[Congressional Bills 117th Congress]
[From the U.S. Government Publishing Office]
[H.R. 4036 Introduced in House (IH)]

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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 provisions 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 Representatives 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''.

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. According to 
        the Centers for Disease Control and Prevention, 1 in 6 children 
        ages 2 years through 8 years have a diagnosed mental, 
        behavioral, or developmental 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 Administration, 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.
            (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 disorder in 2016.
            (10) Further complicating access to care, as demand 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 primary care physicians and 
        neurologists grew during the same period.
            (12) Technology has evolved to connect individuals 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 treatment to 
        children and, in fact, may be preferable in some cases.
            (14) During the 115th Congress, Congress recognized the 
        potential of telehealth to ensure that those in urgent need of 
        substance use disorder treatment 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 
        disorders.
            (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 TELEHEALTH.

    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)--
                            (i) by striking ``or telehealth services'' 
                        and inserting ``, telehealth services''; and
                            (ii) by inserting ``or telehealth services 
                        described in paragraph (9)'' before the period 
                        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 individuals, 
        including initial patient evaluations, follow-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 
        subclause (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)--
                    (A) in the header, by striking ``Treatment for 
                Substance Use Disorders'' and inserting ``Treatment for 
                Substance Use Disorders and Mental Health Disorders and 
                Behavioral Health Disorders'';
                    (B) in the matter preceding paragraph (1), by 
                striking ``Not later than 1 year after the date of 
                enactment of this Act, the Secretary'' and inserting 
                ``The Secretary'';
                    (C) in paragraph (1)--
                            (i) by striking ``treatment for substance 
                        use disorders'' and inserting ``treatment for 
                        substance use disorders and mental health 
                        disorders and behavioral health disorders''; 
                        and
                            (ii) by inserting ``psychotherapy,'' after 
                        ``counseling,'';
                    (D) in paragraph (2), by inserting ``or mental 
                health disorders and behavioral health disorders'' 
                after ``substance use disorders'';
                    (E) in paragraph (3), by inserting ``and mental 
                health disorders and behavioral health disorders'' 
                after ``substance use disorders''; and
                    (F) by adding at the end, below and after paragraph 
                (3), the following flush left text:
``The Secretary shall issue the guidance under this subsection not 
later than 1 year after the date of the enactment 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 ``Treatment 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 ``treatment 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 
                        substance use disorders,'' after ``paragraph 
                        (1),''; and
                            (ii) by adding at the end the following new 
                        sentence: ``Not later than 2 years after the 
                        date of enactment of this Act, the Comptroller 
                        General shall submit to Congress 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 ``substance 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 disorders''.

SEC. 5. EFFECTIVE DATE.

    The amendments made by this Act shall take effect as is included in 
the enactment of the SUPPORT for Patients and Communities Act.
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