Tele-Mental Health Improvement Act

I 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 jurisdic- tion of the committee concerned 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 VerDate Sep 11 2014 01:28 May 26, 2021 Jkt 019200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\H2264.IH H2264 pbinns on DSKJLVW7X2PROD with BILLS 2 •HR 2264 IH SEC. 2. COVERAGE OF TELEHEALTH MENTAL HEALTH AND 1 SUBSTANCE USE DISORDER SERVICES. 2 (a) IN GENERAL.— 3 (1) INSURER REQUIREMENTS.—During the ap- 4 plicable period described in subsection (g), if a group 5 health plan or group or individual health insurance 6 coverage provides coverage of a mental health or 7 substance use disorder service provided in-person the 8 group health plan or health insurance issuer offering 9 such group or individual health insurance cov- 10 erage— 11 (A) shall provide coverage of the service 12 provided through telehealth at the same rate as 13 the coverage for the same service provided in- 14 person (with the same cost-sharing for enrollees 15 and the same reimbursement rates for pro- 16 viders); 17 (B) shall ensure that providers not charge 18 enrollees facility fees for such services provided 19 through telehealth; 20 (C) may not impose additional barriers to 21 obtaining such coverage for such services 22 through telehealth, compared to coverage for 23 such services provided in-person, such as a 24 prior authorization requirement that is more 25 rigorous than for in-person visits; and 26 VerDate Sep 11 2014 01:28 May 26, 2021 Jkt 019200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\H2264.IH H2264 pbinns on DSKJLVW7X2PROD with BILLS 3 •HR 2264 IH (D) shall provide notice to enrollees, in- 1 forming such enrollees of how to access in-net- 2 work telehealth mental health and substance 3 use disorder services and the scope of their cov- 4 erage. 5 (2) PROVIDER REQUIREMENTS.—During the 6 applicable period described in subsection (g), if a 7 provider of a mental health or substance use dis- 8 order service provides such services via telehealth to 9 an enrollee in a group health plan or group or indi- 10 vidual health insurance coverage, the provider shall 11 not charge such enrollee, such group health plan, or 12 a health insurance issuer of such coverage facility 13 fees for such services. 14 (b) ENFORCEMENT.— 15 (1) INSURER REQUIREMENTS.—The provisions 16 of subsection (a)(1) shall be applied by the Secretary 17 of Health and Human Services, the Secretary of 18 Labor, and the Secretary of the Treasury to group 19 health plans and health insurance issuers offering 20 group or individual health insurance coverage as if 21 included in the provisions of part A of title XXVII 22 of the Public Health Service Act (42 U.S.C. 300gg 23 et seq.), part 7 of subtitle B of title I of the Em- 24 ployee Retirement Income Security Act of 1974 (29 25 VerDate Sep 11 2014 01:28 May 26, 2021 Jkt 019200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\H2264.IH H2264 pbinns on DSKJLVW7X2PROD with BILLS 4 •HR 2264 IH U.S.C. 1181 et seq.), and subchapter B of chapter 1 100 of the Internal Revenue Code of 1986, as appli- 2 cable. 3 (2) PROVIDER REQUIREMENTS.—Subsection 4 (a)(2) shall be applied by the Secretary of Health 5 and Human Services and the Secretary of Labor to 6 providers as if included in the provisions of part E 7 of title XXVII of the Public Health Service Act. 8 (c) IMPLEMENTATION.—The Secretary of Health and 9 Human Services, Secretary of Labor, and Secretary of the 10 Treasury may implement the provisions of this section 11 through sub-regulatory guidance, program instruction, or 12 otherwise. 13 (d) DEFINITIONS.—In this section— 14 (1) the terms ‘‘group health plan’’, ‘‘health in- 15 surance issuer’’, and ‘‘health insurance coverage’’ 16 have the meanings given such terms in section 2791 17 of the Public Health Service Act (42 U.S.C. 300gg– 18 91), section 733 of the Employee Retirement Income 19 Security Act of 1974 (29 U.S.C. 1191b), and section 20 9832 of the Internal Revenue Code of 1986, as ap- 21 plicable; and 22 (2) the term ‘‘telehealth services’’ has the 23 meaning given such term in section 330I(a) of the 24 Public Health Service Act (42 U.S.C. 254c–14(a)), 25 VerDate Sep 11 2014 01:28 May 26, 2021 Jkt 019200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\H2264.IH H2264 pbinns on DSKJLVW7X2PROD with BILLS 5 •HR 2264 IH 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 01:28 May 26, 2021 Jkt 019200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6301 E:\BILLS\H2264.IH H2264 pbinns on DSKJLVW7X2PROD with BILLS