Bill Title: Regarding insurance and Medicaid coverage of telemedicine services.
Spectrum: Partisan Bill (Democrat 1-0)
Status: (Introduced - Dead) 2009-06-16 - To Insurance, Commerce, & Labor
[SB136 Detail]Download: Ohio-2009-SB136-Introduced.html
As Introduced
| 128th General Assembly | | Regular Session | | 2009-2010 |
| |
A BILL
| To enact sections 1739.23, 1751.69, 3923.235, and | 1 |
|
5111.026 of the Revised Code regarding insurance | 2 |
|
and Medicaid coverage of telemedicine
services. | 3 |
BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF OHIO:
| Section 1. That sections 1739.23, 1751.69, 3923.235, and | 4 |
|
5111.026 of the Revised Code be enacted to read as follows: | 5 |
| Sec. 1739.23. (A) As used in this section: | 6 |
|
(1) "Physician" means an individual authorized under Chapter | 7 |
|
4731. of the Revised Code to practice medicine and surgery or | 8 |
|
osteopathic medicine and surgery, including the holder of a | 9 |
|
telemedicine certificate issued under section 4731.296 of the | 10 |
|
Revised Code. | 11 |
|
(2) "Telemedicine service" means a medical service delivered | 12 |
|
by a physician
through the use of any communication, including | 13 |
|
oral, written, or
electronic communication. | 14 |
|
(B) Notwithstanding section 3901.71 of the Revised Code, no | 15 |
|
multiple employer welfare arrangement operating a group | 16 |
|
self-insurance program shall exclude coverage for a telemedicine | 17 |
|
service solely because the service is not provided through a | 18 |
|
face-to-face consultation. The arrangement may require a | 19 |
|
deductible, copayment, or coinsurance for the telemedicine | 20 |
|
service. The amount of the deductible, copayment, or coinsurance | 21 |
|
shall not exceed the amount of the deductible, copayment, or | 22 |
|
coinsurance required for a comparable medical service provided | 23 |
|
through a face-to-face consultation. | 24 |
| Sec. 1751.69. (A) As used in this section: | 25 |
|
(1) "Physician" means an individual authorized under Chapter | 26 |
|
4731. of the Revised Code to practice medicine and surgery or | 27 |
|
osteopathic medicine and surgery, including the holder of a | 28 |
|
telemedicine certificate issued under section 4731.296 of the | 29 |
|
Revised Code. | 30 |
|
(2) "Telemedicine service" means a medical service delivered | 31 |
|
by a physician
through the use of any communication, including | 32 |
|
oral, written, or
electronic communication. | 33 |
|
(B) Notwithstanding section 3901.71 of the Revised Code, no | 34 |
|
individual or group health insuring corporation policy, contract, | 35 |
|
or agreement that is delivered, issued for delivery, or renewed in | 36 |
|
this state shall exclude coverage for a telemedicine service | 37 |
|
solely because the service is not provided through a face-to-face | 38 |
|
consultation. The policy, contract, or agreement may require a | 39 |
|
deductible, copayment, or coinsurance for the telemedicine | 40 |
|
service. The amount of the deductible, copayment, or coinsurance | 41 |
|
shall not exceed the amount of the deductible, copayment, or | 42 |
|
coinsurance required for a comparable medical service provided | 43 |
|
through a face-to-face consultation. | 44 |
| Sec. 3923.235. (A) As used in this section: | 45 |
|
(1) "Physician" means an individual authorized under Chapter | 46 |
|
4731. of the Revised Code to practice medicine and surgery or | 47 |
|
osteopathic medicine and surgery, including the holder of a | 48 |
|
telemedicine certificate issued under section 4731.296 of the | 49 |
|
Revised Code. | 50 |
|
(2) "Telemedicine service" means a medical service delivered | 51 |
|
by a physician through the use of any communication, including | 52 |
|
oral, written, or
electronic communication. | 53 |
|
(B) Notwithstanding section 3901.71 of the Revised Code, no | 54 |
|
individual or group policy of sickness and accident insurance | 55 |
|
delivered, issued for delivery, or renewed in this state shall | 56 |
|
exclude coverage for a telemedicine service solely because the | 57 |
|
service is not provided through a face-to-face consultation. The | 58 |
|
policy may require a deductible, copayment, or coinsurance for the | 59 |
|
telemedicine service. The amount of the deductible, copayment, or | 60 |
|
coinsurance shall not exceed the amount of the deductible, | 61 |
|
copayment, or coinsurance required for a comparable medical | 62 |
|
service provided through a face-to-face consultation. | 63 |
| Sec. 5111.026. (A) As used in this section: | 64 |
|
(1) "Physician" means an individual authorized under Chapter | 65 |
|
4731. of the Revised Code to practice medicine and surgery or | 66 |
|
osteopathic medicine and surgery, including the holder of a | 67 |
|
telemedicine certificate issued under section 4731.296 of the | 68 |
|
Revised Code. | 69 |
|
(2) "Telemedicine service" means a medical service delivered | 70 |
|
by a physician
through the use of any communication, including | 71 |
|
oral, written, or
electronic communication. | 72 |
|
(B) The director of job and family services shall do the | 73 |
|
following with respect to the provision of telemedicine services: | 74 |
|
(1) Ensure that the medicaid program does not exclude | 75 |
|
coverage
for a telemedicine service solely because the service is | 76 |
|
not
provided through a face-to-face consultation; | 77 |
|
(2) Ensure that the medicaid program does not require a | 78 |
|
medical service to be provided to a medicaid recipient through a | 79 |
|
telemedicine service when the service can reasonably be provided | 80 |
|
through a face-to-face consultation; | 81 |
|
(3) Establish a system to monitor the provision of | 82 |
|
telemedicine services to medicaid recipients for purposes of | 83 |
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ensuring quality care and preventing fraud and abuse. | 84 |
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(C) The director of job and family services may require a | 85 |
|
face-to-face consultation between a medicaid recipient and a | 86 |
|
physician to occur within a specified
period of time following an | 87 |
|
initial telemedicine service only if
the physician has never seen | 88 |
|
the patient. | 89 |
