Bill Text: OH SB28 | 2011-2012 | 129th General Assembly | Introduced

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Bill Title: Regarding insurance and Medicaid coverage of telemedicine services.

Spectrum: Partisan Bill (Democrat 1-0)

Status: (Introduced - Dead) 2011-02-01 - To Insurance, Commerce, & Labor [SB28 Detail]

Download: Ohio-2011-SB28-Introduced.html

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As Introduced

129th General Assembly Regular Session 2011-2012

S. B. No. 28

Senator Tavares 

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A BILL

To enact sections 1739.23, 1751.69, 3923.235, and

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5111.026 of the Revised Code regarding insurance

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and Medicaid coverage of telemedicine services.

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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:

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(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:

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(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:

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(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:

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(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 all of	73
the following with respect to the provision of telemedicine	74
services:	75

(1) Ensure that the medicaid program does not exclude	76
coverage for a telemedicine service solely because the service is	77
not provided through a face-to-face consultation;	78

(2) Ensure that the medicaid program does not require a	79
medical service to be provided to a medicaid recipient through a	80
telemedicine service when the service can reasonably be provided	81
through a face-to-face consultation;	82

(3) Establish a system to monitor the provision of	83
telemedicine services to medicaid recipients for purposes of	84
ensuring quality care and preventing fraud and abuse.	85

(C) The director may require a face-to-face consultation	86
between a medicaid recipient and a physician to occur following an	87
initial telemedicine service only if the physician who provided	88
the service had never before seen the recipient as a patient. The	89
director may specify a period of time within which the	90
consultation must occur.	91