United States HR 8308: Telehealth Coverage and Payment Parity Act

Bill Text

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116TH CONGRESS
2D SESSION H. R. 8308
To amend the Public Health Service Act to require group health plans
and health insurance issuers offering group or individual health insurance
coverage to provide coverage for services furnished via telehealth if such
services would be covered if furnished in-person, and for other purposes.
IN THE HOUSE OF REPRESENTATIVES
SEPTEMBER 17, 2020
Mr. PHILLIPS (for himself, Mr. CHABOT, and Mr. MORELLE) introduced the
following bill; which was referred to the Committee on Energy and Commerce
A BILL
To amend the Public Health Service Act to require group
health plans and health insurance issuers offering group
or individual health insurance coverage to provide cov-
erage for services furnished via telehealth if such services
would be covered if furnished in-person, and for other
purposes.
Be it enacted by the Senate and House of Representa-1
tives of the United States of America in Congress assembled, 2
SECTION 1. SHORT TITLE. 3
This Act may be cited as the ‘‘Telehealth Coverage 4
and Payment Parity Act’’. 5
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SEC. 2. REQUIRING GROUP HEALTH PLANS AND HEALTH 1
INSURANCE ISSUERS OFFERING GROUP OR 2
INDIVIDUAL HEALTH INSURANCE COVERAGE 3
TO PROVIDE COVERAGE FOR SERVICES FUR-4
NISHED VIA TELEHEALTH IF SUCH SERVICES 5
WOULD BE COVERED IF FURNISHED IN-PER-6
SON. 7
(a) PUBLIC HEALTH SERVICE ACT.—Subpart II of 8
part A of title XXVII of the Public Health Service Act 9
(42 U.S.C. 300gg–11 et seq.) is amended by adding at 10
the end the following new section: 11
‘‘SEC. 2730. REQUIRED COVERAGE OF TELEHEALTH SERV-12
ICES. 13
‘‘(a) IN GENERAL.—A group health plan and a health 14
insurance issuer offering group or individual health insur-15
ance coverage, including a grandfathered health plan (as 16
defined in section 1251(e) of the Patient Protection and 17
Affordable Care Act (42 U.S.C. 18011(e)))— 18
‘‘(1) shall— 19
‘‘(A) provide benefits under such plan or 20
such coverage for any eligible service (as de-21
fined in subsection (b)), including a mental 22
health and substance use disorder service, fur-23
nished via a qualifying telecommunications sys-24
tem (as defined in subsection (b)) by a health 25
care provider to an individual who is a partici-26
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pant, beneficiary, or enrollee under such plan or 1
such coverage, notwithstanding that such pro-2
vider furnishing such service is not at the same 3
location as the individual; 4
‘‘(B) so provide such benefits for such 5
service under the same terms and with applica-6
tion of the same cost-sharing requirements (in-7
cluding a deductible, copayment, or coinsur-8
ance) as would apply if such service were fur-9
nished by such provider to such individual in- 10
person; 11
‘‘(C) reimburse such provider for such 12
service in an amount equal to the amount of re-13
imbursement for such service had such service 14
been furnished by such provider to such indi-15
vidual in-person; 16
‘‘(D) not impose any requirement under 17
such plan or coverage that such provider have 18
a prior relationship with such individual; and 19
‘‘(E) not restrict the ability of any health 20
care provider with a contractual relationship for 21
furnishing an eligible service under such plan or 22
coverage from furnishing such service via a 23
qualifying telecommunications system, and shall 24
not establish incentives or penalties under such 25
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plan or coverage for receiving such an eligible 1
service from such a provider via such a system; 2
and 3
‘‘(2) may waive any cost-sharing requirement 4
(including application of a deductible, copayment, or 5
coinsurance) for an item or service furnished for 6
purposes of diagnosing or treating COVID-19, in-7
cluding any such service that is an eligible service 8
furnished via a qualifying telecommunications sys-9
tem. 10
‘‘(b) DEFINITIONS.—In this section: 11
‘‘(1) ELIGIBLE SERVICE.—The term ‘eligible 12
service’ means, with respect to a group health plan 13
and a health insurance issuer offering group or indi-14
vidual health insurance coverage, a service— 15
‘‘(A) for which benefits are provided under 16
such plan or such coverage when such service is 17
furnished in-person; 18
‘‘(B) that is medically necessary (as deter-19
mined by the health care provider furnishing 20
such service); and 21
‘‘(C) that is able to be safely and effec-22
tively furnished via a telecommunications sys-23
tem. 24
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