Bill Text: CA AB1982 | 2021-2022 | Regular Session | Chaptered
Bill Title: Telehealth: dental care.
Spectrum: Partisan Bill (Democrat 1-0)
Status: (Passed) 2022-09-25 - Chaptered by Secretary of State - Chapter 525, Statutes of 2022. [AB1982 Detail]
Download: California-2021-AB1982-Chaptered.html
Assembly Bill
No. 1982
CHAPTER 525
An act to add Section 1374.142 to the Health and Safety Code, and to add Section 10123.857 to the Insurance Code, relating to telehealth.
[
Approved by
Governor
September 25, 2022.
Filed with
Secretary of State
September 25, 2022.
]
LEGISLATIVE COUNSEL'S DIGEST
AB 1982, Santiago.
Telehealth: dental care.
Existing law, the Knox-Keene Health Care Service Plan Act of 1975, provides for the licensure and regulation of health care service plans by the Department of Managed Health Care, and makes a willful violation of the act a crime. Existing law provides for the regulation of health insurers by the Department of Insurance. Existing law requires contract between a health care service plan or health insurer and a health care provider to require the plan or insurer to reimburse the provider for the diagnosis, consultation, or treatment of an enrollee, subscriber, insured, or policyholder appropriately delivered through telehealth services on the same basis and to the same extent as the same service through in-person diagnosis, consultation, or treatment. Existing law requires a health care service plan or health insurer that offers a service via telehealth to meet specified conditions,
including, that the health care service plan or health insurer disclose to the enrollee or insured the availability of receiving the service on an in-person basis or via telehealth.
This bill would require a health care service plan or health insurer covering dental services that offers a service via telehealth through a third-party corporate telehealth provider, as defined, to disclose to the enrollee or insured the impact of third-party telehealth visits on the patient’s benefit limitations, including frequency limitations and the patient’s annual maximum. The bill would also require those plans and insurers to submit specified information for each product type. Because a willful violation of the bill’s requirements relative to health care service plans would be a crime, the bill would impose a state-mandated local program.
The California Constitution requires the
state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement.
This bill would provide that no reimbursement is required by this act for a specified reason.
Digest Key
Vote: MAJORITY Appropriation: NO Fiscal Committee: YES Local Program: YESBill Text
The people of the State of California do enact as follows:
SECTION 1.
Section 1374.142 is added to the Health and Safety Code, immediately following Section 1374.141, to read:1374.142.
(a) A health care service plan that issues, sells, renews, or offers a plan contract covering dental services, including a specialized health care service plan contract covering dental services that offers a service via telehealth to an enrollee through a third-party corporate telehealth provider shall report to the department, in a manner specified by the department, all of the following for each product type:(1) The total number of services delivered via telehealth by a third-party corporate telehealth provider.
(2) For each third-party corporate telehealth provider with which it contracts, the
percentage of the third-party telehealth provider’s contracted providers available to the plan’s enrollees that are also network providers.
(3) For each third-party corporate telehealth provider with which it contracts, the types of telehealth services utilized by enrollees, including information on the gender and age of the enrollee, and any other information as determined by the department.
(b) A health care service plan that issues, sells, renews, or offers a plan contract covering dental services, including a specialized health care service plan contract covering dental services that offers a service via telehealth to an enrollee through a third-party corporate telehealth provider, shall disclose to the enrollee the impact of third-party telehealth visits on the enrollee’s
benefit limitations, including frequency limitations and the enrollee’s annual maximum.
(c) Section 1374.141 shall not apply to specialized health care service plans covering dental services.
(d) For the purposes of this section, “third-party corporate telehealth provider” means a corporation
that provides dental services exclusively through a telehealth technology platform and has no physical location at which a patient can receive services, and is directly contracted with a health care service plan, including a specialized health care service plan, that issues, sells, renews, or offers a plan contract covering dental services.
SEC. 2.
Section 10123.857 is added to the Insurance Code, immediately following Section 10123.856, to read:10123.857.
(a) A health insurer that issues, sells, renews, or offers a policy covering dental services, including a specialized health insurance policy covering dental services that offers a service via telehealth to an insured through a third-party corporate telehealth provider shall report to the department, in a manner specified by the department, all of the following for each product type:(1) The total number of services delivered via telehealth by a third-party corporate telehealth provider.
(2) For each third-party corporate telehealth provider with which it contracts, the percentage of the third-party
telehealth provider’s contracted providers available to the insurer’s insured that are also network providers.
(3) For each third-party corporate telehealth provider with which it contracts, the types of telehealth services utilized by insureds, including information on the gender and age of the insured, and any other information as determined by the department.
(b) A health care insurance policy that issues, sells, renews, or offers an insurance policy covering dental services, including a specialized health care policy covering dental services that offers a service via telehealth to an insured through a third-party corporate telehealth provider, shall disclose to the insured the impact of third-party telehealth visits on the insured’s benefit limitations, including frequency
limitations and the insured’s annual maximum.
(c) Section 10123.856 shall not apply to specialized health insurance policies covering dental services.
(d) For the purposes of this section, “third-party corporate telehealth provider” means a corporation that provides dental services exclusively through a telehealth technology platform and has no physical location at which a patient can receive services, and is directly contracted with a health
insurer that issues, sells, renews, or offers a policy, including a specialized health insurance policy, that covers dental services.
