Bill Text: NY A06256 | 2021-2022 | General Assembly | Introduced
Bill Title: Enacts specific provisions regarding the delivery of health care services via telehealth including requiring coverage and setting reimbursement rates under certain health care plans.
Spectrum: Partisan Bill (Democrat 27-0)
Status: (Introduced - Dead) 2022-01-05 - referred to insurance [A06256 Detail]
Download: New_York-2021-A06256-Introduced.html
STATE OF NEW YORK ________________________________________________________________________ 6256 2021-2022 Regular Sessions IN ASSEMBLY March 11, 2021 ___________ Introduced by M. of A. WOERNER, GOTTFRIED -- read once and referred to the Committee on Insurance AN ACT to amend the public health law in relation to the delivery of health care services via telehealth The People of the State of New York, represented in Senate and Assem- bly, do enact as follows: 1 Section 1. Section 2999-cc of the public health law is amended by 2 adding a new subdivision 8 to read as follows: 3 8. "Health care plan" means an entity (other than a health care 4 provider) that approves, provides, arranges for, or pays for health care 5 services, including but not limited to: 6 (a) a health maintenance organization licensed under article forty- 7 three of the insurance law; 8 (b) a health maintenance organization or other organization certified 9 under article forty-four of this chapter; 10 (c) an insurer or corporation subject to the insurance law; and 11 (d) the medical assistance program under title eleven of article five 12 of the social services law ("medicaid"); the child health plus program 13 under title one-A of article twenty-five of this chapter, and the basic 14 health program under section three hundred sixty-nine-gg of the social 15 services law. 16 § 2. Section 2999-dd of the public health law, as amended by section 4 17 of subpart C of Part S of chapter 57 of the laws of 2018, subdivision 1 18 as amended by chapter 124 of the laws of 2020, subdivisions 3 and 4 as 19 added by chapter 328 of the laws of 2020, is amended to read as follows: 20 § 2999-dd. Telehealth delivery of services. 1. [Health care services21delivered by means of telehealth shall be entitled to reimbursement22under section three hundred sixty-seven-u of the social services law;23provided however, reimbursement for additional modalities, provider24categories and originating sites specified in accordance with section25twenty-nine hundred ninety-nine-ee of this article, and audio-only tele-EXPLANATION--Matter in italics (underscored) is new; matter in brackets [] is old law to be omitted. LBD09895-01-1A. 6256 2 1phone communication defined in regulations promulgated pursuant to2subdivision four of section twenty-nine hundred ninety-nine-cc of this3article, shall be contingent upon federal financial participation.] (a) 4 A health care service may be delivered by means of telehealth by a tele- 5 health provider otherwise authorized to perform that service. A health 6 care service delivered by telehealth shall be with the consent of the 7 patient or a person authorized to consent for the patient. The consent 8 shall be documented in the patient's medical record. 9 (b) In-person contact between a telehealth provider and a patient 10 prior to the delivery of health care services via telehealth shall not 11 be required, unless the provider determines it to be clinically neces- 12 sary. 13 2. (a) A health care plan shall cover a service, regardless of whether 14 it is provided by telehealth, if the service would otherwise be covered 15 by the health care plan and the provider is otherwise covered by the 16 health care plan. 17 (b) A health care plan shall reimburse a treating or consulting health 18 care provider for health care services appropriately delivered by tele- 19 health on the same basis, at the same rate, and to the same extent that 20 the health care plan reimburses for the service when provided through 21 in-person diagnosis, consultation, or treatment. 22 (c) A health care plan may subject the coverage of a telehealth 23 service to copayments, coinsurance or deductibles if they are at least 24 as favorable to the enrollee as would apply if the service is not 25 provided by telehealth. 26 (d) This article does not alter any obligation a health care plan may 27 have to ensure that enrollees have access to all covered services 28 through an adequate network of contracted providers. 29 (e) With respect to health care plans under paragraph (d) of subdivi- 30 sion eight of section 2999-cc of this article (medicaid, child health 31 plus, and the basic health plan), this article shall only apply where 32 there is federal financial participation. The commissioner shall make 33 state plan amendments and seek federal waivers as necessary to obtain 34 that federal financial participation. 35 3. The department of health, the office of mental health, the office 36 of [alcoholism and substance abuse services] addiction services and 37 supports, and the office for people with developmental disabilities 38 shall coordinate on the issuance of a single guidance document, to be 39 updated as appropriate, that shall: (a) identify any differences in 40 regulations or policies issued by the agencies, including with respect 41 to reimbursement [pursuant to section three hundred sixty-seven-u of the42social services law]; and (b) be designed to assist consumers, provid- 43 ers, and health care plans in understanding and facilitating the appro- 44 priate use of telehealth in addressing barriers to care. 45 [3.] 4. The authority of the department of financial services to 46 establish and enforce minimum standards for accident and health insur- 47 ance under articles thirty-two and forty-three of the insurance law 48 shall include enforcement of telehealth standards set forth in this 49 article. 50 5. (a) Dental telehealth services shall adhere to the standards of 51 appropriate patient care required in other dental health care settings, 52 including but not limited to appropriate patient examination, taking of 53 x-rays, and review of a patient's medical and dental history. All dental 54 telehealth providers shall identify themselves to patients, including 55 providing the professional's New York state license number. No dental 56 telehealth provider shall attempt to waive liability for its telehealthA. 6256 3 1 services in advance of delivering such telehealth services and no dental 2 telehealth provider shall attempt to prevent a patient from filing any 3 complaint with any governmental agency or authority. 4 (b) This subdivision shall not be construed to diminish requirements 5 for other telehealth services. 6 [4.] 6. Nothing in this article shall be deemed to allow any person to 7 provide any service for which a license, registration, certification or 8 other authorization under title eight of the education law is required 9 and which the person does not possess. 10 § 3. If any provision of this act, or any application of any provision 11 of this act, is held to be invalid, or to violate or be inconsistent 12 with any federal law or regulation, that shall not affect the validity 13 or effectiveness of any other provision of this act, or of any other 14 application of any provision of this act, which can be given effect 15 without that provision or application; and to that end, the provisions 16 and applications of this act are severable. 17 § 4. This act shall take effect January 1, 2022 and shall apply to all 18 policies and contracts issued, renewed, modified, altered or amended on 19 or after such date. Effective immediately, the commissioner of health, 20 the superintendent of the department of financial services, the commis- 21 sioner of the office of mental health, the commissioner of the office of 22 addiction services and supports, and the commissioner of the office for 23 people with developmental disabilities shall make regulations and take 24 other actions reasonably necessary to implement this act on that date.
