What This Bill Does
This bill changes Medicare and Medicaid rules to allow mental health and behavioral health treatment through telehealth (video visits and remote technology). It expands which types of mental health services patients can receive from home or other locations without traveling to a doctor's office.
##
Who It Affects
- Medicare patients who need mental health or behavioral health treatment
- Medicaid patients who need mental health or behavioral health treatment
- Mental health providers and doctors offering telehealth services
- The federal government Secretary (the leader of a federal department) who implements the rules
##
Key Provisions
- Medicare removes geographic location requirements (rules about where treatment must happen) for mental health telehealth services starting January 1, 2025, including first-time evaluations and follow-up appointments (Sec. 3)
- Medicaid guidance must expand to cover mental health and behavioral health treatment through telehealth, not just substance use disorder treatment (Sec. 4)
- The Secretary must issue guidance for substance use disorders within 1 year and for mental health and behavioral health disorders within 4 years (Sec. 4)
- The Comptroller General (a government official who checks spending and programs) must report back to Congress within 4 years on how mental health telehealth treatment is working (Sec. 4)
##
What Changes
Starting January 1, 2025, Medicare patients can receive mental health treatment through video visits and telehealth from more locations. Medicaid will expand its telehealth rules to cover mental health disorders and behavioral health disorders alongside substance use disorder treatment. Patients no longer need to travel to specific medical facilities for these services.
##
Important Definitions
- **Telehealth**: Providing health care services through technology like video calls instead of in-person visits
- **Behavioral health services**: Medical care treating mental health and behavioral problems
- **Originating site**: The location where a patient receives telehealth treatment
##
Effective Date
January 1, 2025 (for Medicare behavioral health telehealth services)
II
118TH CONGRESS
1ST SESSION
S. 730
To amend title XVIII of the Social Security Act and the SUPPORT for
Patients and Communities Act to provide for Medicare and Medicaid
mental and behavioral health treatment through telehealth.
IN THE SENATE OF THE UNITED STATES
MARCH 9, 2023
Mr. KENNEDY introduced the following bill; which was read twice and referred
to the Committee on Finance
A BILL
To amend title XVIII of the Social Security Act and the
SUPPORT for Patients and Communities Act to provide
for Medicare and Medicaid mental and behavioral health
treatment 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 ‘‘Enhance Access to
4
Support Essential Behavioral Health Services Act’’ or the
5
‘‘EASE Behavioral Health Services Act’’.
6
SEC. 2. FINDINGS.
7
Congress finds as follows:
8
VerDate Sep 11 2014
22:20 Mar 17, 2023
Jkt 039200
PO 00000
Frm 00001
Fmt 6652
Sfmt 6201
E:\BILLS\S730.IS
S730
kjohnson on DSK79L0C42PROD with BILLS
2
•S 730 IS
(1) Nearly 18 percent of adults in the United
1
States reported a mental, behavioral, or emotional
2
disorder in 2015.
3
(2) Children are also significantly impacted. Ac-
4
cording to the Centers for Disease Control and Pre-
5
vention, 1 in 6 children ages 2 years through 8 years
6
have a diagnosed mental, behavioral, or develop-
7
mental disorder, indicating that disorders begin in
8
early childhood and affect lifelong health.
9
(3) Moreover, 1 in 7 children and adolescents
10
have at least one treatable mental health disorder.
11
(4) There is a critical link between mental
12
health and substance use disorders. According to the
13
Substance Abuse and Mental Health Services Ad-
14
ministration, 1 in 4 adults with severe mental illness
15
had a substance use disorder in 2017.
16
(5) Moreover, children who have had a major
17
depressive episode are more than twice as likely to
18
use illicit drugs.
19
(6) In 2017, approximately 19.7 million people
20
aged 12 years or older had a substance use disorder
21
related to their use of alcohol or illicit drugs in the
22
past year.
23
VerDate Sep 11 2014
22:20 Mar 17, 2023
Jkt 039200
PO 00000
Frm 00002
Fmt 6652
Sfmt 6201
E:\BILLS\S730.IS
S730
kjohnson on DSK79L0C42PROD with BILLS
3
•S 730 IS
(7) Despite this overwhelming need, access to
1
behavioral health services remains among the most
2
pressing health care challenges in our country.
