senate Bill S4023A

Amended

Relates to establishing the New York state telehealth/telemedicine act

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Bill Status


  • Introduced
  • In Committee
  • On Floor Calendar
    • Passed Senate
    • Passed Assembly
  • Delivered to Governor
  • Signed/Vetoed by Governor
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actions

  • 05 / Mar / 2013
    • REFERRED TO HEALTH
  • 06 / May / 2013
    • AMEND AND RECOMMIT TO HEALTH
  • 06 / May / 2013
    • PRINT NUMBER 4023A
  • 08 / Jan / 2014
    • REFERRED TO HEALTH
  • 23 / Jan / 2014
    • AMEND AND RECOMMIT TO HEALTH
  • 23 / Jan / 2014
    • PRINT NUMBER 4023B

Summary

Promotes the development, provision and accessibility of telehealth/telemedicine services in New York state; establishes a telehealth/telemedicine development and research grant fund.

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Bill Details

Versions:
S4023
S4023A
S4023B
Legislative Cycle:
2013-2014
Current Committee:
Senate Health
Law Section:
Public Health Law
Laws Affected:
Add Art 27-M §§2799-t - 2799-w, amd §3614, Pub Health L; add §99-u, St Fin L
Versions Introduced in Previous Legislative Cycles:
2011-2012: S662A
2009-2010: S3198B

Sponsor Memo

BILL NUMBER:S4023A

TITLE OF BILL: An act to amend the public health law, in relation to
promoting the development, provision and accessibility of
telehealth/telemedicine services in New York state; and to amend the
state finance law, in relation to establishing a New York state
telehealth/telemedicine development and research grant fund

PURPOSE:
This legislation would enact the "New York State
telehealth/telemedicine development act" to coordinate and focus state
policy and program planning for telehealth and telemedicine.

SUMMARY OF SPECIFIC PROVISIONS:
This legislation would add a new article 27-M to the public health
law, creating the "New York State telehealth/telemedicine act."

Section 2799-u establishes a telehealth/telemedicine development
program to coordinate and focus state administrative responsibilities
and planning efforts relative to telehealth & telemedicine. This would
involve the submission of an annual plan to the governor and
legislature to include necessary recommendations for legislation,
regulatory or budgetary support; the identification of barriers to the
provision of an access to telehealth/telemedicine; an overview of
relevant research being conduction.

The commissioner is also charged with identifying standards from the
American Telemedicine Association, the Federal Food and Drug
Administration, the public health law, the education law and other
generally recognized standard setting or accrediting sources as the
commissioner may determine necessary to ensure appropriate safeguards
for the use of telehealth/telemedicine services are in place.

Section 2799-v authorizes funding and grants for eligible providers
for the development of telehealth/telemedicine services in underserved
geographic areas in the state, and where it is determined that the
implementation of such telehealth/telemedicine services would improve
patient access and quality of care.

Section 2799-w directs the health commissioner to promote and support
clinical and programmatic research to develop effective and efficient
application of telehealth/telemedicine methods. It also authorizes the
commissioner to apply for governmental and philanthropic grants.

This legislation also amends the public health law to provide for the
capital reimbursement for telehealth and telemedicine expenditures.
It also creates the New York state telehealth/telemedicine development
and research grant fund.

JUSTIFICATION:
One measure of a community's quality of life is the availability,
accessibility and quality of its health care services. The Internet
and other electronic technologies have the potential to fundamentally
reshape health care service delivery in ways that improve quality of
and access to care in a cost-efficient manner. Technology can bring
cutting-edge health care to any location, help reduce and prevent
medication errors and enhance information about state-of-the-art


health care. Large segments of New York's population in rural and
other medically underserved areas have difficulty accessing primary
health care and specialty services as well as health education.
Providers in these communities are often isolated from mentors,
colleagues and information necessary to provide optimal patient care.

The proven potential of telehealth/telemedicine to both provide
primary care access to underserved populations, as well as reduce
hospitalizations of patients suffering from chronic disease, through
the use of home care, warrants an increased focus on the application
of such technology in our health care system.

The purpose of this bill is to serve as catalyst to expand and improve
telehealth and telemedicine programs in communities across the State,
through adoption of a state policy to direct telemedicine/telehealth
health services in New York. Through an integrated telecommunications
system, patients and providers across the continuum of care can have
increased access to medical treatment and state-of the-art health
care, as well as educational and professional training opportunities.

Congress has recognized these benefits in authorizing Medicare
reimbursement for telemedicine services. However, the issues are more
complex at the state level because each state has the authority to set
its own requirements for licensure and credentialing, as well as
different rules for insurance and Medicaid programs.

