Tele-Mental Health Improvement Act

II 116TH CONGRESS 2D SESSION S. 3792 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 MAY 21, 2020 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 VerDate Sep 11 2014 02:10 Jun 13, 2020 Jkt 099200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\S3792.IS S3792 kjohnson on DSK79L0C42PROD with BILLS 2 •S 3792 IS SEC. 2. COVERAGE OF TELEHEALTH MENTAL HEALTH AND 1 SUBSTANCE USE DISORDER SERVICES. 2 (a) IN GENERAL.—During the public health emer- 3 gency declared by the Secretary of Health and Human 4 Services under section 319 of the Public Health Service 5 Act (42 U.S.C. 247d) on January 31, 2020, with respect 6 to COVID-19, if a group health plan or group or indi- 7 vidual health insurance coverage provides coverage of a 8 mental health or substance use disorder service provided 9 in-person, the group health plan or health insurance issuer 10 offering such group or individual health insurance cov- 11 erage— 12 (1) shall provide coverage of the service pro- 13 vided through telehealth at the same rate as the cov- 14 erage for the same service provided in-person; 15 (2) shall ensure that providers not charge en- 16 rollees facility fees; 17 (3) may not impose additional barriers on ob- 18 taining such coverage for such services through tele- 19 health, compared to coverage for such services pro- 20 vided in-person, such as a prior authorization re- 21 quirements, a requirement that the enrollee have a 22 pre-existing relationship with the provider, a require- 23 ment that a provider be present with the enrollee 24 during the provision of services, or any other finan- 25 VerDate Sep 11 2014 02:10 Jun 13, 2020 Jkt 099200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\S3792.IS S3792 kjohnson on DSK79L0C42PROD with BILLS 3 •S 3792 IS cial requirement, treatment limitation, or utilization 1 control policy or procedure; 2 (4) shall provide notice to enrollees, informing 3 such enrollees of how to access in-network telehealth 4 mental health and substance use disorder services 5 and the scope of their coverage; and 6 (5) shall work with providers to ensure that 7 telehealth services are provided to enrollees in com- 8 pliance with, as applicable, the privacy regulations 9 promulgated pursuant to section 264(c) of the 10 Health Insurance Portability and Accountability Act 11 of 1996 (42 U.S.C. 1320d–2) or privacy guidelines 12 promulgated and implemented by the Secretary of 13 Health and Human Services during a public health 14 emergency. 15 (b) ENFORCEMENT.—The provisions of subsection 16 (a) shall be applied by the Secretary of Health and Human 17 Services, Secretary of Labor, and Secretary of the Treas- 18 ury to group health plans and health insurance issuers of- 19 fering group or individual health insurance coverage as if 20 included in the provisions of part A of title XXVII of the 21 Public Health Service Act, part 7 of the Employee Retire- 22 ment Income Security Act of 1974, and subchapter B of 23 chapter 100 of the Internal Revenue Code of 1986, as ap- 24 plicable. 25 VerDate Sep 11 2014 02:10 Jun 13, 2020 Jkt 099200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\S3792.IS S3792 kjohnson on DSK79L0C42PROD with BILLS 4 •S 3792 IS (c) IMPLEMENTATION.—The Secretary of Health and 1 Human Services, Secretary of Labor, and Secretary of the 2 Treasury may implement the provisions of this section 3 through sub-regulatory guidance, program instruction, or 4 otherwise. 5 (d) DEFINITIONS.—In this section— 6 (1) the terms ‘‘group health plan’’, ‘‘health in- 7 surance issuer’’, and ‘‘health insurance coverage’’ 8 have the meanings given such terms in section 2791 9 of the Public Health Service Act (42 U.S.C. 300gg– 10 91), section 733 of the Employee Retirement Income 11 Security Act of 1974 (29 U.S.C. 1191b), and section 12 9832 of the Internal Revenue Code of 1986, as ap- 13 plicable; and 14 (2) the term ‘‘telehealth services’’ has the 15 meaning given such term in section 330I(a) of the 16 Public Health Service Act (42 U.S.C. 254c–14(a)), 17 and includes 2-way video communication, audio-only 18 communication, and written information shared by 19 phone or email. 20 (e) RULE OF CONSTRUCTION.—Nothing in this sec- 21 tion shall prevent the application of any State law that 22 is not inconsistent with this section. 23 (f) REPORT TO CONGRESS.—Not later than 180 days 24 after the conclusion of the public health emergency de- 25 VerDate Sep 11 2014 02:10 Jun 13, 2020 Jkt 099200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\S3792.IS S3792 kjohnson on DSK79L0C42PROD with BILLS 5 •S 3792 IS scribed in subsection (a), the Secretary of Health and 1 Human Services shall submit to the Committee on Health, 2 Education, Labor, and Pensions of the Senate, the Com- 3 mittee on Education and Labor of the House of Rep- 4 resentatives, and the Committee on Energy and Commerce 5 of the House of Representatives on the impacts the re- 6 quirement under subsection (a) has on the use of both 7 telehealth services and health services provided in-person. 8 Æ VerDate Sep 11 2014 02:10 Jun 13, 2020 Jkt 099200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6301 E:\BILLS\S3792.IS S3792 kjohnson on DSK79L0C42PROD with BILLS