide coverage of the service 9 provided through telehealth at the same rate as 10 the coverage for the same service provided in- 11 person (with the same cost-sharing for enrollees 12 and the same reimbursement rates for pro- 13 viders); 14 (B) shall ensure that providers not charge 15 enrollees facility fees for such services provided 16 through telehealth; 17 (C) may not impose additional barriers to 18 obtaining or providing such coverage for such 19 services through telehealth, compared to cov- 20 erage for such services provided in-person, such 21 as a prior authorization requirement that is 22 more rigorous than for in-person visits; and 23 (D) shall provide notice to enrollees, in- 24 forming such enrollees of how to access in-net- 25 VerDate Sep 11 2014 21:42 Apr 04, 2021 Jkt 019200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\S660.IS S660 kjohnson on DSK79L0C42PROD with BILLS 3 •S 660 IS work telehealth mental health and substance 1 use disorder services and the scope of their cov- 2 erage. 3 (2) PROVIDER REQUIREMENTS.—During the 4 applicable period described in subsection (g), if a 5 provider of a mental health or substance use dis- 6 order service provides such services via telehealth to 7 an enrollee in a group health plan or group or indi- 8 vidual health insurance coverage, the provider shall 9 not charge such enrollee, such group health plan, or 10 a health insurance issuer of such coverage facility 11 fees for such services. 12 (b) ENFORCEMENT.— 13 (1) INSURER REQUIREMENTS.—The provisions 14 of subsection (a)(1) shall be applied by the Secretary 15 of Health and Human Services, the Secretary of 16 Labor, and the Secretary of the Treasury to group 17 health plans and health insurance issuers offering 18 group or individual health insurance coverage as if 19 included in the provisions of part A of title XXVII 20 of the Public Health Service Act (42 U.S.C. 300gg 21 et seq.), part 7 of subtitle B of title I of the Em- 22 ployee Retirement Income Security Act of 1974 (29 23 U.S.C. 1181 et seq.), and subchapter B of chapter 24 VerDate Sep 11 2014 21:42 Apr 04, 2021 Jkt 019200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\S660.IS S660 kjohnson on DSK79L0C42PROD with BILLS 4 •S 660 IS 100 of the Internal Revenue Code of 1986, as appli- 1 cable. 2 (2) PROVIDER REQUIREMENTS.—Subsection 3 (a)(2) shall be applied by the Secretary of Health 4 and Human Services and the Secretary of Labor to 5 providers as if included in the provisions of part E 6 of title XXVII of the Public Health Service Act. 7 (c) IMPLEMENTATION.—The Secretary of Health and 8 Human Services, Secretary of Labor, and Secretary of the 9 Treasury may implement the provisions of this section 10 through sub-regulatory guidance, program instruction, or 11 otherwise. 12 (d) DEFINITIONS.—In this section— 13 (1) the terms ‘‘group health plan’’, ‘‘health in- 14 surance issuer’’, and ‘‘health insurance coverage’’ 15 have the meanings given such terms in section 2791 16 of the Public Health Service Act (42 U.S.C. 300gg– 17 91), section 733 of the Employee Retirement Income 18 Security Act of 1974 (29 U.S.C. 1191b), and section 19 9832 of the Internal Revenue Code of 1986, as ap- 20 plicable; and 21 (2) the term ‘‘telehealth services’’ has the 22 meaning given such term in section 330I(a) of the 23 Public Health Service Act (42 U.S.C. 254c–14(a)), 24 VerDate Sep 11 2014 21:42 Apr 04, 2021 Jkt 019200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\S660.IS S660 kjohnson on DSK79L0C42PROD with BILLS 5 •S 660 IS and includes 2-way video communication, and audio- 1 only communication. 2 (e) RULE OF CONSTRUCTION.—Nothing in this sec- 3 tion shall prevent the application of any State law that 4 is not inconsistent with this section. 5 (f) REPORT TO CONGRESS.—Not later than 180 days 6 after the conclusion of the public health emergency de- 7 scribed in subsection (a), the Secretary of Health and 8 Human Services shall submit to the Committee on Health, 9 Education, Labor, and Pensions of the Senate, the Com- 10 mittee on Education and Labor of the House of Rep- 11 resentatives, and the Committee on Energy and Commerce 12 of the House of Representatives on the impacts the re- 13 quirement under subsection (a) has on the use of both 14 telehealth services and health services provided in-person. 15 (g) APPLICABLE PERIOD.—The applicable period de- 16 scribed in subsection (a) is the period beginning on the 17 date of enactment of this Act and ending on the date that 18 is 90 days after the public health emergency declared by 19 the Secretary of Health and Human Services under sec- 20 tion 319 of the Public Health Service Act (42 U.S.C. 21 247d) on January 31, 2020, with respect to COVID–19, 22 expires. 23 Æ VerDate Sep 11 2014 21:42 Apr 04, 2021 Jkt 019200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6301 E:\BILLS\S660.IS S660 kjohnson on DSK79L0C42PROD with BILLS