To require group health plans and health insurance issuers offering group or individual health insurance coverage to provide coverage for services furnished via telehealth if such services would be covered if furnished in-person during the COVID-19 emergency.

To require group health plans and health insurance issuers offering group or individual health insurance coverage to provide coverage for services furnished via telehealth if such services would be covered if furnished in-person during the COVID-19 emergency. 1. Requiring group health plans and health insurance issuers offering group or individual health insurance coverage to provide coverage for services furnished via telehealth if such services would be covered if furnished in-person during the COVID-19 emergency (a) In general During any portion of the emergency period described in section 1135(g)(1)(B) of the Social Security Act ( 42 U.S.C. 1320b–5(g)(1)(B) 42 U.S.C. 300gg–2 42 U.S.C. 18011(e) (1) shall— (A) provide benefits under such plan or such coverage for any eligible service (as defined in subsection (c)), including a mental health and substance use disorder service, furnished via a qualifying telecommunications system (as defined in subsection (c)) by a health care provider to an individual who is a participant, beneficiary, or enrollee under such plan or such coverage, notwithstanding that such provider furnishing such service is not at the same location as the individual; (B) so provide such benefits for such service under the same terms and with application of the same cost-sharing requirements (including a deductible, copayment, or coinsurance) as would apply if such service were furnished by such provider to such individual in-person; (C) reimburse such provider for such service in an amount equal to the amount of reimbursement for such service had such service been furnished by such provider to such individual in-person; (D) not impose any requirement under such plan or coverage that such provider have a prior relationship with such individual; and (E) not restrict the ability of any health care provider with a contractual relationship for furnishing an eligible service under such plan or coverage from furnishing such service via a qualifying telecommunications system, and shall not establish incentives or penalties under such plan or coverage for receiving such an eligible service from such a provider via such a system; and (2) may waive any cost-sharing requirement (including application of a deductible, copayment, or coinsurance) for an item or service furnished for purposes of diagnosing or treating COVID-19, including any such service that is an eligible service furnished via a qualifying telecommunications system. (b) Application The provisions of this section shall be applied by the Secretary of Health and Human Services, Secretary of Labor, and Secretary of the Treasury to group health plans and health insurance issuers offering group or individual health insurance coverage as if included in the provisions of part A of title XXVII of the Public Health Service Act, part 7 of the Employee Retirement Income Security Act of 1974, and subchapter B of chapter 100 (c) Definitions In this section: (1) Eligible service The term eligible service (A) for which benefits are provided under such plan or such coverage when such service is furnished in-person; (B) that is medically necessary (as determined by the health care provider furnishing such service); and (C) that is able to be safely and effectively furnished via a telecommunications system. (2) Health insurance terms The terms group health plan health insurance issuer group health insurance coverage individual health insurance coverage 42 U.S.C. 300gg–91 29 U.S.C. 1191b section 9832 (3) Qualifying telecommunications system The term qualifying telecommunications system (d) Effective date This section shall apply with respect to items and services furnished on or after the first day of the emergency period described in subsection (a).

Summary: This bill requires private health insurance plans to cover certain services provided via telecommunications systems (i.e., telehealth) during the COVID-19 (i.e., coronavirus disease 2019) public health emergency. Specifically, the telehealth services must be deemed medically necessary by a health care provider and covered under the plan if provided in person. Plans must apply the same cost-sharing and reimbursement amounts that would otherwise apply to such services and may waive cost-sharing requirements for any services to diagnose or treat COVID-19, including via telehealth.