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 provisions 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. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Enhance Access to 

5 Support Essential Behavioral Health Services Act’’ or the 

6 ‘‘EASE Behavioral Health Services Act’’. 


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1 SEC. 2. FINDINGS. 

2 Congress finds as follows: 

3 (1) Nearly 18 percent of adults in the United 

4 States reported a mental, behavioral, or emotional 

5 disorder in 2015. 

6 (2) Children are also significantly impacted. Ac7 cording to the Centers for Disease Control and Pre8 vention, 1 in 6 children ages 2 years through 8 years 

9 have a diagnosed mental, behavioral, or develop10 mental disorder, indicating that disorders begin in 

11 early childhood and affect lifelong health. 

12 (3) Moreover, 1 in 7 children and adolescents 

13 have at least one treatable mental health disorder. 

14 (4) There is a critical link between mental 

15 health and substance use disorders. According to the 

16 Substance Abuse and Mental Health Services Ad17 ministration, 1 in 4 adults with severe mental illness 

18 had a substance use disorder in 2017. 

19 (5) Moreover, children who have had a major 

20 depressive episode are more than twice as likely to 

21 use illicit drugs. 

22 (6) In 2017, approximately 19.7 million people 

23 aged 12 years or older had a substance use disorder 

24 related to their use of alcohol or illicit drugs in the 

25 past year. 


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1 (7) Despite this overwhelming need, access to 

2 behavioral health services remains among the most 

3 pressing health care challenges in our country. 

4 (8) An estimated 56 percent of Americans with 

5 a mental health disorder did not receive treatment in 

6 2017. 

7 (9) Similarly, half of children and adolescents 

8 did not receive treatment for their mental health dis9 order in 2016. 

10 (10) Further complicating access to care, as de11 mand for behavioral health services increases in 

12 communities across the United States, the number 

13 of psychiatrists available to treat them continues to 

14 decline. 

15 (11) The population of practicing psychiatrists 

16 declined by more than 10 percent between the period 

17 of 2003 through 2013, while the population of pri18 mary care physicians and neurologists grew during 

19 the same period. 

20 (12) Technology has evolved to connect individ21 uals to health care services in new ways, including 

22 via telehealth. 

23 (13) Moreover, studies show that video visits 

24 are an effective strategy to provide mental health 


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1 treatment to children and, in fact, may be preferable 

2 in some cases. 

3 (14) During the 115th Congress, Congress rec4 ognized the potential of telehealth to ensure that 

5 those in urgent need of substance use disorder treat6 ment receive the care they require. 

7 (15) As passed and signed into law, sections 

8 2001 and 1009 of the SUPPORT for Patients and 

9 Communities Act (Public Law 115–271) expands 

10 the use of telehealth services for the treatment of 

11 opioid use disorder and other substance use dis12 orders. 

13 (16) It is widely recognized that there is a close 

14 relationship between mental health and substance 

15 use disorders. 

16 SEC. 3. MEDICARE TREATMENT OF BEHAVIORAL HEALTH 

17 SERVICES FURNISHED THROUGH TELE18 HEALTH. 

19 Section 1834(m) of the Social Security Act (42 

20 U.S.C. 1395m(m)) is amended— 

21 (1) in paragraph (4)(C)— 

22 (A) in clause (i), by striking ‘‘and (7)’’ and 

23 inserting ‘‘(7), and (8)’’; and 

24 (B) in clause (ii)(X)— 


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1 (i) by striking ‘‘or telehealth services’’ 

2 and inserting ‘‘, telehealth services’’; and 

3 (ii) by inserting ‘‘or telehealth services 

4 described in paragraph (8)’’ before the pe5 riod at the end; and 

6 (2) by adding at the end the following new 

7 paragraph: 

8 ‘‘(8) TREATMENT OF BEHAVIORAL HEALTH

9 SERVICES FURNISHED THROUGH TELEHEALTH.— 

10 The geographic requirements described in paragraph 

11 (4)(C)(i) shall not apply with respect to telehealth 

12 services that are behavioral health services furnished 

13 on or after July 1, 2020, to eligible telehealth indi14 viduals, including initial patient evaluations, follow15 up medical management, and other behavioral health 

16 services, as determined by the Secretary, at an origi17 nating site described in paragraph (4)(C)(ii) (other 

18 than an originating site described in subclause (IX) 

19 of such paragraph).’’. 

