Bill Text: PA HB1939 | 2011-2012 | Regular Session | Introduced

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Bill Title: Further providing for medical assistance payments; and establishing the Gaining Access to Physicians via Telehealth Program.

Spectrum: Moderate Partisan Bill (Republican 17-5)

Status: (Introduced - Dead) 2011-10-31 - Referred to HEALTH [HB1939 Detail]

Download: Pennsylvania-2011-HB1939-Introduced.html

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PRINTER'S NO. 2661
THE GENERAL ASSEMBLY OF PENNSYLVANIA
HOUSE BILL
No. 1939 Session of2011
INTRODUCED BY HEFFLEY, BAKER, CAUSER, CUTLER, DALEY, DENLINGER, DUNBAR, GEIST, HICKERNELL, KILLION, LONGIETTI, MUNDY, MURT, PICKETT, READSHAW, REICHLEY, CULVER, SIMMONS, TOOHIL, TRUITT AND WAGNER, OCTOBER 31, 2011
REFERRED TO COMMITTEE ON HEALTH, OCTOBER 31, 2011
AN ACT
Amending the act of June 13, 1967 (P.L.31, No.21), entitled "An
act to consolidate, editorially revise, and codify the public
welfare laws of the Commonwealth," further providing for
medical assistance payments; and establishing the Gaining
Access to Physicians via Telehealth Program.
The General Assembly of the Commonwealth of Pennsylvania
hereby enacts as follows:
Section 1. Section 443.3(a) of the act of June 13, 1967
(P.L.31, No.21), known as the Public Welfare Code, amended July
7, 2005 (P.L.177, No.42), is amended to read:
Section 443.3. Other Medical Assistance Payments.--(a)
Payments on behalf of eligible persons shall be made for other
services, as follows:
(1) Rates established by the department for outpatient
services as specified by regulations of the department adopted
under Title XIX of the Social Security Act (49 Stat. 620, 42
U.S.C. § 1396 et seq.) consisting of preventive, diagnostic,
therapeutic, rehabilitative or palliative services; furnished by
or under the direction of a physician, chiropractor or
podiatrist, by a hospital or outpatient clinic which qualifies
to participate under Title XIX of the Social Security Act, to a
patient to whom such hospital or outpatient clinic does not
furnish room, board and professional services on a continuous,
twenty-four hour a day basis.
(2) Rates established by the department for (i) other
laboratory and X-ray services prescribed by a physician,
chiropractor or podiatrist and furnished by a facility other
than a hospital which is qualified to participate under Title
XIX of the Social Security Act, (ii) physician's services
consisting of professional care by a physician, chiropractor or
podiatrist in his office, the patient's home, a hospital, a
nursing facility or elsewhere, (iii) the first three pints of
whole blood, (iv) remedial eye care, as provided in [Article
VIII] subarticle (b) of Article XXII of the act of April 9, 1929
(P.L.177, No.175), known as The Administrative Code of 1929,
consisting of medical or surgical care and aids and services and
other vision care provided by a physician skilled in diseases of
the eye or by an optometrist which are not otherwise available
under this [Article] article, (v) special medical services for
school children, as provided in the act of May 10, 1949 (P.L.30,
No.14), known as the Public School Code of 1949, consisting of
medical, dental, vision care provided by a physician skilled in
diseases of the eye or by an optometrist or surgical care and
aids and services which are not otherwise available under this
article.
(3) Notwithstanding any other provision of law, for
recipients aged twenty-one years or older receiving services
under the fee for service delivery system who are eligible for
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medical assistance under Title XIX of the Social Security Act
and for recipients aged twenty-one years or older receiving
services under the fee-for-service delivery system who are
eligible for general assistance-related categories of medical
assistance, the following medically necessary services:
(i) Psychiatric outpatient clinic services not to exceed
five hours or ten one-half-hour sessions per thirty consecutive
day period.
(ii) Psychiatric partial hospitalization not to exceed five
hundred forty hours per fiscal year.
* * *
Section 2. The act is amended by adding a section to read:
Section 443.11. Gaining Access to Physicians via
Telehealth.--(a) The department shall eliminate any regulation
which requires a health care professional utilizing telehealth
to be in the physical presence of the patient in order for
Medicaid reimbursement to occur under the program.
(b) Rates established by the department for telemedicine
services delivered to a Medicaid beneficiary shall be the same
as if those services were provided in person to a Medicaid
beneficiary.
(c) In order to implement the program, the department shall
file a State plan amendment with the Centers for Medicare and
Medicaid Services of the United States Department of Health and
Human Services pursuant to Title XIX of the Social Security Act
(49 Stat. 620, 42 U.S.C. § 1396 et seq.) by June 30, 2012. The
program shall be structured and administered by the department
in accordance with Federal law and applicable Federal guidelines
for qualified State telemedicine services.
(d) The following words and phrases when used in this
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section shall have the meanings given to them in this subsection
unless the context clearly indicates otherwise:
"Health care professional" means an individual who is
licensed, certified or otherwise regulated to provide health
care services under the laws of this Commonwealth.
"Health care services" means services for the diagnosis,
prevention, treatment cure or relief of a health condition,
injury, disease or illness.
"Telehealth" mens the remote interaction between a health
care professional and a patient through the use of any of the
following:
(1) An audio/video transmission.
(2) A computer-based audio/video transmission.
(3) An electronic health monitoring device.
(4) Another telecommunications device that delivers health
information concerning a patient to a health care professional.
Section 3. This act shall take effect immediately.
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