[Congressional Bills 116th Congress]
[From the U.S. Government Publishing Office]
[S. 4421 Introduced in Senate (IS)]

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116th CONGRESS
  2d Session
                                S. 4421

     To provide temporary licensing reciprocity for telehealth and 
                   interstate health care treatment.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                             August 4, 2020

 Mr. Murphy (for himself and Mr. Blunt) introduced the following bill; 
     which was read twice and referred to the Committee on Health, 
                     Education, Labor, and Pensions

_______________________________________________________________________

                                 A BILL


 
     To provide temporary licensing reciprocity for telehealth and 
                   interstate health care treatment.

    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 ``Temporary Reciprocity to Ensure 
Access to Treatment Act'' or the ``TREAT Act''.

SEC. 2. FINDINGS.

    Congress finds the following:
            (1) It is necessary to regulate, on a temporary and 
        emergency basis, the provision of interstate commerce as it 
        pertains to treatment by medical professionals licensed in one 
        State to patients in other States.
            (2) COVID-19, the disease caused by SARS-CoV-2, has created 
        a national public health emergency, as 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, 
        and by the President under the National Emergencies Act on 
        March 13, 2020.
            (3) The COVID-19 pandemic has resulted in closing many 
        businesses and nonprofit organizations, including colleges and 
        universities, and large areas of the country remain under full 
        or partial stay-at-home orders, precluding the ability to seek 
        routine or elective medical treatment and consultation. The 
        closing of campus-based in-person learning at institutions of 
        higher education has also meant that up to 1,000,000 students 
        have returned to live with their families across State lines 
        from where they may have been receiving medical care in the 
        university setting. Furthermore, in many rural areas, in-person 
        medical treatment is inaccessible. Even in urban areas, the 
        pandemic has severely disrupted access to medical care, 
        requiring medical professionals licensed in one State to 
        provide treatment to patients residing nearby but across a 
        State line and unable to visit the medical professional's 
        office in the State of licensure.
            (4) It is vital that hospitals, temporary surge or field 
        facilities, skilled nursing facilities, and nursing homes in 
        areas with high caseloads of COVID-19 patients be able to have 
        access to qualified medical professionals, including such 
        professionals licensed in other States, without the delays that 
        would be required for individualized licensing during a time 
        when State agencies' capacity to review and process licensing 
        requests are limited by the pandemic.
            (5) The provision of services by medical professionals, 
        including services provided at no cost and services provided to 
        patients in a State other than the State or States in which the 
        medical professional maintains an office for professional 
        services, affects interstate commerce. When used to provide 
        services to patients located in a State other than the State in 
        which the medical professional is located, telehealth services, 
        as defined in section 3, utilize facilities of interstate 
        commerce.
            (6) The inability of patients to visit in-State health care 
        providers during the current crisis substantially affects 
        interstate commerce. Economic activity has been limited by 
        public health authorities and other government officials to 
        ``flatten the curve'' of infections and hospitalizations and 
        thereby prevent the health care system from becoming 
        overwhelmed. Maximizing the efficient and effective use of 
        health care resources is therefore vital to reopening the 
        economy.
            (7) Barriers to the efficient delivery of health care 
        services will lead to a shortage of those services that 
        substantially affect health care availability across State 
        lines. Shortages in health care services in one State prompt 
        interstate travel to obtain health care in other States, even 
        though discouraging such travel, particularly among the sick, 
        is vital to containing the contagion and reopening the national 
        economy.

SEC. 3. DEFINITIONS.

    In this Act:
            (1) the term ``health care professional'' means an 
        individual who--
                    (A) has a valid and unrestricted license or 
                certification from, or is otherwise authorized by, a 
                State, the District of Columbia, or a territory or 
                possession of the United States, for any health 
                profession, including mental health; and
                    (B) is not affirmatively excluded from practice in 
                the licensing or certifying jurisdiction or in any 
                other jurisdiction;
            (2) the term ``Secretary'' means the Secretary of Health 
        and Human Services; and
            (3) the term ``telehealth services'' means use of 
        telecommunications and information technology (including 
        synchronous or asynchronous audio-visual, audio-only, or store 
        and forward technology) to provide access to physical and 
        mental health assessment, diagnosis, treatment, intervention, 
        consultation, supervision, and information across distance.

SEC. 4. TEMPORARY AUTHORIZATION OF TELEHEALTH AND INTERSTATE TREATMENT.

