II 

117TH CONGRESS 

1ST SESSION S. 660 

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 

MARCH 10, 2021 

Ms. SMITH (for herself and Ms. MURKOWSKI) introduced the following bill; 

which was read twice and referred to the Committee on Health, Education, Labor, and Pensions 

A BILL 

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. 

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 ‘‘Tele-Mental Health 

5 Improvement Act’’. 

6 SEC. 2. COVERAGE OF TELEHEALTH MENTAL HEALTH AND 

7 SUBSTANCE USE DISORDER SERVICES. 

8 (a) IN GENERAL.— 


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1 (1) INSURER REQUIREMENTS.—During the ap2 plicable period described in subsection (g), if a group 

3 health plan or group or individual health insurance 

4 coverage provides coverage of a mental health or 

5 substance use disorder service provided in-person the 

6 group health plan or health insurance issuer offering 

7 such group or individual health insurance cov8 erage— 

9 (A) shall provide coverage of the service 

10 provided through telehealth at the same rate as 

11 the coverage for the same service provided in12 person (with the same cost-sharing for enrollees 

13 and the same reimbursement rates for pro14 viders); 

15 (B) shall ensure that providers not charge 

16 enrollees facility fees for such services provided 

17 through telehealth; 

18 (C) may not impose additional barriers to 

19 obtaining or providing such coverage for such 

20 services through telehealth, compared to cov21 erage for such services provided in-person, such 

22 as a prior authorization requirement that is 

23 more rigorous than for in-person visits; and 

24 (D) shall provide notice to enrollees, in25 forming such enrollees of how to access in-netVerDate Sep 11 2014 21:42 Apr 04, 2021 Jkt 019200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\S660.IS S660

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1 work telehealth mental health and substance 

2 use disorder services and the scope of their cov3 erage. 

4 (2) PROVIDER REQUIREMENTS.—During the 

5 applicable period described in subsection (g), if a 

6 provider of a mental health or substance use dis7 order service provides such services via telehealth to 

8 an enrollee in a group health plan or group or indi9 vidual health insurance coverage, the provider shall 

10 not charge such enrollee, such group health plan, or 

11 a health insurance issuer of such coverage facility 

12 fees for such services. 

13 (b) ENFORCEMENT.— 

14 (1) INSURER REQUIREMENTS.—The provisions 

15 of subsection (a)(1) shall be applied by the Secretary 

16 of Health and Human Services, the Secretary of 

17 Labor, and the Secretary of the Treasury to group 

18 health plans and health insurance issuers offering 

19 group or individual health insurance coverage as if 

20 included in the provisions of part A of title XXVII 

21 of the Public Health Service Act (42 U.S.C. 300gg 

22 et seq.), part 7 of subtitle B of title I of the Em23 ployee Retirement Income Security Act of 1974 (29 

24 U.S.C. 1181 et seq.), and subchapter B of chapter 


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1 100 of the Internal Revenue Code of 1986, as appli2 cable. 

3 (2) PROVIDER REQUIREMENTS.—Subsection 

4 (a)(2) shall be applied by the Secretary of Health 

5 and Human Services and the Secretary of Labor to 

6 providers as if included in the provisions of part E 

7 of title XXVII of the Public Health Service Act. 

8 (c) IMPLEMENTATION.—The Secretary of Health and 

9 Human Services, Secretary of Labor, and Secretary of the 

10 Treasury may implement the provisions of this section 

11 through sub-regulatory guidance, program instruction, or 

12 otherwise. 

13 (d) DEFINITIONS.—In this section— 

14 (1) the terms ‘‘group health plan’’, ‘‘health in15 surance issuer’’, and ‘‘health insurance coverage’’ 

16 have the meanings given such terms in section 2791 

17 of the Public Health Service Act (42 U.S.C. 300gg– 

18 91), section 733 of the Employee Retirement Income 

19 Security Act of 1974 (29 U.S.C. 1191b), and section 

20 9832 of the Internal Revenue Code of 1986, as ap21 plicable; and 

22 (2) the term ‘‘telehealth services’’ has the 

23 meaning given such term in section 330I(a) of the 

24 Public Health Service Act (42 U.S.C. 254c–14(a)), 


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1 and includes 2-way video communication, and audio2 only communication. 

3 (e) RULE OF CONSTRUCTION.—Nothing in this sec4 tion shall prevent the application of any State law that 

5 is not inconsistent with this section. 

6 (f) REPORT TO CONGRESS.—Not later than 180 days 

7 after the conclusion of the public health emergency de8 scribed in subsection (a), the Secretary of Health and 

9 Human Services shall submit to the Committee on Health, 

10 Education, Labor, and Pensions of the Senate, the Com11 mittee on Education and Labor of the House of Rep12 resentatives, and the Committee on Energy and Commerce 

13 of the House of Representatives on the impacts the re14 quirement under subsection (a) has on the use of both 

15 telehealth services and health services provided in-person. 

16 (g) APPLICABLE PERIOD.—The applicable period de17 scribed in subsection (a) is the period beginning on the 

18 date of enactment of this Act and ending on the date that 

19 is 90 days after the public health emergency declared by 

20 the Secretary of Health and Human Services under sec21 tion 319 of the Public Health Service Act (42 U.S.C. 

22 247d) on January 31, 2020, with respect to COVID–19, 

23 expires. 

Æ 


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