Bill Text: NY S04337 | 2013-2014 | General Assembly | Amended


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

Spectrum: Moderate Partisan Bill (Republican 4-1)

Status: (Engrossed - Dead) 2014-06-11 - referred to health [S04337 Detail]

Download: New_York-2013-S04337-Amended.html
                           S T A T E   O F   N E W   Y O R K
       ________________________________________________________________________
                                        4337--B
                              2013-2014 Regular Sessions
                                   I N  S E N A T E
                                    March 21, 2013
                                      ___________
       Introduced  by  Sens.  YOUNG,  O'MARA,  RITCHIE,  ROBACH, VALESKY -- (at
         request of the Legislative Commission  on  Rural  Resources)  --  read
         twice  and  ordered  printed,  and when printed to be committed to the
         Committee on Health -- committee  discharged,  bill  amended,  ordered
         reprinted  as amended and recommitted to said committee -- recommitted
         to the Committee on Health in accordance with Senate Rule 6, sec. 8 --
         committee discharged, bill amended, ordered reprinted as  amended  and
         recommitted to said committee
       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
        EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                             [ ] is old law to be omitted.
                                                                  LBD02532-04-4
       S. 4337--B                          2
    1  TO  HIM  OR  HER  BY  MEANS  OF  A  FEDERAL FOOD AND DRUG ADMINISTRATION
    2  APPROVED AND INTEROPERABLE TELECOMMUNICATIONS SYSTEM.
    3    (R)  TELEHEALTH.  THE  TERM  "TELEHEALTH" MEANS THE MODE OF DELIVERING
    4  HEALTH CARE SERVICES BY MEANS OF INFORMATION AND COMMUNICATIONS TECHNOL-
    5  OGIES CONSISTING OF TELEPHONES, REMOTE  PATIENT  MONITORING  DEVICES  OR
    6  OTHER  ELECTRONIC  MEANS  WHICH  FACILITATE  THE  ASSESSMENT, DIAGNOSIS,
    7  CONSULTATION, TREATMENT, EDUCATION, CARE MANAGEMENT AND SELF  MANAGEMENT
    8  OF A PATIENT'S HEALTH CARE WHILE SUCH PATIENT IS AT THE ORIGINATING SITE
    9  AND  THE  HEALTH  CARE  PROVIDER  IS  AT A DISTANT SITE. SUCH TERM SHALL
   10  INCLUDE TELEMEDICINE.
   11    (S) TELEMEDICINE. THE TERM "TELEMEDICINE" MEANS THE DELIVERY OF  CLIN-
   12  ICAL HEALTH CARE SERVICES BY MEANS OF REAL TIME TWO-WAY ELECTRONIC AUDIO
   13  VISUAL   COMMUNICATIONS  WHICH  FACILITATE  THE  ASSESSMENT,  DIAGNOSIS,
   14  CONSULTATION, TREATMENT, EDUCATION, CARE MANAGEMENT AND SELF  MANAGEMENT
   15  OF A PATIENT'S HEALTH CARE WHILE SUCH PATIENT IS AT THE ORIGINATING SITE
   16  AND THE HEALTH CARE PROVIDER IS AT A DISTANT SITE.
   17    S 2. Subsection (i) of section 3216 of the insurance law is amended by
   18  adding a new paragraph 30 to read as follows:
   19    (30) EVERY POLICY DELIVERED OR ISSUED FOR DELIVERY IN THIS STATE WHICH
   20  PROVIDES  COVERAGE  FOR  HOSPITAL,  MEDICAL  OR SURGICAL CARE SHALL MAKE
   21  AVAILABLE, AND IF REQUESTED BY A POLICY  HOLDER,  PROVIDE  COVERAGE  FOR
   22  SERVICES  WHICH ARE OTHERWISE COVERED UNDER THE POLICY THAT ARE PROVIDED
   23  VIA TELEMEDICINE, AS DEFINED IN SECTION TWO OF THE  PUBLIC  HEALTH  LAW,
   24  PROVIDED  THAT SUCH SERVICES MEET THE REQUIREMENTS OF FEDERAL LAW, RULES
   25  AND REGULATIONS FOR MEDICARE, AND FOR THOSE TELEHEALTH SERVICES THAT ARE
   26  REQUIRED TO BE PROVIDED PURSUANT TO SUBDIVISION THREE-C OF SECTION THIR-
   27  TY-SIX HUNDRED FOURTEEN  OF  THE  PUBLIC  HEALTH  LAW.    SUCH  COVERAGE
   28  REQUIRED  BY  THIS  PARAGRAPH  MAY  BE SUBJECT TO ANNUAL DEDUCTIBLES AND
   29  COINSURANCE, AND OTHER TERMS AND CONDITIONS OF COVERAGE, INCLUDING,  BUT
   30  NOT  LIMITED TO, UTILIZATION MANAGEMENT AND OTHER MANAGED CARE TOOLS, AS
   31  ARE CONSISTENT WITH THOSE ESTABLISHED FOR THE  SAME  SERVICES  WHEN  NOT
   32  PROVIDED VIA TELEMEDICINE OR TELEHEALTH.
   33    S 3. Subsection (k) of section 3221 of the insurance law is amended by
   34  adding a new paragraph 19 to read as follows:
