I 

117TH CONGRESS 

1ST SESSION H. R. 2264 

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 HOUSE OF REPRESENTATIVES 

MARCH 26, 2021 

Mr. TRONE (for himself and Mr. FITZPATRICK) introduced the following bill; 

which was referred to the Committee on Energy and Commerce, and in 

addition to the Committees on Ways and Means, and Education and 

Labor, 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 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’’. 


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1 SEC. 2. COVERAGE OF TELEHEALTH MENTAL HEALTH AND 

2 SUBSTANCE USE DISORDER SERVICES. 

3 (a) IN GENERAL.— 

4 (1) INSURER REQUIREMENTS.—During the ap5 plicable period described in subsection (g), if a group 

6 health plan or group or individual health insurance 

7 coverage provides coverage of a mental health or 

8 substance use disorder service provided in-person the 

9 group health plan or health insurance issuer offering 

10 such group or individual health insurance cov11 erage— 

12 (A) shall provide coverage of the service 

13 provided through telehealth at the same rate as 

14 the coverage for the same service provided in15 person (with the same cost-sharing for enrollees 

16 and the same reimbursement rates for pro17 viders); 

18 (B) shall ensure that providers not charge 

19 enrollees facility fees for such services provided 

20 through telehealth; 

21 (C) may not impose additional barriers to 

22 obtaining such coverage for such services 

23 through telehealth, compared to coverage for 

24 such services provided in-person, such as a 

25 prior authorization requirement that is more 

26 rigorous than for in-person visits; and 


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1 (D) shall provide notice to enrollees, in2 forming such enrollees of how to access in-net3 work telehealth mental health and substance 

4 use disorder services and the scope of their cov5 erage. 

6 (2) PROVIDER REQUIREMENTS.—During the 

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

8 provider of a mental health or substance use dis9 order service provides such services via telehealth to 

10 an enrollee in a group health plan or group or indi11 vidual health insurance coverage, the provider shall 

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

13 a health insurance issuer of such coverage facility 

14 fees for such services. 

15 (b) ENFORCEMENT.— 

16 (1) INSURER REQUIREMENTS.—The provisions 

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

18 of Health and Human Services, the Secretary of 

19 Labor, and the Secretary of the Treasury to group 

20 health plans and health insurance issuers offering 

21 group or individual health insurance coverage as if 

22 included in the provisions of part A of title XXVII 

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

24 et seq.), part 7 of subtitle B of title I of the Em25 ployee Retirement Income Security Act of 1974 (29 


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

2 100 of the Internal Revenue Code of 1986, as appli3 cable. 

4 (2) PROVIDER REQUIREMENTS.—Subsection 

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

6 and Human Services and the Secretary of Labor to 

7 providers as if included in the provisions of part E 

8 of title XXVII of the Public Health Service Act. 

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

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

11 Treasury may implement the provisions of this section 

12 through sub-regulatory guidance, program instruction, or 

13 otherwise. 

14 (d) DEFINITIONS.—In this section— 

15 (1) the terms ‘‘group health plan’’, ‘‘health in16 surance issuer’’, and ‘‘health insurance coverage’’ 

17 have the meanings given such terms in section 2791 

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

19 91), section 733 of the Employee Retirement Income 

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

21 9832 of the Internal Revenue Code of 1986, as ap22 plicable; and 

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

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

25 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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