3
(8) An estimated 56 percent of Americans with
4
a mental health disorder did not receive treatment in
5
2017.
6
(9) Similarly, half of children and adolescents
7
did not receive treatment for their mental health dis-
8
order in 2016.
9
(10) Further complicating access to care, as de-
10
mand for behavioral health services increases in
11
communities across the United States, the number
12
of psychiatrists available to treat them continues to
13
decline.
14
(11) The population of practicing psychiatrists
15
declined by more than 10 percent between the period
16
of 2003 through 2013, while the population of pri-
17
mary care physicians and neurologists grew during
18
the same period.
19
(12) Technology has evolved to connect individ-
20
uals to health care services in new ways, including
21
via telehealth.
22
(13) Moreover, studies show that video visits
23
are an effective strategy to provide mental health
24
VerDate Sep 11 2014
22:20 Mar 17, 2023
Jkt 039200
PO 00000
Frm 00003
Fmt 6652
Sfmt 6201
E:\BILLS\S730.IS
S730
kjohnson on DSK79L0C42PROD with BILLS
4
•S 730 IS
treatment to children and, in fact, may be preferable
1
in some cases.
2
(14) During the 115th Congress, Congress rec-
3
ognized the potential of telehealth to ensure that
4
those in urgent need of substance use disorder treat-
5
ment receive the care they require.
6
(15) As passed and signed into law, sections
7
2001 and 1009 of the SUPPORT for Patients and
8
Communities Act (Public Law 115–271) expands
9
the use of telehealth services for the treatment of
10
opioid use disorder and other substance use dis-
11
orders.
12
(16) It is widely recognized that there is a close
13
relationship between mental health and substance
14
use disorders.
15
SEC. 3. MEDICARE TREATMENT OF BEHAVIORAL HEALTH
16
SERVICES
FURNISHED
THROUGH
TELE-
17
HEALTH.
18
Section 1834(m) of the Social Security Act (42
19
U.S.C. 1395m(m)) is amended—
20
(1) in paragraph (4)(C)—
21
(A) in clause (i), by striking ‘‘and (7)’’ and
22
inserting ‘‘(7), and (10)’’; and
23
(B) in clause (ii)(X)—
24
VerDate Sep 11 2014
22:20 Mar 17, 2023
Jkt 039200
PO 00000
Frm 00004
Fmt 6652
Sfmt 6201
E:\BILLS\S730.IS
S730
kjohnson on DSK79L0C42PROD with BILLS
5
•S 730 IS
(i) by striking ‘‘or telehealth services’’
1
and inserting ‘‘, telehealth services’’; and
2
(ii) by inserting ‘‘or telehealth services
3
described in paragraph (10)’’ before the
4
period at the end; and
5
(2) by adding at the end the following new
6
paragraph:
7
‘‘(10) TREATMENT
OF
BEHAVIORAL
HEALTH
8
SERVICES
FURNISHED
THROUGH
TELEHEALTH.—
9
The geographic requirements described in paragraph
10
(4)(C)(i) shall not apply with respect to telehealth
11
services that are behavioral health services furnished
12
on or after January 1, 2025, to eligible telehealth in-
13
dividuals, including initial patient evaluations, fol-
14
low-up medical management, and other behavioral
15
health services, as determined by the Secretary, at
16
an originating site described in paragraph (4)(C)(ii)
17
(other than an originating site described in sub-
18
clause (IX) of such paragraph).’’.
19
SEC. 4. MEDICAID MENTAL AND BEHAVIORAL HEALTH
20
TREATMENT THROUGH TELEHEALTH.
