EASE Behavioral Health Services Act

I 116TH CONGRESS 1ST SESSION H. R. 5473 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 HOUSE OF REPRESENTATIVES DECEMBER 18, 2019 Mr. BILIRAKIS (for himself and Mr. SOTO) introduced the following bill; which was referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provi- sions as fall within the jurisdiction of the committee concerned 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 VerDate Sep 11 2014 22:18 Dec 30, 2019 Jkt 099200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\H5473.IH H5473 pamtmann on DSKBC07HB2PROD with BILLS 2 •HR 5473 IH SEC. 2. FINDINGS. 1 Congress finds as follows: 2 (1) Nearly 18 percent of adults in the United 3 States reported a mental, behavioral, or emotional 4 disorder in 2015. 5 (2) Children are also significantly impacted. Ac- 6 cording to the Centers for Disease Control and Pre- 7 vention, 1 in 6 children ages 2 years through 8 years 8 have a diagnosed mental, behavioral, or develop- 9 mental disorder, indicating that disorders begin in 10 early childhood and affect lifelong health. 11 (3) Moreover, 1 in 7 children and adolescents 12 have at least one treatable mental health disorder. 13 (4) There is a critical link between mental 14 health and substance use disorders. According to the 15 Substance Abuse and Mental Health Services Ad- 16 ministration, 1 in 4 adults with severe mental illness 17 had a substance use disorder in 2017. 18 (5) Moreover, children who have had a major 19 depressive episode are more than twice as likely to 20 use illicit drugs. 21 (6) In 2017, approximately 19.7 million people 22 aged 12 years or older had a substance use disorder 23 related to their use of alcohol or illicit drugs in the 24 past year. 25 VerDate Sep 11 2014 22:18 Dec 30, 2019 Jkt 099200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\H5473.IH H5473 pamtmann on DSKBC07HB2PROD with BILLS 3 •HR 5473 IH (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 22:18 Dec 30, 2019 Jkt 099200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\H5473.IH H5473 pamtmann on DSKBC07HB2PROD with BILLS 4 •HR 5473 IH 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 (8)’’; and 23 (B) in clause (ii)(X)— 24 VerDate Sep 11 2014 22:18 Dec 30, 2019 Jkt 099200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\H5473.IH H5473 pamtmann on DSKBC07HB2PROD with BILLS 5 •HR 5473 IH (i) by striking ‘‘or telehealth services’’ 1 and inserting ‘‘, telehealth services’’; and 2 (ii) by inserting ‘‘or telehealth services 3 described in paragraph (8)’’ before the pe- 4 riod at the end; and 5 (2) by adding at the end the following new 6 paragraph: 7 ‘‘(8) 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 July 1, 2020, to eligible telehealth indi- 13 viduals, including initial patient evaluations, follow- 14 up medical management, and other behavioral health 15 services, as determined by the Secretary, at an origi- 16 nating site described in paragraph (4)(C)(ii) (other 17 than an originating site described in subclause (IX) 18 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 22:18 Dec 30, 2019 Jkt 099200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\H5473.IH H5473 pamtmann on DSKBC07HB2PROD with BILLS 6 •HR 5473 IH (A) in the header, by striking ‘‘TREAT- 1 MENT FOR SUBSTANCE USE DISORDERS’’ 2 and inserting ‘‘TREATMENT FOR SUBSTANCE 3 USE DISORDERS AND MENTAL HEALTH 4 DISORDERS AND BEHAVIORAL HEALTH 5 DISORDERS’’; 6 (B) in the matter preceding paragraph (1), 7 by striking ‘‘Not later than 1 year after the 8 date of enactment of this Act, the Secretary’’ 9 and inserting ‘‘The Secretary’’; 10 (C) in paragraph (1)— 11 (i) by striking ‘‘treatment for sub- 12 stance use disorders’’ and inserting ‘‘treat- 13 ment for substance use disorders and men- 14 tal health disorders and behavioral health 15 disorders’’; and 16 (ii) by inserting ‘‘psychotherapy,’’ 17 after ‘‘counseling,’’; 18 (D) in paragraph (2), by inserting ‘‘or 19 mental health disorders and behavioral health 20 disorders’’ after ‘‘substance use disorders’’; 21 (E) in paragraph (3), by inserting ‘‘and 22 mental health disorders and behavioral health 23 disorders’’ after ‘‘substance use disorders’’; and 24 VerDate Sep 11 2014 22:18 Dec 30, 2019 Jkt 099200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\H5473.IH H5473 pamtmann on DSKBC07HB2PROD with BILLS 7 •HR 5473 IH (F) by adding at the end, below and after 1 paragraph (3), the following flush left text: 2 ‘‘The Secretary shall issue the guidance under this sub- 3 section not later than 1 year after the date of the enact- 4 ment of this Act, with respect to the matters described 5 in the previous provisions of this subsection relating to 6 substance use disorders, and not later than 2 years after 7 the date of the enactment of this Act, with respect to the 8 matters described in such previous provisions relating to 9 mental health disorders and behavioral health disorders.’’; 10 (2) in subsection (c)— 11 (A) in the header, by striking ‘‘TREAT- 12 MENT FOR SUBSTANCE USE DISORDERS’’ 13 and inserting ‘‘TREATMENT FOR SUBSTANCE 14 USE DISORDERS AND MENTAL HEALTH 15 DISORDERS AND BEHAVIORAL HEALTH 16 DISORDERS’’; 17 (B) in paragraph (1), by striking ‘‘treat- 18 ment for substance use disorders’’ and inserting 19 ‘‘treatment for substance use disorders and 20 mental health disorders and behavioral health 21 disorders’’ each place it appears; and 22 (C) in paragraph (2)— 23 VerDate Sep 11 2014 22:18 Dec 30, 2019 Jkt 099200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\H5473.IH H5473 pamtmann on DSKBC07HB2PROD with BILLS 8 •HR 5473 IH (i) by inserting ‘‘with respect to sub- 1 stance use disorders,’’ after ‘‘paragraph 2 (1),’’; and 3 (ii) by adding at the end the following 4 new sentence: ‘‘Not later than 2 years 5 after the date of enactment of this Act, the 6 Comptroller General shall submit to Con- 7 gress a report containing the results of the 8 evaluation conducted under paragraph (1), 9 with respect to mental health disorders and 10 behavioral health disorders, together with 11 recommendations for such legislation and 12 administrative action as the Comptroller 13 General determines appropriate.’’; and 14 (3) in subsection (d)(1)— 15 (A) in the matter preceding subparagraph 16 (A), by inserting ‘‘and mental health disorders 17 and behavioral health disorders’’ after ‘‘sub- 18 stance use disorders’’; 19 (B) in subparagraph (A), by inserting ‘‘, 20 and mental health disorders and behavioral 21 health disorders’’ after ‘‘opioid use disorder’’; 22 and 23 (C) in subparagraph (B), by inserting 24 ‘‘and mental health disorders and behavioral 25 VerDate Sep 11 2014 22:18 Dec 30, 2019 Jkt 099200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6201 E:\BILLS\H5473.IH H5473 pamtmann on DSKBC07HB2PROD with BILLS 9 •HR 5473 IH health disorders’’ after ‘‘substance use dis- 1 orders’’. 2 SEC. 5. EFFECTIVE DATE. 3 The amendments made by this Act shall take effect 4 as is included in the enactment of the SUPPORT for Pa- 5 tients and Communities Act. 6 Æ VerDate Sep 11 2014 22:18 Dec 30, 2019 Jkt 099200 PO 00000 Frm 00009 Fmt 6652 Sfmt 6301 E:\BILLS\H5473.IH H5473 pamtmann on DSKBC07HB2PROD with BILLS