Tele-Mental Health Improvement Act
Bill: H.R.2264 | Sponsor: Rep. Trone, David J. (D-MD)
Policy area: Health

Summary:
Tele-Mental Health Improvement Act  This bill requires private health insurance plans that cover in-person mental health or substance use disorder services to cover such services on equal terms via telehealth (i.e., information technology used to aid treatment and diagnosis at a physical distance) during and shortly after the COVID-19 (i.e., coronavirus disease 2019) public health emergency. Specifically, this bill requires plans to, among other things, cover these services at the same rate as in-person services, exclude charges for facility fees, and provide information about how to access these services. Additionally, providers of these services may not charge facility fees to plan enrollees.

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.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Tele-Mental Health Improvement 
Act''.

SEC. 2. COVERAGE OF TELEHEALTH MENTAL HEALTH AND SUBSTANCE USE DISORDER 
              SERVICES.

    (a) In General.--
            (1) Insurer requirements.--During the applicable period 
        described in subsection (g), if a group health plan or group or 
        individual health insurance coverage provides coverage of a 
        mental health or substance use disorder service provided in-
        person the group health plan or health insurance issuer 
        offering such group or individual health insurance coverage--
                    (A) shall provide coverage of the service provided 
                through telehealth at the same rate as the coverage for 
                the same service provided in-person (with the same 
                cost-sharing for enrollees and the same reimbursement 
                rates for providers);
                    (B) shall ensure that providers not charge 
                enrollees facility fees for such services provided 
                through telehealth;
                    (C) may not impose additional barriers to obtaining 
                such coverage for such services through telehealth, 
                compared to coverage for such services provided in-
                person, such as a prior authorization requirement that 
                is more rigorous than for in-person visits; and
                    (D) shall provide notice to enrollees, informing 
                such enrollees of how to access in-network telehealth 
                mental health and substance use disorder services and 
                the scope of their coverage.
            (2) Provider requirements.--During the applicable period 
        described in subsection (g), if a provider of a mental health 
        or substance use disorder service provides such services via 
        telehealth to an enrollee in a group health plan or group or 
        individual health insurance coverage, the provider shall not 
        charge such enrollee, such group health plan, or a health 
        insurance issuer of such coverage facility fees for such 
        services.
    (b) Enforcement.--
            (1) Insurer requirements.--The provisions of subsection 
        (a)(1) shall be applied by the Secretary of Health and Human 
        Services, the Secretary of Labor, and the 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 (42 U.S.C. 300gg et seq.), part 7 of 
        subtitle B of title I of the Employee Retirement Income 
        Security Act of 1974 (29 U.S.C. 1181 et seq.), and subchapter B 
        of chapter 100 of the Internal Revenue Code of 1986, as 
        applicable.
            (2) Provider requirements.--Subsection (a)(2) shall be 
        applied by the Secretary of Health and Human Services and the 
        Secretary of Labor to providers as if included in the 
        provisions of part E of title XXVII of the Public Health 
        Service Act.
    (c) Implementation.--The Secretary of Health and Human Services, 
Secretary of Labor, and Secretary of the Treasury may implement the 
provisions of this section through sub-regulatory guidance, program 
instruction, or otherwise.
    (d) Definitions.--In this section--
            (1) the terms ``group health plan'', ``health insurance 
        issuer'', and ``health insurance coverage'' have the meanings 
        given such terms in section 2791 of the Public Health Service 
        Act (42 U.S.C. 300gg-91), section 733 of the Employee 
        Retirement Income Security Act of 1974 (29 U.S.C. 1191b), and 
        section 9832 of the Internal Revenue Code of 1986, as 
        applicable; and
            (2) the term ``telehealth services'' has the meaning given 
        such term in section 330I(a) of the Public Health Service Act 
        (42 U.S.C. 254c-14(a)), and includes 2-way video communication, 
        and audio-only communication.
    (e) Rule of Construction.--Nothing in this section shall prevent 
the application of any State law that is not inconsistent with this 
section.
    (f) Report to Congress.--Not later than 180 days after the 
conclusion of the public health emergency described in subsection (a), 
the Secretary of Health and Human Services shall submit to the 
Committee on Health, Education, Labor, and Pensions of the Senate, the 
Committee on Education and Labor of the House of Representatives, and 
the Committee on Energy and Commerce of the House of Representatives on 
the impacts the requirement under subsection (a) has on the use of both 
telehealth services and health services provided in-person.
    (g) Applicable Period.--The applicable period described in 
subsection (a) is the period beginning on the date of enactment of this 
Act and ending on the date that is 90 days after the public health 
emergency declared by the Secretary of Health and Human Services under 
section 319 of the Public Health Service Act (42 U.S.C. 247d) on 
January 31, 2020, with respect to COVID-19, expires.
                                 <all>