   35    (19) EVERY GROUP OR BLANKET POLICY DELIVERED OR ISSUED FOR DELIVERY IN
   36  THIS  STATE  WHICH  PROVIDES  COVERAGE FOR HOSPITAL, MEDICAL OR SURGICAL
   37  CARE SHALL MAKE AVAILABLE, AND IF REQUESTED BY THE  GROUP  POLICYHOLDER,
   38  PROVIDE  COVERAGE  FOR  SERVICES  WHICH  ARE OTHERWISE COVERED UNDER THE
   39  POLICY THAT ARE PROVIDED VIA TELEMEDICINE, AS DEFINED IN SECTION TWO  OF
   40  THE PUBLIC HEALTH LAW, PROVIDED THAT SUCH SERVICES MEET THE REQUIREMENTS
   41  OF  FEDERAL  LAW, RULES AND REGULATIONS FOR MEDICARE, AND FOR TELEHEALTH
   42  SERVICES THAT ARE, AT A MINIMUM, THOSE REQUIRED TO BE PROVIDED  PURSUANT
   43  TO  SUBDIVISION  THREE-C  OF  SECTION THIRTY-SIX HUNDRED FOURTEEN OF THE
   44  PUBLIC HEALTH LAW.   SUCH COVERAGE REQUIRED BY  THIS  PARAGRAPH  MAY  BE
   45  SUBJECT  TO  ANNUAL  DEDUCTIBLES  AND  COINSURANCE,  AND OTHER TERMS AND
   46  CONDITIONS OF COVERAGE,  INCLUDING,  BUT  NOT  LIMITED  TO,  UTILIZATION
   47  MANAGEMENT  AND  OTHER  MANAGED CARE TOOLS, AS ARE CONSISTENT WITH THOSE
   48  ESTABLISHED FOR THE SAME SERVICES WHEN NOT PROVIDED VIA TELEMEDICINE  OR
   49  TELEHEALTH.
   50    S  4.   Paragraph 2 of subsection (a) of section 3229 of the insurance
   51  law, as amended by chapter 659 of the laws of 1997, is amended  to  read
   52  as follows:
   53    (2)  a  home  care benefit with personal care, nursing care, adult day
   54  health care [and], respite  care  services,  TELEMEDICINE  SERVICES,  AS
   55  DEFINED  IN  SECTION  TWO  OF  THE PUBLIC HEALTH LAW, PROVIDED THAT SUCH
   56  TELEMEDICINE SERVICES ARE PURSUANT TO AN AGREEMENT  BETWEEN  A  PROVIDER
       S. 4337--B                          3
    1  PARTICIPATING  IN  THE  INSURER'S  NETWORK AND THE INSURER, AND MEET THE
    2  REQUIREMENTS OF FEDERAL LAW, RULES AND  REGULATIONS  FOR  MEDICARE,  AND
    3  THOSE  TELEHEALTH  SERVICES THAT ARE REQUIRED TO BE PROVIDED PURSUANT TO
    4  SUBDIVISION THREE-C OF SECTION THIRTY-SIX HUNDRED FOURTEEN OF THE PUBLIC
    5  HEALTH  LAW,  which shall provide total benefits in an amount determined
    6  by regulations of the superintendent;
    7    S 5. Section 4303 of the insurance law is  amended  by  adding  a  new
    8  subsection (oo) to read as follows:
