Bill Text: NY A09129 | 2013-2014 | General Assembly | Introduced

NOTE: There are more recent revisions of this legislation. Read Latest Draft

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Bill Title: Requires insurers and medical assistance for needy persons to provide coverage for the provision of telehealth services.

Spectrum: Slight Partisan Bill (Democrat 9-4)

Status: (Introduced - Dead) 2014-06-19 - substituted by s7852 [A09129 Detail]

Download: New_York-2013-A09129-Introduced.html

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                           S T A T E   O F   N E W   Y O R K
       ________________________________________________________________________
                                         9129
                                 I N  A S S E M B L Y
                                    March 19, 2014
                                      ___________
       Introduced  by M. of A. RUSSELL -- read once and referred to the Commit-
         tee on Health
       AN ACT to amend the public health law, the insurance law and the  social
         services law, in relation to the provision of telehealth services
         THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
       BLY, DO ENACT AS FOLLOWS:
    1    Section 1.  Subdivision 1 of section 2 of the  public  health  law  is
    2  amended by adding five new paragraphs (o), (p), (q), (r) and (s) to read
    3  as follows:
    4    (O)  DISTANT  SITE.  THE  TERM  "DISTANT SITE" MEANS A SITE AT WHICH A
    5  HEALTH CARE PROVIDER IS LOCATED WHILE PROVIDING HEALTH CARE SERVICES  BY
    6  MEANS OF A FEDERAL FOOD AND DRUG ADMINISTRATION APPROVED AND INTEROPERA-
    7  BLE TELECOMMUNICATIONS SYSTEM.
    8    (P)  HEALTH  CARE  PROVIDER.  THE  TERM "HEALTH CARE PROVIDER" MEANS A
    9  PERSON LICENSED PURSUANT TO ARTICLE ONE HUNDRED THIRTY-ONE, ONE  HUNDRED
   10  THIRTY-ONE-B,  ONE  HUNDRED  THIRTY-THREE,  ONE HUNDRED THIRTY-NINE, ONE
   11  HUNDRED FORTY, ONE  HUNDRED  FORTY-ONE,  ONE  HUNDRED  FORTY-THREE,  ONE
   12  HUNDRED  FORTY-FOUR,  ONE HUNDRED FIFTY-THREE, ONE HUNDRED FIFTY-FOUR OR
   13  ONE HUNDRED FIFTY-NINE OF  THE  EDUCATION  LAW;  A  PHYSICIANS  PRACTICE
   14  GROUP;  A  HOSPITAL;  A  CERTIFIED  HOME HEALTH AGENCY; A LONG TERM HOME
   15  HEALTH CARE PROGRAM;  A FEDERALLY QUALIFIED HEALTH CENTER AS DEFINED  IN
   16  42 U.S.C. 1395X (AA)(4); AND  A LICENSED HOME CARE SERVICE AGENCY.
   17    (Q)  ORIGINATING  SITE.  THE  TERM  "ORIGINATING SITE" MEANS A SITE AT
   18  WHICH A PATIENT IS LOCATED AT THE TIME HEALTH CARE SERVICES ARE PROVIDED
   19  TO HIM OR HER BY  MEANS  OF  A  FEDERAL  FOOD  AND  DRUG  ADMINISTRATION
   20  APPROVED AND INTEROPERABLE TELECOMMUNICATIONS SYSTEM.
   21    (R)  TELEHEALTH.  THE  TERM  "TELEHEALTH" MEANS THE MODE OF DELIVERING
   22  HEALTH CARE SERVICES BY MEANS OF INFORMATION AND COMMUNICATIONS TECHNOL-
   23  OGIES CONSISTING OF TELEPHONES, REMOTE  PATIENT  MONITORING  DEVICES  OR
   24  OTHER  ELECTRONIC  MEANS  WHICH  FACILITATE  THE  ASSESSMENT, DIAGNOSIS,
   25  CONSULTATION, TREATMENT, EDUCATION, CARE MANAGEMENT AND SELF  MANAGEMENT
   26  OF A PATIENT'S HEALTH CARE WHILE SUCH PATIENT IS AT THE ORIGINATING SITE
   27  AND  THE  HEALTH  CARE  PROVIDER  IS  AT A DISTANT SITE. SUCH TERM SHALL
