Telehealth Act

I 116TH CONGRESS 2D SESSION H. R. 7992 To expand access to telehealth services, and for other purposes. IN THE HOUSE OF REPRESENTATIVES AUGUST 7, 2020 Mrs. WAGNER introduced the following bill; which was referred to the Com- mittee on Energy and Commerce, and in addition to the Committees on Ways and Means, the Judiciary, and Veterans’ Affairs, for a period to be subsequently determined by the Speaker, in each case for consider- ation of such provisions as fall within the jurisdiction of the committee concerned A BILL To expand access to telehealth services, and for other purposes. 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 Act’’. 4 VerDate Sep 11 2014 15:46 Aug 29, 2020 Jkt 099200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\H7992.IH H7992 pamtmann on DSKBC07HB2PROD with BILLS 2 •HR 7992 IH TITLE I—VA MISSION 1 TELEHEALTH CLARIFICATION 2 SEC. 101. LICENSURE OF HEALTH CARE PROFESSIONALS 3 PROVIDING TREATMENT VIA TELEMEDICINE. 4 Section 1730C(b) of title 38, United States Code, is 5 amended to read as follows: 6 ‘‘(b) COVERED HEALTH CARE PROFESSIONALS.— 7 For purposes of this section, a covered health care profes- 8 sional is any of the following individuals: 9 ‘‘(1) A health care professional who— 10 ‘‘(A) is an employee of the Department ap- 11 pointed under the authority under section 7306, 12 7401, 7405, 7406, or 7408 of this title or title 13 5; 14 ‘‘(B) is authorized by the Secretary to pro- 15 vide health care under this chapter; 16 ‘‘(C) is required to adhere to all standards 17 for quality relating to the provision of medicine 18 in accordance with applicable policies of the De- 19 partment; and 20 ‘‘(D) has an active, current, full, and unre- 21 stricted license, registration, or certification in 22 a State to practice the health care profession of 23 the health care professional. 24 ‘‘(2) A health professional trainee who— 25 VerDate Sep 11 2014 15:46 Aug 29, 2020 Jkt 099200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\H7992.IH H7992 pamtmann on DSKBC07HB2PROD with BILLS 3 •HR 7992 IH ‘‘(A) is appointed under section 7405 or 1 7406 of this title; and 2 ‘‘(B) is under the clinical supervision of a 3 health care professional described in paragraph 4 (1).’’. 5 TITLE II—ADVANCING 6 TELEHEALTH BEYOND COVID–19 7 SEC. 201. PERMITTING THE SECRETARY OF HEALTH AND 8 HUMAN SERVICES TO WAIVE REQUIREMENTS 9 RELATING TO THE FURNISHING OF TELE- 10 HEALTH SERVICES UNDER THE MEDICARE 11 PROGRAM. 12 Section 1834(m) of the Social Security Act (42 13 U.S.C. 1395m(m)) is amended by adding at the end the 14 following new paragraph: 15 ‘‘(9) AUTHORITY TO WAIVE TELEHEALTH RE- 16 QUIREMENTS.—Notwithstanding any other provision 17 of this subsection, the Secretary may waive any such 18 provision for any area and time period specified by 19 the Secretary.’’. 20 VerDate Sep 11 2014 15:46 Aug 29, 2020 Jkt 099200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\H7992.IH H7992 pamtmann on DSKBC07HB2PROD with BILLS 4 •HR 7992 IH SEC. 202. MAKING PERMANENT THE ABILITY OF FEDER- 1 ALLY QUALIFIED HEALTH CENTERS AND 2 RURAL HEALTH CLINICS TO FURNISH TELE- 3 HEALTH SERVICES UNDER THE MEDICARE 4 PROGRAM. 5 Section 1834(m)(8) of the Social Security Act (42 6 U.S.C. 1395m(m)(8)) is amended— 7 (1) in the header, by striking ‘‘DURING EMER- 8 GENCY PERIOD’’; 9 (2) in subparagraph (A), in the matter pre- 10 ceding clause (i), by striking ‘‘During’’ and inserting 11 ‘‘Beginning on the first day of’’; and 12 (3) in subparagraph (B)(i), by striking ‘‘during 13 such emergency period’’. 14 SEC. 203. CLARIFICATION FOR FRAUD AND ABUSE LAWS 15 REGARDING TECHNOLOGIES PROVIDED TO 16 BENEFICIARIES. 