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.