It is well established that New York spends far more on Medicaid
expenses than any other state, per capita. The legislature must seek
long-term solutions that look to maintain quality of care, while
lowering the utilization of non-ambulatory health care services that
increase cost borne by our taxpayers. Breaking down the geographic
barriers between patients and providers through telecommunications
must lie at the heart of this effort.

PRIOR LEGISLATIVE HISTORY:
Similar legislation (A.1766-A of 2009) creating a
telehealth/telemedicine task force passed the Assembly in 2009.
Introduced in 2009 as S.3918. S.652 of 2011-12.

FISCAL IMPLICATIONS:
To be determined.

EFFECTIVE DATE:
Immediately, provided that section three shall take effect the first
of April succeeding the date on which this act shall become law.

view bill text
                    S T A T E   O F   N E W   Y O R K
________________________________________________________________________

                                 4023--A

                       2013-2014 Regular Sessions

                            I N  S E N A T E

                              March 5, 2013
                               ___________

Introduced  by  Sen. VALESKY -- 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

AN  ACT  to  amend  the  public health law, in relation to promoting the
  development, provision and  accessibility  of  telehealth/telemedicine
  services  in  New  York  state; and to amend the state finance law, in
  relation to establishing  a  New  York  state  telehealth/telemedicine
  development and research grant fund

  THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
BLY, DO ENACT AS FOLLOWS:

  Section 1. This act shall be known and may be cited as the  "New  York
state telehealth/telemedicine development act."
  S  2. The public health law is amended by adding a new article 27-M to
read as follows:
                              ARTICLE 27-M
       NEW YORK STATE TELEHEALTH/TELEMEDICINE DEVELOPMENT PROGRAM
SECTION 2799-T. LEGISLATIVE INTENT.
        2799-U. COORDINATION   OF   DEPARTMENT   RESPONSIBILITIES    FOR
                  TELEHEALTH/TELEMEDICINE; ANNUAL PLAN.
        2799-V. TELEHEALTH/TELEMEDICINE  DEVELOPMENT;  GRANTS FOR UNDER-
                  SERVED AREAS AND POPULATIONS.
        2799-W. TELEHEALTH/TELEMEDICINE RESEARCH.
  S 2799-T. LEGISLATIVE INTENT. THE LEGISLATURE  RECOGNIZES  THE  DEMON-
STRATED  COST-EFFECTIVENESS,  IMPROVEMENTS  IN  DISEASE  MANAGEMENT  AND
IMPROVED   PATIENT   OUTCOMES   RESULTING   FROM   THE   PROVISION    OF
TELEHEALTH/TELEMEDICINE  SERVICES.  TELEHEALTH/TELEMEDICINE SERVICES ARE
THOSE SERVICES WHICH UTILIZE ELECTRONIC  TECHNOLOGY  OVER  A  GEOGRAPHIC
DISTANCE  BETWEEN PATIENTS AND HEALTH CARE PROVIDERS FOR THE PURPOSES OF
ASSESSMENT, MONITORING, INTERVENTION, CLINICAL MANAGEMENT AND/OR  EDUCA-
TION  WITH  PATIENTS.  STUDIES HAVE CHRONICLED SIGNIFICANT REDUCTIONS IN