21
Section 1009 of the SUPPORT for Patients and
22
Communities Act (Public Law 115–271) is amended—
23
(1) in subsection (b)—
24
VerDate Sep 11 2014
22:20 Mar 17, 2023
Jkt 039200
PO 00000
Frm 00005
Fmt 6652
Sfmt 6201
E:\BILLS\S730.IS
S730
kjohnson on DSK79L0C42PROD with BILLS
6
•S 730 IS
(A) in the header, by striking ‘‘TREAT-
1
MENT FOR SUBSTANCE USE DISORDERS’’ and
2
inserting ‘‘TREATMENT FOR SUBSTANCE USE
3
DISORDERS AND MENTAL HEALTH DISORDERS
4
AND BEHAVIORAL HEALTH DISORDERS’’;
5
(B) in the matter preceding paragraph (1),
6
by striking ‘‘Not later than 1 year after the
7
date of enactment of this Act, the Secretary’’
8
and inserting ‘‘The Secretary’’;
9
(C) in paragraph (1)—
10
(i) by striking ‘‘treatment for sub-
11
stance use disorders’’ and inserting ‘‘treat-
12
ment for substance use disorders and men-
13
tal health disorders and behavioral health
14
disorders’’; and
15
(ii) by inserting ‘‘psychotherapy,’’
16
after ‘‘counseling,’’;
17
(D) in paragraph (2), by inserting ‘‘or
18
mental health disorders and behavioral health
19
disorders’’ after ‘‘substance use disorders’’;
20
(E) in paragraph (3), by inserting ‘‘and
21
mental health disorders and behavioral health
22
disorders’’ after ‘‘substance use disorders’’; and
23
(F) by adding at the end, below and after
24
paragraph (3), the following flush left text:
25
VerDate Sep 11 2014
22:20 Mar 17, 2023
Jkt 039200
PO 00000
Frm 00006
Fmt 6652
Sfmt 6201
E:\BILLS\S730.IS
S730
kjohnson on DSK79L0C42PROD with BILLS
7
•S 730 IS
‘‘The Secretary shall issue the guidance under this sub-
1
section not later than 1 year after the date of the enact-
2
ment of this Act, with respect to the matters described
3
in the previous provisions of this subsection relating to
4
substance use disorders, and not later than 4 years after
5
the date of the enactment of this Act, with respect to the
6
matters described in such previous provisions relating to
7
mental health disorders and behavioral health disorders.’’;
8
(2) in subsection (c)—
9
(A) in the header, by striking ‘‘TREAT-
10
MENT FOR SUBSTANCE USE DISORDERS’’ and
11
inserting ‘‘TREATMENT FOR SUBSTANCE USE
12
DISORDERS AND MENTAL HEALTH DISORDERS
13
AND BEHAVIORAL HEALTH DISORDERS’’;
14
(B) in paragraph (1), by striking ‘‘treat-
15
ment for substance use disorders’’ and inserting
16
‘‘treatment for substance use disorders and
17
mental health disorders and behavioral health
18
disorders’’ each place it appears; and
19
(C) in paragraph (2)—
20
(i) by inserting ‘‘with respect to sub-
21
stance use disorders,’’ after ‘‘paragraph
22
(1),’’; and
23
(ii) by adding at the end the following
24
new sentence: ‘‘Not later than 4 years
25
VerDate Sep 11 2014
22:20 Mar 17, 2023
Jkt 039200
PO 00000
Frm 00007
Fmt 6652
Sfmt 6201
E:\BILLS\S730.IS
S730
kjohnson on DSK79L0C42PROD with BILLS
8
•S 730 IS
after the date of enactment of this Act, the
1
Comptroller General shall submit to Con-
2
gress a report containing the results of the
3
evaluation conducted under paragraph (1),
4
with respect to mental health disorders and
5
behavioral health disorders, together with
6
recommendations for such legislation and
7
administrative action as the Comptroller
8
General determines appropriate.’’; and
9
(3) in subsection (d)(1)—
10
(A) in the matter preceding subparagraph
11
(A), by inserting ‘‘and mental health disorders
12
and behavioral health disorders’’ after ‘‘sub-
13
stance use disorders’’;
14
(B) in subparagraph (A), by inserting ‘‘,
15
and mental health disorders and behavioral
16
health disorders’’ after ‘‘opioid use disorder’’;
17
and
18
(C) in subparagraph (B), by inserting
19
‘‘and mental health disorders and behavioral
20
health disorders’’ after ‘‘substance use dis-
21
orders’’.
22
Æ
VerDate Sep 11 2014
22:20 Mar 17, 2023
Jkt 039200
PO 00000
Frm 00008
Fmt 6652
Sfmt 6301
E:\BILLS\S730.IS
S730
kjohnson on DSK79L0C42PROD with BILLS