IB 

Union Calendar No. 579 

115TH CONGRESS 

2D SESSION H. R. 5603 

[Report No. 115–745, Part I] 

To amend title XVIII of the Social Security Act to provide the Secretary 

of Health and Human Services authority to waive certain Medicare 

telehealth requirements in the case of certain treatment of an opioid 

use disorder or co-occurring mental health disorder. 

IN THE HOUSE OF REPRESENTATIVES 

APRIL 24, 2018 

Ms. MATSUI (for herself and Mr. CA ́RDENAS) 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 

JUNE 12, 2018 

Additional sponsors: Mr. JOHNSON of Ohio, Mrs. BLACKBURN, Mr. GRIFFITH, 

Mr. THOMPSON of California, Mr. WALDEN, Mr. MITCHELL, and Mr. BOST

JUNE 12, 2018 

Reported from the Committee on Energy and Commerce with amendments 

[Strike out all after the enacting clause and insert the part printed in italic] 

JUNE 12, 2018 

The Committee on Ways and Means discharged; committed to the Committee 

of the Whole House on the State of the Union and ordered to be printed 

[For text of introduced bill, see copy of bill as introduced on April 24, 2018] 


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•HR 5603 RH

A BILL 

To amend title XVIII of the Social Security Act to provide 

the Secretary of Health and Human Services authority 

to waive certain Medicare telehealth requirements in the 

case of certain treatment of an opioid use disorder or 

co-occurring mental health disorder. 


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•HR 5603 RH

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 ‘‘Access to Telehealth 

5 Services for Substance Use Disorders Act’’. 

6 SEC. 2. AUTHORITY NOT TO APPLY CERTAIN MEDICARE 

7 TELEHEALTH REQUIREMENTS IN THE CASE 

8 OF CERTAIN TREATMENT OF A SUBSTANCE 

9 USE DISORDER OR CO-OCCURRING MENTAL 

10 HEALTH DISORDER. 

11 Section 1834(m) of the Social Security Act (42 U.S.C. 

12 1395m(m)) is amended— 

13 (1) in paragraph (2)(B)(i), by inserting ‘‘and 

14 paragraph (7)(E)’’ after ‘‘Subject to clause (ii)’’; and 

15 (2) by adding at the end the following new para16 graphs: 

17 ‘‘(7) AUTHORITY NOT TO APPLY CERTAIN RE18 QUIREMENTS IN THE CASE OF CERTAIN TREATMENT

19 OF SUBSTANCE USE DISORDER OR CO-OCCURRING

20 MENTAL HEALTH DISORDER.— 

21 ‘‘(A) IN GENERAL.—For purposes of pay22 ment under this subsection, in the case of tele23 health services described in subparagraph (C) 

24 furnished on or after January 1, 2020, to an eli25 gible beneficiary (as defined in subparagraph 


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1 (F)) for the treatment of a substance use disorder 

2 or a mental health disorder that is co-occurring 

3 with a substance use disorder, the Secretary is 

4 authorized to, through rulemaking, not apply 

5 any of the requirements described in subpara6 graph (B). 

7 ‘‘(B) REQUIREMENTS DESCRIBED.—For 

8 purposes of this paragraph, the requirements de9 scribed in this subparagraph are any of the fol10 lowing: 

11 ‘‘(i) Qualifications for an originating 

12 site under paragraph (4)(C)(ii). 

13 ‘‘(ii) Geographic limitations under 

14 paragraph (4)(C)(i). 

15 ‘‘(C) TELEHEALTH SERVICES DESCRIBED.— 

16 For purposes of this paragraph, the telehealth 

17 services described in this subparagraph are serv18 ices that are both telehealth services and identi19 fied by the Secretary, through rulemaking, as 

20 services that are the most commonly furnished 

21 (as defined by the Secretary) under this part to 

22 individuals diagnosed with a substance use dis23 order or a mental health disorder that is co-oc24 curring with a substance use disorder. 


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•HR 5603 RH

1 ‘‘(D) CLARIFICATION.—Nothing in this 

2 paragraph shall be construed as limiting or oth3 erwise affecting the authority of the Secretary to 

4 limit or eliminate the non-application pursuant 

5 to this paragraph of any of the requirements 

6 under subparagraph (B). 

7 ‘‘(E) TREATMENT OF ORIGINATING SITE FA8 CILITY FEE.—No facility fee shall be paid under 

9 paragraph (2)(B) to an originating site with re10 spect to a telehealth service described in subpara11 graph (B) for which payment is made under this 

12 subsection by reason of the non-application of a 

13 requirement described in subparagraph (B) pur14 suant to this paragraph if payment for such 

15 service would not otherwise be permitted under 

16 this subsection if such requirement were applied. 

17 ‘‘(F) ELIGIBLE BENEFICIARY DEFINED.— 

18 For purposes of this paragraph, the term ‘eligible 

19 beneficiary’ means an individual who— 

20 ‘‘(i) is entitled to, or enrolled for, bene21 fits under part A and enrolled for benefits 

22 under this part; 

23 ‘‘(ii) has a diagnosis for a substance 

24 use disorder; and 


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•HR 5603 RH

1 ‘‘(iii) meets such other criteria as the 

2 Secretary determines appropriate. 

3 ‘‘(G) REPORT.—Not later than 5 years after 

4 the date of the enactment of this paragraph, the 

5 Secretary shall submit to Congress a report on 

6 the impact of any non-application under this 

7 paragraph of any of the requirements described 

8 in subparagraph (B) on 

9 ‘‘(i) the utilization of health care serv10 ices related to substance use disorder, such 

11 as behavioral health services and emergency 

12 department visits; and 

13 ‘‘(ii) health outcomes related to sub14 stance use disorder, such as substance use 

15 overdose deaths. 

16 ‘‘(H) FUNDING.—For purposes of carrying 

17 out this paragraph, in addition to funds other18 wise available, the Secretary shall provide for the 

19 transfer, from the Federal Supplementary Med20 ical Insurance Trust Fund under section 1841, 

21 of $3,000,000 to the Centers for Medicare & Med22 icaid Services Program Management Account to 

23 remain available until expended. 

24 ‘‘(8) RULE OF CONSTRUCTION.—Nothing in this 

25 subsection may be construed as waiving requirements 


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1 under this title to comply with applicable State law, 

2 including State licensure requirements.’’. 

Amend the title so as to read: ‘‘A bill to amend title 

XVIII of the Social Security Act to provide the Secretary 

of Health and Human Services authority not to apply 

certain Medicare telehealth requirements in the case of 

certain treatment of a substance use disorder or co-occurring mental health disorder.’’. 


pbinns on DSK79D2C42PROD with BILLS
Union Calendar No. 579 

115TH CONGRESS 

2D SESSION H. R. 5603 

[Report No. 115–745, Part I] 

A BILL 

To amend title XVIII of the Social Security Act to 

mental health disorder. ment of an opioid use disorder or co-occurring health requirements in the case of certain treatServices authority to waive certain Medicare teleprovide the Secretary of Health and Human 

JUNE 12, 2018 

Reported from the Committee on Energy and Commerce 

with amendments 

JUNE 12, 2018 

The Committee on Ways and Means discharged; comState of the Union and ordered to be printed mitted to the Committee of the Whole House on the 


pbinns on DSK79D2C42PROD with BILLS