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House Bill 5603
115th Congress(2017-2018)
Access to Telehealth Services for Substance Use Disorders Act
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Introduced in House on Apr 24, 2018
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H. R. 5603 (Reported-in-House)

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. Cárdenas) 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]

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.

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 “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 paragraphs:

“(7) AUTHORITY NOT TO APPLY CERTAIN REQUIREMENTS IN THE CASE OF CERTAIN TREATMENT OF SUBSTANCE USE DISORDER OR CO-OCCURRING MENTAL HEALTH DISORDER.—

“(A) IN GENERAL.—For purposes of payment under this subsection, in the case of telehealth services described in subparagraph (C) furnished on or after January 1, 2020, to an eligible beneficiary (as defined in subparagraph (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 subparagraph (B).

“(B) REQUIREMENTS DESCRIBED.—For purposes of this paragraph, the requirements described in this subparagraph are any of the following:

“(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 services that are both telehealth services and identified 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 disorder or a mental health disorder that is co-occurring with a substance use disorder.

“(D) CLARIFICATION.—Nothing in this paragraph shall be construed as limiting or otherwise 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 FACILITY FEE.—No facility fee shall be paid under paragraph (2)(B) to an originating site with respect to a telehealth service described in subparagraph (B) for which payment is made under this subsection by reason of the non-application of a requirement described in subparagraph (B) pursuant 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, benefits under part A and enrolled for benefits under this part;

“(ii) has a diagnosis for a substance use disorder; and

“(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 services related to substance use disorder, such as behavioral health services and emergency department visits; and

“(ii) health outcomes related to substance use disorder, such as substance use overdose deaths.

“(H) FUNDING.—For purposes of carrying out this paragraph, in addition to funds otherwise available, the Secretary shall provide for the transfer, from the Federal Supplementary Medical Insurance Trust Fund under section 1841, of $3,000,000 to the Centers for Medicare & Medicaid Services Program Management Account to remain available until expended.

“(8) RULE OF CONSTRUCTION.—Nothing in this subsection may be construed as waiving requirements 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-occurring mental health disorder.”.

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 telehealth requirements in the case of certain treatment 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; committed to the Committee of the Whole House on the State of the Union and ordered to be printed