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 subse-
quently 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] 
VerDate Sep 11 2014 
01:04 Jun 13, 2018
Jkt 079200
PO 00000
Frm 00001
Fmt 6652
Sfmt 6652
E:\BILLS\H5603.RH
H5603
pbinns on DSK79D2C42PROD with BILLS
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. 
VerDate Sep 11 2014 
01:04 Jun 13, 2018
Jkt 079200
PO 00000
Frm 00002
Fmt 6652
Sfmt 6652
E:\BILLS\H5603.RH
H5603
pbinns on DSK79D2C42PROD with BILLS
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 ‘‘Access to Telehealth 
Services for Substance Use Disorders Act’’. 
SEC. 2. 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. 
Section 1834(m) of the Social Security Act (42 U.S.C. 
1395m(m)) is amended— 
(1) in paragraph (2)(B)(i), by inserting ‘‘and 
paragraph (7)(E)’’ after ‘‘Subject to clause (ii)’’; and 
(2) by adding at the end the following new para-
graphs: 
‘‘(7) AUTHORITY NOT TO APPLY CERTAIN RE-
QUIREMENTS IN THE CASE OF CERTAIN TREATMENT 
OF
SUBSTANCE
USE
DISORDER
OR
CO-OCCURRING 
MENTAL HEALTH DISORDER.— 
‘‘(A) IN GENERAL.—For purposes of pay-
ment under this subsection, in the case of tele-
health services described in subparagraph (C) 
furnished on or after January 1, 2020, to an eli-
gible beneficiary (as defined in subparagraph 
VerDate Sep 11 2014 
01:04 Jun 13, 2018
Jkt 079200
PO 00000
Frm 00003
Fmt 6652
Sfmt 6203
E:\BILLS\H5603.RH
H5603
pbinns on DSK79D2C42PROD with BILLS
(F)) for the treatment of a substance use disorder 
or a mental health disorder that is co-occurring 
with a substance use disorder, the Secretary is 
authorized to, through rulemaking, not apply 
any of the requirements described in subpara-
graph (B). 
‘‘(B) 
REQUIREMENTS
DESCRIBED.—For 
purposes of this paragraph, the requirements de-
scribed in this subparagraph are any of the fol-
lowing: 
‘‘(i) Qualifications for an originating 
site under paragraph (4)(C)(ii). 
‘‘(ii) Geographic limitations under 
paragraph (4)(C)(i). 
‘‘(C) TELEHEALTH SERVICES DESCRIBED.— 
For purposes of this paragraph, the telehealth 
services described in this subparagraph are serv-
ices that are both telehealth services and identi-
fied by the Secretary, through rulemaking, as 
services that are the most commonly furnished 
(as defined by the Secretary) under this part to 
individuals diagnosed with a substance use dis-
order or a mental health disorder that is co-oc-
curring with a substance use disorder. 
VerDate Sep 11 2014 
01:04 Jun 13, 2018
Jkt 079200
PO 00000
Frm 00004
Fmt 6652
Sfmt 6203
E:\BILLS\H5603.RH
H5603
pbinns on DSK79D2C42PROD with BILLS
‘‘(D) 
CLARIFICATION.—Nothing 
in 
this 
paragraph shall be construed as limiting or oth-
erwise affecting the authority of the Secretary to 
limit or eliminate the non-application pursuant 
to this paragraph of any of the requirements 
under subparagraph (B). 
‘‘(E) TREATMENT OF ORIGINATING SITE FA-
CILITY FEE.—No facility fee shall be paid under 
paragraph (2)(B) to an originating site with re-
spect to a telehealth service described in subpara-
graph (B) for which payment is made under this 
subsection by reason of the non-application of a 
requirement described in subparagraph (B) pur-
suant to this paragraph if payment for such 
service would not otherwise be permitted under 
this subsection if such requirement were applied. 
‘‘(F) ELIGIBLE
BENEFICIARY
DEFINED.— 
For purposes of this paragraph, the term ‘eligible 
beneficiary’ means an individual who— 
‘‘(i) is entitled to, or enrolled for, bene-
fits under part A and enrolled for benefits 
under this part; 
‘‘(ii) has a diagnosis for a substance 
use disorder; and 
VerDate Sep 11 2014 
01:04 Jun 13, 2018
Jkt 079200
PO 00000
Frm 00005
Fmt 6652
Sfmt 6203
E:\BILLS\H5603.RH
H5603
pbinns on DSK79D2C42PROD with BILLS
‘‘(iii) meets such other criteria as the 
Secretary determines appropriate. 
‘‘(G) REPORT.—Not later than 5 years after 
the date of the enactment of this paragraph, the 
Secretary shall submit to Congress a report on 
the impact of any non-application under this 
paragraph of any of the requirements described 
in subparagraph (B) on 
‘‘(i) the utilization of health care serv-
ices related to substance use disorder, such 
as behavioral health services and emergency 
department visits; and 
‘‘(ii) health outcomes related to sub-
stance use disorder, such as substance use 
overdose deaths. 
‘‘(H) FUNDING.—For purposes of carrying 
out this paragraph, in addition to funds other-
wise available, the Secretary shall provide for the 
transfer, from the Federal Supplementary Med-
ical Insurance Trust Fund under section 1841, 
of $3,000,000 to the Centers for Medicare & Med-
icaid Services Program Management Account to 
remain available until expended. 
‘‘(8) RULE OF CONSTRUCTION.—Nothing in this 
subsection may be construed as waiving requirements 
VerDate Sep 11 2014 
01:04 Jun 13, 2018
Jkt 079200
PO 00000
Frm 00006
Fmt 6652
Sfmt 6203
E:\BILLS\H5603.RH
H5603
pbinns on DSK79D2C42PROD with BILLS
under this title to comply with applicable State law, 
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-occur-
ring mental health disorder.’’. 
VerDate Sep 11 2014 
01:04 Jun 13, 2018
Jkt 079200
PO 00000
Frm 00007
Fmt 6652
Sfmt 6201
E:\BILLS\H5603.RH
H5603
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 
provide the Secretary of Health and Human 
Services authority to waive certain Medicare tele-
health requirements in the case of certain treat-
ment of an opioid use disorder or co-occurring 
mental health disorder. 
JUNE 12, 2018 
Reported from the Committee on Energy and Commerce 
with amendments 
JUNE 12, 2018 
The Committee on Ways and Means discharged; com-
mitted to the Committee of the Whole House on the 
State of the Union and ordered to be printed 
VerDate Sep 11 2014 
01:04 Jun 13, 2018
Jkt 079200
PO 00000
Frm 00008
Fmt 6651
Sfmt 6651
E:\BILLS\H5603.RH
H5603
pbinns on DSK79D2C42PROD with BILLS