II 

116TH CONGRESS 

2D SESSION S. 4211 

To amend title XVIII of the Social Security Act to expand access in frontier 

States to mental health services furnished through telehealth, and for 

other purposes. 

IN THE SENATE OF THE UNITED STATES 

JULY 2, 2020 

Mr. SULLIVAN (for himself and Ms. ROSEN) 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 in frontier States to mental health services furnished through telehealth, and for other purposes. 

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 ‘‘Facilitating Reforms 

5 that Offer Necessary Telehealth In Every Rural (FRON6 TIER) Community Act’’. 


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•S 4211 IS

1 SEC. 2. EXPANDING ACCESS TO MENTAL HEALTH SERVICES 

2 FURNISHED IN FRONTIER STATES THROUGH 

3 TELEHEALTH. 

4 (a) IN GENERAL.—Section 1834(m) of the Social Se5 curity Act (42 U.S.C. 1395m(m)) is amended— 

6 (1) in paragraph (2)(B)(i), in the matter pre7 ceding subclause (I), by striking ‘‘paragraph (6)(C)’’ 

8 and inserting ‘‘paragraphs (6)(C) and (9)’’; 

9 (2) in paragraph (4)(C)(i), by striking ‘‘and 

10 (7)’’ and inserting ‘‘(7), and (9)’’; and 

11 (3) by adding at the end the following new 

12 paragraph: 

13 ‘‘(9) TREATMENT OF MENTAL HEALTH SERV14 ICES FURNISHED IN FRONTIER STATES.— 

15 ‘‘(A) IN GENERAL.—The originating site 

16 requirements under paragraph (4)(C) shall not 

17 apply with respect to telehealth services fur18 nished on or after January 1, 2021, that are 

19 furnished in a frontier State (as defined in sec20 tion 1886(d)(3)(E)(iii)(II)) and are mental 

21 health services (as determined by the Sec22 retary), except that a facility fee under para23 graph (2)(B)(i) may only be paid to an origi24 nating site that is a site described in any of 

25 subclauses (I) through (IX) of paragraph 

26 (4)(C)(ii). 


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•S 4211 IS

1 ‘‘(B) DEFINITION OF ORIGINATING SITE.— 

2 With respect to telehealth services described in 

3 subparagraph (A), the term ‘originating site’ 

4 means any fixed or mobile location at which the 

5 individual is located at the time the service is 

6 furnished.’’. 

7 (b) GRANTS FOR THE DEPLOYMENT OF BROADBAND

8 STRUCTURE.— 

9 (1) IN GENERAL.—The Chairman of the Fed10 eral Communications Commission and the Adminis11 trator of the Rural Utilities Service of the United 

12 States Department of Agriculture, in consultation 

13 with the Administrator of the Health Resources and 

14 Services Administration and the Director of the In15 dian Health Service, shall award grants for the de16 ployment of broadband infrastructure in frontier 

17 States, as defined in section 1886(d)(3)(E)(iii)(II) of 

18 the Social Security Act (42 U.S.C. 

19 1395ww(d)(3)(E)(iii)(II)), to support the furnishing 

20 of mental health services through telehealth pursu21 ant to section 1834(m)(9) of such Act, as added by 

22 subsection (a). 

23 (2) AUTHORIZATION.—There are authorized to 

24 be appropriated such sums as are necessary for pur25 poses of carrying out this subsection. 


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•S 4211 IS

1 SEC. 3. INDIAN HEALTH SERVICE FACILITIES. 

2 (a) IN GENERAL.—Section 1834(m)(4)(C) of the So3 cial Security Act (42 U.S.C. 1395m(m)(4)(C)), as amend4 ed by section 2(a), is amended— 

5 (1) in clause (i), in the matter preceding sub6 clause (I), by inserting ‘‘, and subject to clause (iii)’’ 

7 after ‘‘and (9)’’; and 

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

9 clause: 

10 ‘‘(iii) INDIAN HEALTH SERVICE FA11 CILITIES.—The originating site require12 ments described in clauses (i) and (ii) shall 

13 not apply with respect to a facility of the 

14 Indian Health Service, whether operated 

15 by such Service, or by an Indian tribe (as 

16 that term is defined in section 4 of the In17 dian Health Care Improvement Act (25 

18 U.S.C. 1603)) or a tribal organization (as 

19 that term is defined in section 4 of the In20 dian Self-Determination and Education 

21 Assistance Act (25 U.S.C. 5304)).’’. 

22 (b) NO ORIGINATING SITE FACILITY FEE FOR NEW

23 SITES.—Section 1834(m)(2)(B)(i) of the Social Security 

24 Act (42 U.S.C. 1395m(m)(2)(B)(i)) is amended, in the 

25 matter preceding subclause (I), by inserting ‘‘(other than 

26 an originating site that is only described in clause (iii) of 


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•S 4211 IS

1 paragraph (4)(C), and does not meet the requirement for 

2 an originating site under clause (i) of such paragraph)’’ 

3 after ‘‘the originating site’’. 

4 (c) EFFECTIVE DATE.—The amendments made by 

5 this section shall apply to services furnished on or after 

6 January 1, 2021. 

Æ 


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