Telehealth Expansion Act of 2020

II 116TH CONGRESS 2D SESSION S. 4230 To amend title XVIII of the Social Security Act to expand access to mental health services and certain evaluation and management services furnished through telehealth under the Medicare program. IN THE SENATE OF THE UNITED STATES JULY 20, 2020 Mr. WYDEN 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 to expand access to mental health services and certain evaluation and management services furnished through telehealth under the Medicare program. 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 ‘‘Telehealth Expansion 4 Act of 2020’’. 5 VerDate Sep 11 2014 01:19 Jul 26, 2020 Jkt 099200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\S4230.IS S4230 pbinns on DSKJLVW7X2PROD with BILLS 2 •S 4230 IS SEC. 2. EXPANDING ACCESS TO MENTAL HEALTH SERVICES 1 AND CERTAIN EVALUATION AND MANAGE- 2 MENT SERVICES FURNISHED THROUGH 3 TELEHEALTH. 4 (a) TREATMENT OF MENTAL HEALTH SERVICES 5 FURNISHED THROUGH TELEHEALTH.—Paragraph (7) of 6 section 1834(m) of the Social Security Act (42 U.S.C. 7 1395m(m)) is amended— 8 (1) in the paragraph heading, by inserting 9 ‘‘AND MENTAL HEALTH SERVICES’’ after ‘‘DISORDER 10 SERVICES’’; and 11 (2) by inserting ‘‘or, on or after the first day 12 after the end of the public health emergency de- 13 scribed in section 1135(g)(1)(B), to an eligible tele- 14 health individual for purposes of diagnosis, evalua- 15 tion, or treatment of a mental health disorder, as de- 16 termined by the Secretary,’’ after ‘‘as determined by 17 the Secretary,’’. 18 (b) TREATMENT OF CERTAIN EVALUATION AND 19 MANAGEMENT SERVICES FURNISHED THROUGH TELE- 20 HEALTH.—Such section 1834(m), as amended by sub- 21 section (a), is amended— 22 (1) in paragraph (4)(C)— 23 (A) in clause (i), by striking ‘‘and (7)’’ and 24 inserting ‘‘(7), and (9)’’; and 25 VerDate Sep 11 2014 01:19 Jul 26, 2020 Jkt 099200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\S4230.IS S4230 pbinns on DSKJLVW7X2PROD with BILLS 3 •S 4230 IS (B) in clause (ii)(X), by inserting ‘‘or 1 paragraph (9)(A)’’ before the period; and 2 (2) by adding at the end the following new 3 paragraph: 4 ‘‘(9) TREATMENT OF CERTAIN EVALUATION 5 AND MANAGEMENT SERVICES FURNISHED THROUGH 6 TELEHEALTH.— 7 ‘‘(A) IN GENERAL.—The geographic re- 8 quirements described in paragraph 4(C)(i) shall 9 not apply with respect to a telehealth service 10 that is a medical visit that is in the category of 11 HCPCS evaluation and management services 12 for office and other outpatient services and that 13 is furnished on or after the first day after the 14 end of the public health emergency described in 15 section 1135(g)(1)(B), to an eligible telehealth 16 individual by a qualified provider, at an origi- 17 nating site described in paragraph 4(C)(ii) 18 (other than an originating site described in sub- 19 clause (IX) of such paragraph). 20 ‘‘(B) DEFINITION OF QUALIFIED PRO- 21 VIDER.—For purposes of this paragraph, the 22 term ‘qualified provider’ means, with respect to 23 a telehealth service described in subparagraph 24 VerDate Sep 11 2014 01:19 Jul 26, 2020 Jkt 099200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\S4230.IS S4230 pbinns on DSKJLVW7X2PROD with BILLS 4 •S 4230 IS (A) that is furnished to an eligible telehealth in- 1 dividual, a physician or practitioner who— 2 ‘‘(i) furnished to such individual, dur- 3 ing the 18-month period ending on the 4 date the telehealth service was furnished, 5 an item or service in person for which— 6 ‘‘(I) payment was made under 7 this title; or 8 ‘‘(II) such payment would have 9 been made if such individual were en- 10 titled to, or enrolled for, benefits 11 under this title at the time such item 12 or service was furnished; or 13 ‘‘(ii) is in the same practice (as deter- 14 mined by tax identification number) as a 15 physician or practitioner who furnished 16 such an item or service in person to such 17 individual during such period.’’. 18 (c) IMPLEMENTATION.—Notwithstanding any other 19 provision of law, the Secretary may implement the provi- 20 sions of, or amendments made by, this section by interim 21 final rule, program instruction, or otherwise. 22 Æ VerDate Sep 11 2014 01:19 Jul 26, 2020 Jkt 099200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6301 E:\BILLS\S4230.IS S4230 pbinns on DSKJLVW7X2PROD with BILLS