[Congressional Bills 118th Congress]
[From the U.S. Government Publishing Office]
[H.R. 9457 Reported in House (RH)]
<DOC>
Union Calendar No. 785
118th CONGRESS
2d Session
H. R. 9457
[Report No. 118-876, Part I]
To amend the Employee Retirement Income Security Act of 1974 to
prohibit increased payments under a group health plan or group health
insurance coverage for telehealth services furnished by a provider
located at a facility.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
September 6, 2024
Mr. Bean of Florida introduced the following bill; which was referred
to the Committee on Education and the Workforce, and in addition to the
Committee on Energy and Commerce, 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
December 16, 2024
Reported from the Committee on Education and the Workforce with an
amendment
[Strike out all after the enacting clause and insert the part printed
in italic]
December 16, 2024
Referral to the Committee on Energy and Commerce extended for a period
ending not later than December 19, 2024
December 19, 2024
Committee on Energy and Commerce 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
September 6, 2024]
_______________________________________________________________________
A BILL
To amend the Employee Retirement Income Security Act of 1974 to
prohibit increased payments under a group health plan or group health
insurance coverage for telehealth services furnished by a provider
located at a facility.
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 ``Transparent Telehealth Bills Act of
2024''.
SEC. 2. PROHIBITING INCREASED PAYMENTS UNDER A GROUP HEALTH PLAN OR
GROUP HEALTH INSURANCE COVERAGE FOR TELEHEALTH SERVICES
FURNISHED BY A PROVIDER LOCATED AT A FACILITY.
(a) In General.--Subpart B of part 7 of subtitle B of title I of
the Employee Retirement Income Security Act of 1974 (29 U.S.C. 1185 et
seq.) is amended by adding at the end the following new section:
``SEC. 726. PROHIBITION ON INCREASED PAYMENTS FOR TELEHEALTH SERVICES
FURNISHED BY A PROVIDER LOCATED AT A FACILITY.
``(a) In General.--In the case of a telehealth service furnished to
a participant or beneficiary of a group health plan or group health
insurance coverage by a health care provider located at a health care
facility, the total amount recognized by such plan or coverage as
payment for such service (including any facility fee or other amount
that may be billed separately by such facility in relation to such
provider's furnishing of such service) may not exceed the total amount
that would have been recognized by such plan or coverage as payment for
such service had such provider not been located at such a facility.
``(b) Telehealth Service Defined.--For purposes of this section,
the term `telehealth service' means a service furnished by a health
care provider via a telecommunications system where such provider is
not at the same location as the individual receiving such service.''.
(b) Clerical Amendment.--The table of contents in section 1 of such
Act is amended by inserting after the item relating to section 725 the
following new item:
``Sec. 726. Prohibition on increased payments for telehealth services
furnished by a provider located at a
facility.''.
(c) Report.--Not later than 18 months after the date of the
enactment of this Act, the Comptroller General of the United States
shall submit to Congress a report on what is known about the use of
telehealth under group health plans and group or individual health
insurance coverage (as such terms are defined in section 2791 of the
Public Health Service Act (42 U.S.C. 1395x)). Such report shall include
the following:
(1) Trends and statistics regarding the use of telehealth
for specific types of care, including primary care, mental
health care, and specialty care.
(2) Trends and statistics regarding the availability,
access, and utilization of telehealth services by individuals
residing in rural areas and urban areas.
(3) Trends and statistics regarding the application of
hospital facility fees in the context of telehealth services.
(4) Trends and statistics regarding how individuals access
telehealth services, including with respect to the devices used
and tools offered by such plans and issuers of such coverage to
facilitate access to such services and with respect to the
utilization of audio-only telehealth services.
(5) Trends and statistics with respect to individuals
accessing telehealth services provided from physicians or other
medical professionals residing in a State other than the State
that the individual is located in while receiving such services
and with respect to applicable State laws or State-to-State
compacts that impact cross-State provision of telehealth
services.
(6) Trends and statistics regarding payment and
reimbursement for telehealth services.
(7) Trends and statistics regarding premiums for such plans
and coverage offering telehealth services.
(d) Effective Date.--The amendment made by subsection (a) shall
apply to plan years beginning on or after January 1, 2026.
SEC. 3. PROHIBITING HEALTH CARE PROVIDERS AND FACILITIES FROM IMPOSING
CERTAIN FACILITY FEES FOR TELEHEALTH.
(a) In General.--Subtitle B of title I of the Employee Retirement
Income Security Act of 1974 (29 U.S.C. 1021 et seq.) is amended by
adding at the end the following new part:
``PART 9--BILLING REQUIREMENTS FOR HEALTH CARE FACILITIES AND PROVIDERS
``SEC. 901. LIMITATION ON TELEHEALTH FACILITY FEES.
``A health care facility may not bill a separate facility fee when
a health care provider who provided telehealth services is authorized
to bill independently for the professional services rendered.''.
(b) Enforcement.--Section 502 of the Employee Retirement Income
Security Act of 1974 (29 U.S.C. 1132) is amended--
(1) in subsection (a)(6), by striking ``or (9)'' and
inserting ``(9), or (13)''; and
(2) in subsection (c), by adding at the end the following
new paragraph:
``(13) If a health care provider or facility is found by
the Secretary to be in violation of section 901, the Secretary
may assess a civil monetary penalty against such provider or
facility in an amount not to exceed $10,000 per violation.''.
(c) Clerical Amendment.--The table of contents of the Employee
Retirement Income Security Act of 1974 (29 U.S.C. 1001 note) is amended
by inserting after the item relating to section 804 the following new
item:
``Part 9--Billing Requirements for Health Care Facilities and Providers
``901. Limitation on telehealth facility fees.''.
Union Calendar No. 785
118th CONGRESS
2d Session
H. R. 9457
[Report No. 118-876, Part I]
_______________________________________________________________________
A BILL
To amend the Employee Retirement Income Security Act of 1974 to
prohibit increased payments under a group health plan or group health
insurance coverage for telehealth services furnished by a provider
located at a facility.
_______________________________________________________________________
December 19, 2024
Committee on Energy and Commerce discharged; committed to the Committee
of the Whole House on the State of the Union and ordered to be printed