   28  INCLUDE TELEMEDICINE.
        EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                             [ ] is old law to be omitted.
                                                                  LBD02532-05-4
       A. 9129                             2
    1    (S) TELEMEDICINE. THE TERM "TELEMEDICINE" MEANS THE DELIVERY OF  CLIN-
    2  ICAL HEALTH CARE SERVICES BY MEANS OF REAL TIME TWO-WAY ELECTRONIC AUDIO
    3  VISUAL   COMMUNICATIONS  WHICH  FACILITATE  THE  ASSESSMENT,  DIAGNOSIS,
    4  CONSULTATION, TREATMENT, EDUCATION, CARE MANAGEMENT AND SELF  MANAGEMENT
    5  OF A PATIENT'S HEALTH CARE WHILE SUCH PATIENT IS AT THE ORIGINATING SITE
    6  AND THE HEALTH CARE PROVIDER IS AT A DISTANT SITE.
    7    S 2. Subsection (i) of section 3216 of the insurance law is amended by
    8  adding a new paragraph 30 to read as follows:
    9    (30) EVERY POLICY DELIVERED OR ISSUED FOR DELIVERY IN THIS STATE WHICH
   10  PROVIDES  COVERAGE  FOR  HOSPITAL,  MEDICAL  OR SURGICAL CARE SHALL MAKE
   11  AVAILABLE, AND IF REQUESTED BY A POLICY  HOLDER,  PROVIDE  COVERAGE  FOR
   12  SERVICES  WHICH ARE OTHERWISE COVERED UNDER THE POLICY THAT ARE PROVIDED
   13  VIA TELEMEDICINE, AS DEFINED IN SECTION TWO OF THE  PUBLIC  HEALTH  LAW,
   14  PROVIDED  THAT SUCH SERVICES MEET THE REQUIREMENTS OF FEDERAL LAW, RULES
   15  AND REGULATIONS FOR MEDICARE, AND FOR THOSE TELEHEALTH SERVICES THAT ARE
   16  REQUIRED TO BE PROVIDED PURSUANT TO SUBDIVISION THREE-C OF SECTION THIR-
   17  TY-SIX HUNDRED FOURTEEN  OF  THE  PUBLIC  HEALTH  LAW.    SUCH  COVERAGE
   18  REQUIRED  BY  THIS  PARAGRAPH  MAY  BE SUBJECT TO ANNUAL DEDUCTIBLES AND
   19  COINSURANCE, AND OTHER TERMS AND CONDITIONS OF COVERAGE, INCLUDING,  BUT
   20  NOT  LIMITED TO, UTILIZATION MANAGEMENT AND OTHER MANAGED CARE TOOLS, AS
   21  ARE CONSISTENT WITH THOSE ESTABLISHED FOR THE  SAME  SERVICES  WHEN  NOT
   22  PROVIDED VIA TELEMEDICINE OR TELEHEALTH.
   23    S 3. Subsection (k) of section 3221 of the insurance law is amended by
   24  adding a new paragraph 19 to read as follows:
   25    (19) EVERY GROUP OR BLANKET POLICY DELIVERED OR ISSUED FOR DELIVERY IN
   26  THIS  STATE  WHICH  PROVIDES  COVERAGE FOR HOSPITAL, MEDICAL OR SURGICAL
   27  CARE SHALL MAKE AVAILABLE, AND IF REQUESTED BY THE  GROUP  POLICYHOLDER,
   28  PROVIDE  COVERAGE  FOR  SERVICES  WHICH  ARE OTHERWISE COVERED UNDER THE
   29  POLICY THAT ARE PROVIDED VIA TELEMEDICINE, AS DEFINED IN SECTION TWO  OF
   30  THE PUBLIC HEALTH LAW, PROVIDED THAT SUCH SERVICES MEET THE REQUIREMENTS
   31  OF  FEDERAL  LAW, RULES AND REGULATIONS FOR MEDICARE, AND FOR TELEHEALTH
   32  SERVICES THAT ARE, AT A MINIMUM, THOSE REQUIRED TO BE PROVIDED  PURSUANT
   33  TO  SUBDIVISION  THREE-C  OF  SECTION THIRTY-SIX HUNDRED FOURTEEN OF THE
   34  PUBLIC HEALTH LAW.   SUCH COVERAGE REQUIRED BY  THIS  PARAGRAPH  MAY  BE
   35  SUBJECT  TO  ANNUAL  DEDUCTIBLES  AND  COINSURANCE,  AND OTHER TERMS AND
   36  CONDITIONS OF COVERAGE,  INCLUDING,  BUT  NOT  LIMITED  TO,  UTILIZATION
   37  MANAGEMENT  AND  OTHER  MANAGED CARE TOOLS, AS ARE CONSISTENT WITH THOSE
   38  ESTABLISHED FOR THE SAME SERVICES WHEN NOT PROVIDED VIA TELEMEDICINE  OR
   39  TELEHEALTH.
   40    S  4.   Paragraph 2 of subsection (a) of section 3229 of the insurance
