I 
117TH CONGRESS 
1ST SESSION H. R. 4036 
To amend title XVIII of the Social Security Act and the SUPPORT for 
Patients and Communities Act to provide for Medicare and Medicaid 
mental and behavioral health treatment through telehealth. 
IN THE HOUSE OF REPRESENTATIVES 
JUNE 22, 2021 
Mr. BILIRAKIS (for himself and Mr. SOTO) 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 provi-
sions as fall within the jurisdiction of the committee concerned 
A BILL 
To amend title XVIII of the Social Security Act and the 
SUPPORT for Patients and Communities Act to provide 
for Medicare and Medicaid mental and behavioral health 
treatment through telehealth. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Enhance Access to 
Support Essential Behavioral Health Services Act’’ or the 
‘‘EASE Behavioral Health Services Act’’. 
VerDate Sep 11 2014 
04:04 Jul 09, 2021
Jkt 019200
PO 00000
Frm 00001
Fmt 6652
Sfmt 6201
E:\BILLS\H4036.IH
H4036
kjohnson on DSK79L0C42PROD with BILLS
SEC. 2. FINDINGS. 
Congress finds as follows: 
(1) Nearly 18 percent of adults in the United 
States reported a mental, behavioral, or emotional 
disorder in 2015. 
(2) Children are also significantly impacted. Ac-
cording to the Centers for Disease Control and Pre-
vention, 1 in 6 children ages 2 years through 8 years 
have a diagnosed mental, behavioral, or develop-
mental disorder, indicating that disorders begin in 
early childhood and affect lifelong health. 
(3) Moreover, 1 in 7 children and adolescents 
have at least one treatable mental health disorder. 
(4) There is a critical link between mental 
health and substance use disorders. According to the 
Substance Abuse and Mental Health Services Ad-
ministration, 1 in 4 adults with severe mental illness 
had a substance use disorder in 2017. 
(5) Moreover, children who have had a major 
depressive episode are more than twice as likely to 
use illicit drugs. 
(6) In 2017, approximately 19.7 million people 
aged 12 years or older had a substance use disorder 
related to their use of alcohol or illicit drugs in the 
past year. 
VerDate Sep 11 2014 
04:04 Jul 09, 2021
Jkt 019200
PO 00000
Frm 00002
Fmt 6652
Sfmt 6201
E:\BILLS\H4036.IH
H4036
kjohnson on DSK79L0C42PROD with BILLS
(7) Despite this overwhelming need, access to 
behavioral health services remains among the most 
pressing health care challenges in our country. 
(8) An estimated 56 percent of Americans with 
a mental health disorder did not receive treatment in 
2017. 
(9) Similarly, half of children and adolescents 
did not receive treatment for their mental health dis-
order in 2016. 
(10) Further complicating access to care, as de-
mand for behavioral health services increases in 
communities across the United States, the number 
of psychiatrists available to treat them continues to 
decline. 
(11) The population of practicing psychiatrists 
declined by more than 10 percent between the period 
of 2003 through 2013, while the population of pri-
mary care physicians and neurologists grew during 
the same period. 
(12) Technology has evolved to connect individ-
uals to health care services in new ways, including 
via telehealth. 
(13) Moreover, studies show that video visits 
are an effective strategy to provide mental health 
VerDate Sep 11 2014 
04:04 Jul 09, 2021
Jkt 019200
PO 00000
Frm 00003
Fmt 6652
Sfmt 6201
E:\BILLS\H4036.IH
H4036
kjohnson on DSK79L0C42PROD with BILLS
treatment to children and, in fact, may be preferable 
in some cases. 
(14) During the 115th Congress, Congress rec-
ognized the potential of telehealth to ensure that 
those in urgent need of substance use disorder treat-
ment receive the care they require. 
(15) As passed and signed into law, sections 
2001 and 1009 of the SUPPORT for Patients and 
Communities Act (Public Law 115–271) expands 
the use of telehealth services for the treatment of 
opioid use disorder and other substance use dis-
orders. 
(16) It is widely recognized that there is a close 
relationship between mental health and substance 
use disorders. 
SEC. 3. MEDICARE TREATMENT OF BEHAVIORAL HEALTH 
SERVICES 
FURNISHED 
THROUGH 
TELE-
HEALTH. 