    (a) In General.--Notwithstanding any other provision of Federal or 
State law or regulation regarding the licensure or certification of 
health care providers or the provision of telehealth services, a health 
care professional may practice within the scope of the individual's 
license, certification, or authorization described in section 3(1)(A), 
either in-person or through telehealth, in any State, the District of 
Columbia, or any territory or possession of the United States, or any 
other location designated by the Secretary, based on the licensure, 
certification, or authorization such individual in any one State, the 
District of Columbia, or territory or possession of the United States.
    (b) Scope of Telehealth Services.--Telehealth services authorized 
by this section include services provided to any patient regardless of 
whether the health care professional has a prior treatment relationship 
with the patient, provided that, if the health care professional does 
not have a prior treatment relationship with the patient, a new 
relationship may be established only via a written acknowledgment or 
synchronous technology.
    (c) Initiation of Telehealth Services.--Before providing telehealth 
services authorized by this section, the health care professional 
shall--
            (1) verify the identification of the patient receiving 
        health services;
            (2) obtain oral or written acknowledgment from the patient 
        (or legal representative of the patient) to perform telehealth 
        services, and if such acknowledgment is oral, make a record of 
        such acknowledgment; and
            (3) obtain or confirm an alternative method of contacting 
        the patient in case of a technological failure.
    (d) Written Notice of Provision of Services.--As soon as 
practicable, but not later than 30 days after first providing services 
pursuant to this section in a jurisdiction other than the jurisdiction 
in which a health care professional is licensed, certified, or 
otherwise authorized, such health care professional shall provide 
written notice to the applicable licensing, certifying, or authorizing 
authority in the jurisdiction in which the health care professional 
provided such services. Such notice shall include the health care 
professional's--
            (1) name;
            (2) email address;
            (3) phone number;
            (4) State of primary license, certification, or 
        authorization; and
            (5) license, certification, or authorization type, and 
        applicable number or identifying information with respect to 
        such license, certification, or authorization.
    (e) Clarification.--Nothing in this section authorizes a health 
care professional to--
            (1) practice beyond the scope of practice authorized by any 
        State, District of Columbia, territorial, or local authority in 
        the jurisdiction in which the health care professional holds a 
        license, certification, or authorization described in section 
        3(1)(A);
            (2) provide any service or subset of services prohibited by 
        any such authority in the jurisdiction in which the patient 
        receiving services is located;
            (3) provide any service or subset of services in a manner 
        prohibited by any such authority the jurisdiction in which the 
        patient receiving services is located; or
            (4) provide any service or subset of services in a manner 
        other than the manner prescribed by any such authority in the 
        jurisdiction in which the patient receiving services is 
        located.
    (f) Investigative and Disciplinary Authority.--A health care 
professional providing services pursuant to the authority under this 
section shall be subject to investigation and disciplinary action by 
the licensing, certifying, or authorizing authorities in the 
jurisdiction in which the patient receiving services is located. The 
jurisdiction in which the patient receiving services is located shall 
have the authority to preclude the health care provider from practicing 
further in its jurisdiction, whether such practice is authorized by the 
laws of such jurisdiction or the authority granted under this section, 
and shall report any such preclusion to the licensing authority in the 
jurisdiction in which the health care provider is licensed, certified, 
or authorized.
    (g) Multiple Jurisdiction Licensure.--Notwithstanding any other 
provision of this section, a health care professional shall be subject 
to the requirements of the jurisdiction of licensure if the 
professional is licensed in the State, the District of Columbia, or 
territory or possession where the patient is located.
    (h) Interstate Licensure Compacts.--If a health care professional 
is licensed in multiple jurisdictions through an interstate licensure 
compact, with respect to services provided to a patient located in a 
jurisdiction covered by such compact, the health care professional 
shall be subject to the requirements of the compact and not this 
section.

SEC. 5. APPLICATION.

    This Act shall apply--
            (1) during the period beginning on the date of enactment of 
        this Act and ending on the date that is at least 180 days (as 
        determined by the Secretary) after the end of 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; and
            (2) subject to a declaration by the Secretary of Health and 
        Human Services invoking such application--
                    (A) during a period in which there is in effect 
                both--
                            (i)(I) a major disaster with respect to not 
                        less than 12 States, declared by the President 
                        pursuant to section 401 of the Robert T. 
                        Stafford Disaster Relief and Emergency 
                        Assistance Act (42 U.S.C. 5170) or emergency 
                        declared by the President under section 501 of 
                        the Robert T. Stafford Disaster Relief and 
                        Emergency Assistance Act (42 U.S.C. 5191); or
                            (II) a national emergency declared by the 
                        President under the National Emergencies Act 
                        (50 U.S.C. 1601 et seq.); and
                            (ii) a 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); and
                    (B) for at least 180 days after the disaster or 
                emergency period under subclause (I) or (II) of 
                subparagraph (a)(I) ends, as determined by the 
                Secretary of Health and Human Services.
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