17 Section 1128A(i)(6) of the Social Security Act (42 18 U.S.C. 1320a–7a(i)(6)) is amended— 19 (1) in subparagraph (I), by striking ‘‘; or’’ and 20 inserting a semicolon; 21 (2) in subparagraph (J), by striking the period 22 at the end and inserting ‘‘; or’’; and 23 (3) by adding at the end the following new sub- 24 paragraph: 25 VerDate Sep 11 2014 15:46 Aug 29, 2020 Jkt 099200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\H7992.IH H7992 pamtmann on DSKBC07HB2PROD with BILLS 5 •HR 7992 IH ‘‘(K) the provision of technologies (as de- 1 fined by the Secretary) on or after the date of 2 the enactment of this subparagraph, by a pro- 3 vider of services or supplier (as such terms are 4 defined for purposes of title XVIII) directly to 5 an individual who is entitled to benefits under 6 part A of title XVIII, enrolled under part B of 7 such title, or both, for the purpose of furnishing 8 telehealth services, remote patient monitoring 9 services, or other services furnished through the 10 use of technology (as defined by the Secretary), 11 if— 12 ‘‘(i) the technologies are not offered 13 as part of any advertisement or solicita- 14 tion; and 15 ‘‘(ii) the provision of the technologies 16 meets any other requirements set forth in 17 regulations promulgated by the Sec- 18 retary.’’. 19 TITLE III—ENHANCE ACCESS TO 20 SUPPORT ESSENTIAL BEHAV- 21 IORAL HEALTH SERVICES 22 SEC. 301. FINDINGS. 23 Congress finds as follows: 24 VerDate Sep 11 2014 15:46 Aug 29, 2020 Jkt 099200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\H7992.IH H7992 pamtmann on DSKBC07HB2PROD with BILLS 6 •HR 7992 IH (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 15:46 Aug 29, 2020 Jkt 099200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\H7992.IH H7992 pamtmann on DSKBC07HB2PROD with BILLS 7 •HR 7992 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 15:46 Aug 29, 2020 Jkt 099200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\H7992.IH H7992 pamtmann on DSKBC07HB2PROD with BILLS 8 •HR 7992 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. 302. 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)), as amended by title II, is further 20 amended— 21 (1) in paragraph (4)(C)— 22 (A) in clause (i), by striking ‘‘and (7)’’ and 23 inserting ‘‘(7), and (10)’’; and 24 (B) in clause (ii)(X)— 25 VerDate Sep 11 2014 15:46 Aug 29, 2020 Jkt 099200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6201 E:\BILLS\H7992.IH H7992 pamtmann on DSKBC07HB2PROD with BILLS 9 •HR 7992 IH (i) by striking ‘‘or telehealth services’’ 1 and inserting ‘‘, telehealth services’’; and 2 (ii) by inserting ‘‘, or telehealth serv- 3 ices described in paragraph (10)’’ before 4 the 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 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. 303. 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 15:46 Aug 29, 2020 Jkt 099200 PO 00000 Frm 00009 Fmt 6652 Sfmt 6201 E:\BILLS\H7992.IH H7992 pamtmann on DSKBC07HB2PROD with BILLS 10 •HR 7992 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 15:46 Aug 29, 2020 Jkt 099200 PO 00000 Frm 00010 Fmt 6652 Sfmt 6201 E:\BILLS\H7992.IH H7992 pamtmann on DSKBC07HB2PROD with BILLS 11 •HR 7992 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 15:46 Aug 29, 2020 Jkt 099200 PO 00000 Frm 00011 Fmt 6652 Sfmt 6201 E:\BILLS\H7992.IH H7992 pamtmann on DSKBC07HB2PROD with BILLS 12 •HR 7992 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 15:46 Aug 29, 2020 Jkt 099200 PO 00000 Frm 00012 Fmt 6652 Sfmt 6201 E:\BILLS\H7992.IH H7992 pamtmann on DSKBC07HB2PROD with BILLS 13 •HR 7992 IH health disorders’’ after ‘‘substance use dis- 1 orders’’. 2 SEC. 304. EFFECTIVE DATE. 3 The amendments made by this title shall take effect 4 as if included in the enactment of the SUPPORT for Pa- 5 tients and Communities Act. 6 TITLE IV—HELPING ENSURE 7 ACCESS TO LOCAL TELEHEALTH 8 SEC. 401. PROVIDING FOR PERMANENT COST-RELATED 9 PAYMENTS FOR TELEHEALTH SERVICES FUR- 10 NISHED BY FEDERALLY QUALIFIED HEALTH 11 CENTERS AND RURAL HEALTH CLINICS 12 UNDER THE MEDICARE PROGRAM AND PER- 13 MANENTLY REMOVING ORIGINATING SITE 14 FACILITY AND LOCATION REQUIREMENTS 15 FOR DISTANT SITE TELEHEALTH SERVICES 16 FURNISHED BY SUCH CENTERS AND SUCH 17 CLINICS. 18 (a) PERMANENT TELEHEALTH PAYMENTS.—Section 19 1834(m)(8) of the Social Security Act (42 U.S.C. 20 1395m(m)(8)) is amended— 21 (1) in the header, by striking ‘‘DURING EMER- 22 GENCY PERIOD’’; 23 (2) in subparagr [Text truncated for display. Full text available on Congress.gov.]