20 SEC. 4. MEDICAID MENTAL AND BEHAVIORAL HEALTH 

21 TREATMENT THROUGH TELEHEALTH. 

22 Section 1009 of the SUPPORT for Patients and 

23 Communities Act (Public Law 115–271) is amended— 

24 (1) in subsection (b)— 


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1 (A) in the header, by striking ‘‘TREAT2 MENT FOR SUBSTANCE USE DISORDERS’’ 

3 and inserting ‘‘TREATMENT FOR SUBSTANCE

4 USE DISORDERS AND MENTAL HEALTH

5 DISORDERS AND BEHAVIORAL HEALTH

6 DISORDERS’’; 

7 (B) in the matter preceding paragraph (1), 

8 by striking ‘‘Not later than 1 year after the 

9 date of enactment of this Act, the Secretary’’ 

10 and inserting ‘‘The Secretary’’; 

11 (C) in paragraph (1)— 

12 (i) by striking ‘‘treatment for sub13 stance use disorders’’ and inserting ‘‘treat14 ment for substance use disorders and men15 tal health disorders and behavioral health 

16 disorders’’; and 

17 (ii) by inserting ‘‘psychotherapy,’’ 

18 after ‘‘counseling,’’; 

19 (D) in paragraph (2), by inserting ‘‘or 

20 mental health disorders and behavioral health 

21 disorders’’ after ‘‘substance use disorders’’; 

22 (E) in paragraph (3), by inserting ‘‘and 

23 mental health disorders and behavioral health 

24 disorders’’ after ‘‘substance use disorders’’; and 


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1 (F) by adding at the end, below and after 

2 paragraph (3), the following flush left text: 

3 ‘‘The Secretary shall issue the guidance under this sub4 section not later than 1 year after the date of the enact5 ment of this Act, with respect to the matters described 

6 in the previous provisions of this subsection relating to 

7 substance use disorders, and not later than 2 years after 

8 the date of the enactment of this Act, with respect to the 

9 matters described in such previous provisions relating to 

10 mental health disorders and behavioral health disorders.’’; 

11 (2) in subsection (c)— 

12 (A) in the header, by striking ‘‘TREAT13 MENT FOR SUBSTANCE USE DISORDERS’’ 

14 and inserting ‘‘TREATMENT FOR SUBSTANCE

15 USE DISORDERS AND MENTAL HEALTH

16 DISORDERS AND BEHAVIORAL HEALTH

17 DISORDERS’’; 

18 (B) in paragraph (1), by striking ‘‘treat19 ment for substance use disorders’’ and inserting 

20 ‘‘treatment for substance use disorders and 

21 mental health disorders and behavioral health 

22 disorders’’ each place it appears; and 

23 (C) in paragraph (2)— 


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1 (i) by inserting ‘‘with respect to sub2 stance use disorders,’’ after ‘‘paragraph 

3 (1),’’; and 

4 (ii) by adding at the end the following 

5 new sentence: ‘‘Not later than 2 years 

6 after the date of enactment of this Act, the 

7 Comptroller General shall submit to Con8 gress a report containing the results of the 

9 evaluation conducted under paragraph (1), 

10 with respect to mental health disorders and 

11 behavioral health disorders, together with 

12 recommendations for such legislation and 

13 administrative action as the Comptroller 

14 General determines appropriate.’’; and 

15 (3) in subsection (d)(1)— 

16 (A) in the matter preceding subparagraph 

17 (A), by inserting ‘‘and mental health disorders 

18 and behavioral health disorders’’ after ‘‘sub19 stance use disorders’’; 

20 (B) in subparagraph (A), by inserting ‘‘, 

21 and mental health disorders and behavioral 

22 health disorders’’ after ‘‘opioid use disorder’’; 

23 and 

24 (C) in subparagraph (B), by inserting 

25 ‘‘and mental health disorders and behavioral 


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1 health disorders’’ after ‘‘substance use dis2 orders’’. 

3 SEC. 5. EFFECTIVE DATE. 

4 The amendments made by this Act shall take effect 

5 as is included in the enactment of the SUPPORT for Pa6 tients and Communities Act. 

Æ 


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