   41  law, as amended by chapter 659 of the laws of 1997, is amended  to  read
   42  as follows:
   43    (2)  a  home  care benefit with personal care, nursing care, adult day
   44  health care [and], respite  care  services,  TELEMEDICINE  SERVICES,  AS
   45  DEFINED  IN  SECTION  TWO  OF  THE PUBLIC HEALTH LAW, PROVIDED THAT SUCH
   46  TELEMEDICINE SERVICES ARE PURSUANT TO AN AGREEMENT  BETWEEN  A  PROVIDER
   47  PARTICIPATING  IN  THE  INSURER'S  NETWORK AND THE INSURER, AND MEET THE
   48  REQUIREMENTS OF FEDERAL LAW, RULES AND  REGULATIONS  FOR  MEDICARE,  AND
   49  THOSE  TELEHEALTH  SERVICES THAT ARE REQUIRED TO BE PROVIDED PURSUANT TO
   50  SUBDIVISION THREE-C OF SECTION THIRTY-SIX HUNDRED FOURTEEN OF THE PUBLIC
   51  HEALTH LAW, which shall provide total benefits in an  amount  determined
   52  by regulations of the superintendent;
   53    S  5.  Section  4303  of  the insurance law is amended by adding a new
   54  subsection (oo) to read as follows:
   55    (OO) EVERY CONTRACT ISSUED BY A MEDICAL EXPENSE INDEMNITY CORPORATION,
   56  A HOSPITAL SERVICE CORPORATION OR A  HEALTH  SERVICE  CORPORATION  WHICH
       A. 9129                             3
    1  PROVIDES  COVERAGE  FOR  HOSPITAL,  MEDICAL  OR SURGICAL CARE SHALL MAKE
    2  AVAILABLE, IF REQUESTED BY  A  CONTRACT  HOLDER,  PROVIDE  COVERAGE  FOR
    3  SERVICES  WHICH ARE OTHERWISE COVERED UNDER THE POLICY THAT ARE PROVIDED
    4  VIA  TELEMEDICINE,  AS  DEFINED IN SECTION TWO OF THE PUBLIC HEALTH LAW,
    5  PROVIDED THAT SUCH SERVICES MEET THE REQUIREMENTS OF FEDERAL LAW,  RULES
    6  AND REGULATIONS FOR MEDICARE, AND FOR THOSE TELEHEALTH SERVICES THAT ARE
    7  REQUIRED TO BE PROVIDED PURSUANT TO SUBDIVISION THREE-C OF SECTION THIR-
    8  TY-SIX  HUNDRED  FOURTEEN  OF  THE  PUBLIC  HEALTH  LAW.   SUCH COVERAGE
    9  REQUIRED BY THIS SUBSECTION MAY BE SUBJECT  TO  ANNUAL  DEDUCTIBLES  AND
   10  COINSURANCE,  AND OTHER TERMS AND CONDITIONS OF COVERAGE, INCLUDING, BUT
   11  NOT LIMITED TO, UTILIZATION MANAGEMENT AND OTHER MANAGED CARE TOOLS,  AS
   12  ARE  CONSISTENT  WITH  THOSE  ESTABLISHED FOR THE SAME SERVICES WHEN NOT
   13  PROVIDED VIA TELEMEDICINE OR TELEHEALTH.
   14    S 6.  The opening paragraph of section 367-u of  the  social  services
   15  law is designated subdivision 1 and a new subdivision 2 is added to read
   16  as follows:
   17    2.  SUBJECT TO THE APPROVAL OF THE DIRECTOR OF THE BUDGET, THE COMMIS-
   18  SIONER SHALL NOT EXCLUDE FROM THE PAYMENT OF  MEDICAL  ASSISTANCE  FUNDS
   19  THE  PROVISION OF MEDICAL CARE THROUGH TELEMEDICINE SERVICES, AS DEFINED
   20  IN SECTION TWO OF THE PUBLIC HEALTH LAW,  PROVIDED  THAT  SUCH  SERVICES
   21  MEET  THE  REQUIREMENTS  OF  FEDERAL  LAW, RULES AND REGULATIONS FOR THE
   22  PROVISION OF MEDICAL ASSISTANCE PURSUANT TO THIS TITLE,  AND  FOR  TELE-
   23  HEALTH  SERVICES  THAT  ARE, AT A MINIMUM, THOSE REQUIRED TO BE PROVIDED
   24  PURSUANT TO SUBDIVISION THREE-C OF SECTION THIRTY-SIX  HUNDRED  FOURTEEN
   25  OF THE PUBLIC HEALTH LAW.
   26    S  7.    This act shall take effect January 1, 2015 and shall apply to
   27  all policies and contracts issued, renewed, modified, altered or amended
   28  on or after such date.