    9    (OO) EVERY CONTRACT ISSUED BY A MEDICAL EXPENSE INDEMNITY CORPORATION,
   10  A  HOSPITAL  SERVICE  CORPORATION  OR A HEALTH SERVICE CORPORATION WHICH
   11  PROVIDES COVERAGE FOR HOSPITAL, MEDICAL  OR  SURGICAL  CARE  SHALL  MAKE
   12  AVAILABLE,  IF  REQUESTED  BY  A  CONTRACT  HOLDER, PROVIDE COVERAGE FOR
   13  SERVICES WHICH ARE OTHERWISE COVERED UNDER THE POLICY THAT ARE  PROVIDED
   14  VIA  TELEMEDICINE,  AS  DEFINED IN SECTION TWO OF THE PUBLIC HEALTH LAW,
   15  PROVIDED THAT SUCH SERVICES MEET THE REQUIREMENTS OF FEDERAL LAW,  RULES
   16  AND REGULATIONS FOR MEDICARE, AND FOR THOSE TELEHEALTH SERVICES THAT ARE
   17  REQUIRED TO BE PROVIDED PURSUANT TO SUBDIVISION THREE-C OF SECTION THIR-
   18  TY-SIX  HUNDRED  FOURTEEN  OF  THE  PUBLIC  HEALTH  LAW.   SUCH COVERAGE
   19  REQUIRED BY THIS SUBSECTION MAY BE SUBJECT  TO  ANNUAL  DEDUCTIBLES  AND
   20  COINSURANCE,  AND OTHER TERMS AND CONDITIONS OF COVERAGE, INCLUDING, BUT
   21  NOT LIMITED TO, UTILIZATION MANAGEMENT AND OTHER MANAGED CARE TOOLS,  AS
   22  ARE  CONSISTENT  WITH  THOSE  ESTABLISHED FOR THE SAME SERVICES WHEN NOT
   23  PROVIDED VIA TELEMEDICINE OR TELEHEALTH.
   24    S 6.  The opening paragraph of section 367-u of  the  social  services
   25  law is designated subdivision 1 and a new subdivision 2 is added to read
   26  as follows:
   27    2.  SUBJECT TO THE APPROVAL OF THE DIRECTOR OF THE BUDGET, THE COMMIS-
   28  SIONER SHALL NOT EXCLUDE FROM THE PAYMENT OF  MEDICAL  ASSISTANCE  FUNDS
   29  THE  PROVISION OF MEDICAL CARE THROUGH TELEMEDICINE SERVICES, AS DEFINED
   30  IN SECTION TWO OF THE PUBLIC HEALTH LAW,  PROVIDED  THAT  SUCH  SERVICES
   31  MEET  THE  REQUIREMENTS  OF  FEDERAL  LAW, RULES AND REGULATIONS FOR THE
   32  PROVISION OF MEDICAL ASSISTANCE PURSUANT TO THIS TITLE,  AND  FOR  TELE-
   33  HEALTH  SERVICES  THAT  ARE, AT A MINIMUM, THOSE REQUIRED TO BE PROVIDED
   34  PURSUANT TO SUBDIVISION THREE-C OF SECTION THIRTY-SIX  HUNDRED  FOURTEEN
   35  OF THE PUBLIC HEALTH LAW.
   36    S  7.    This act shall take effect January 1, 2015 and shall apply to
   37  all policies and contracts issued, renewed, modified, altered or amended
   38  on or after such date.
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