Section 1834(m) of the Social Security Act (42 
U.S.C. 1395m(m)) is amended— 
(1) in paragraph (4)(C)— 
(A) in clause (i), by striking ‘‘and (7)’’ and 
inserting ‘‘(7), and (9)’’; and 
(B) in clause (ii)(X)— 
VerDate Sep 11 2014 
04:04 Jul 09, 2021
Jkt 019200
PO 00000
Frm 00004
Fmt 6652
Sfmt 6201
E:\BILLS\H4036.IH
H4036
kjohnson on DSK79L0C42PROD with BILLS
(i) by striking ‘‘or telehealth services’’ 
and inserting ‘‘, telehealth services’’; and 
(ii) by inserting ‘‘or telehealth services 
described in paragraph (9)’’ before the pe-
riod at the end; and 
(2) by adding at the end the following new 
paragraph: 
‘‘(9) TREATMENT
OF
BEHAVIORAL
HEALTH 
SERVICES
FURNISHED
THROUGH
TELEHEALTH.— 
The geographic requirements described in paragraph 
(4)(C)(i) shall not apply with respect to telehealth 
services that are behavioral health services furnished 
on or after January 1, 2022, to eligible telehealth in-
dividuals, including initial patient evaluations, fol-
low-up medical management, and other behavioral 
health services, as determined by the Secretary, at 
an originating site described in paragraph (4)(C)(ii) 
(other than an originating site described in sub-
clause (IX) of such paragraph).’’. 
SEC. 4. MEDICAID MENTAL AND BEHAVIORAL HEALTH 
TREATMENT THROUGH TELEHEALTH. 
Section 1009 of the SUPPORT for Patients and 
Communities Act (Public Law 115–271) is amended— 
(1) in subsection (b)— 
VerDate Sep 11 2014 
04:04 Jul 09, 2021
Jkt 019200
PO 00000
Frm 00005
Fmt 6652
Sfmt 6201
E:\BILLS\H4036.IH
H4036
kjohnson on DSK79L0C42PROD with BILLS
‘‘The Secretary shall issue the guidance under this sub-
section not later than 1 year after the date of the enact-
ment of this Act, with respect to the matters described 
in the previous provisions of this subsection relating to 
substance use disorders, and not later than 2 years after 
the date of the enactment of this Act, with respect to the 
matters described in such previous provisions relating to 
mental health disorders and behavioral health disorders.’’; 
(2) in subsection (c)— 
(A) in the header, by striking ‘‘TREAT-
MENT FOR SUBSTANCE USE DISORDERS’’ and 
inserting ‘‘TREATMENT FOR SUBSTANCE USE 
DISORDERS AND MENTAL HEALTH DISORDERS 
AND BEHAVIORAL HEALTH DISORDERS’’; 
(B) in paragraph (1), by striking ‘‘treat-
ment for substance use disorders’’ and inserting 
‘‘treatment for substance use disorders and 
mental health disorders and behavioral health 
disorders’’ each place it appears; and 
(C) in paragraph (2)— 
(i) by inserting ‘‘with respect to sub-
stance use disorders,’’ after ‘‘paragraph 
(1),’’; and 
(ii) by adding at the end the following 
new sentence: ‘‘Not later than 2 years 
VerDate Sep 11 2014 
04:04 Jul 09, 2021
Jkt 019200
PO 00000
Frm 00007
Fmt 6652
Sfmt 6201
E:\BILLS\H4036.IH
H4036
kjohnson on DSK79L0C42PROD with BILLS
after the date of enactment of this Act, the 
Comptroller General shall submit to Con-
gress a report containing the results of the 
evaluation conducted under paragraph (1), 
with respect to mental health disorders and 
behavioral health disorders, together with 
recommendations for such legislation and 
administrative action as the Comptroller 
General determines appropriate.’’; and 
(3) in subsection (d)(1)— 
(A) in the matter preceding subparagraph 
(A), by inserting ‘‘and mental health disorders 
and behavioral health disorders’’ after ‘‘sub-
stance use disorders’’; 
(B) in subparagraph (A), by inserting ‘‘, 
and mental health disorders and behavioral 
health disorders’’ after ‘‘opioid use disorder’’; 
and 
(C) in subparagraph (B), by inserting 
‘‘and mental health disorders and behavioral 
health disorders’’ after ‘‘substance use dis-
orders’’. 
VerDate Sep 11 2014 
04:04 Jul 09, 2021
Jkt 019200
PO 00000
Frm 00008
Fmt 6652
Sfmt 6201
E:\BILLS\H4036.IH
H4036
kjohnson on DSK79L0C42PROD with BILLS
SEC. 5. EFFECTIVE DATE. 
The amendments made by this Act shall take effect 
as is included in the enactment of the SUPPORT for Pa-
tients and Communities Act. 
Æ 
VerDate Sep 11 2014 
04:04 Jul 09, 2021
Jkt 019200
PO 00000
Frm 00009
Fmt 6652
Sfmt 6301
E:\BILLS\H4036.IH
H4036
kjohnson on DSK79L0C42PROD with BILLS