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD06551-03-3

S. 4023--A                          2

HOSPITALIZATIONS AND OTHERWISE NECESSARY MEDICAL CARE  AS  A  RESULT  OF
TELEHEALTH/TELEMEDICINE INTERVENTION. THE LEGISLATURE FURTHER RECOGNIZES
THAT GEOGRAPHY, WEATHER AND OTHER FACTORS CAN CREATE BARRIERS TO ACCESS-
ING  APPROPRIATE  HEALTH  AND  MENTAL  HEALTH CARE IN NEW YORK STATE AND
THAT ONE WAY  TO PROVIDE, ENSURE OR ENHANCE ACCESS TO CARE  GIVEN  THESE
BARRIERS  IS  THROUGH  THE APPROPRIATE USE OF TECHNOLOGY TO ALLOW HEALTH
CARE CONSUMERS ACCESS TO QUALIFIED  HEALTH  CARE  PROVIDERS  AND  INSTI-
TUTIONS.    IN   ORDER   TO   PROMOTE   THE   ROLE   AND   CAPACITY   OF
TELEHEALTH/TELEMEDICINE  TECHNOLOGY  RELATIVE  TO  THESE  PURPOSES,  THE
LEGISLATURE  HEREBY  ENACTS  THE  NEW YORK STATE TELEHEALTH/TELEMEDICINE
DEVELOPMENT  ACT  TO  ESTABLISH  A  TELEHEALTH/TELEMEDICINE  DEVELOPMENT
PROGRAM TO COORDINATE AND FOCUS STATE ADMINISTRATIVE RESPONSIBILITIES AS
WELL  AS  STATE POLICY AND PROGRAM PLANNING FOR TELEHEALTH/TELEMEDICINE,
PROVIDE FOR TELEHEALTH/TELEMEDICINE DEVELOPMENT IN UNDERSERVED GEOGRAPH-
IC AREAS AND FOR NEW POPULATIONS,  PROMOTE  QUALITY  AND  SAFEGUARDS  IN
TELEHEALTH/TELEMEDICINE,   PROMOTE  AND  ASSIST  TELEHEALTH/TELEMEDICINE
RESEARCH AND EVALUATION, ESTABLISH THE TELEHEALTH/TELEMEDICINE  RESEARCH
AND DEVELOPMENT FUND, AND PROVIDE FOR CAPITAL FINANCING.
  S    2799-U.   COORDINATION   OF   DEPARTMENT   RESPONSIBILITIES   FOR
TELEHEALTH/TELEMEDICINE; ANNUAL PLAN. 1. THE COMMISSIONER SHALL  COORDI-
NATE  AND FOCUS THE DEPARTMENT'S DEVELOPMENTAL, ADMINISTRATIVE, RESEARCH
AND EVALUATION RESPONSIBILITIES FOR TELEHEALTH/TELEMEDICINE SERVICES.
  2. THE COMMISSIONER, IN CONSULTATION WITH ELIGIBLE PROVIDERS AS SPECI-
FIED IN SUBDIVISION TWO OF SECTION TWENTY-SEVEN HUNDRED NINETY-NINE-V OF
THIS ARTICLE, SHALL PREPARE AND SUBMIT AN ANNUAL  PLAN  TO  SUPPORT  THE
PROVISION  OF  TELEHEALTH/TELEMEDICINE  SERVICES  PROVIDED  PURSUANT  TO
SUBDIVISION THREE-C OF SECTION THIRTY-SIX HUNDRED FOURTEEN OF THIS CHAP-
TER, AS WELL AS OTHER TELEHEALTH/TELEMEDICINE  SERVICES  FOR  WHICH  THE
DEPARTMENT  HAS  DEVELOPMENTAL  AND  ADMINISTRATIVE  RESPONSIBILITY. THE
ANNUAL PLAN SHALL INCLUDE:
  (A) ANY NECESSARY RECOMMENDATIONS FOR LEGISLATIVE,  ADMINISTRATIVE  OR
BUDGETARY SUPPORT FOR TELEHEALTH/TELEMEDICINE SERVICES;
  (B)  THE  IDENTIFICATION OF BARRIERS TO THE PROVISION OF AND ACCESS TO
TELEHEALTH/TELEMEDICINE,  INCLUDING  EDUCATION  AND  TRAINING  FOR  BOTH
PROVIDERS  AND  CONSUMERS,  ELECTRONIC RECORDS INTERFACE, AND OTHER, AND
THE METHODS BY WHICH THE DEPARTMENT WILL AID IN ADDRESSING  SUCH  BARRI-
ERS; AND
  (C) AN ABSTRACT OF TELEHEALTH/TELEMEDICINE RESEARCH EITHER BEING OR TO
BE  CONDUCTED  BY  THE  DEPARTMENT, OR FACILITATED BY THE DEPARTMENT AND
BEING OR TO BE CONDUCTED BY PROVIDERS OR OTHER ENTITIES.
  3. THE COMMISSIONER SHALL PROVIDE COPIES OF THE  ANNUAL  PLAN  TO  THE
GOVERNOR,  THE TEMPORARY PRESIDENT AND MINORITY LEADER OF THE SENATE AND
THE SPEAKER AND MINORITY LEADER OF THE ASSEMBLY.
  4. (A) THE COMMISSIONER, IN CONSULTATION WITH  ELIGIBLE  PROVIDERS  AS
SPECIFIED   IN   SUBDIVISION   TWO   OF   SECTION  TWENTY-SEVEN  HUNDRED
NINETY-NINE-V OF THIS ARTICLE, SHALL IDENTIFY STANDARDS DETERMINED TO BE
NECESSARY FOR TELEHEALTH/TELEMEDICINE SERVICES UNDER THIS ARTICLE.  SUCH
STANDARDS,  INCLUDING  STANDARDS  FOR THE PROTECTION OF PATIENT INFORMA-
TION, SHALL BE IDENTIFIED FROM:
  (I) THE AMERICAN TELEMEDICINE ASSOCIATION, THE FEDERAL FOOD  AND  DRUG
ADMINISTRATION AND/OR OTHER GENERALLY RECOGNIZED STANDARD-SETTING ORGAN-
IZATIONS AS THE COMMISSIONER MAY DETERMINE;
  (II)  TITLE  EIGHT  OF THE EDUCATION LAW AND REGULATIONS THERETO, THIS
CHAPTER AND REGULATIONS THERETO AND, AS  APPLICABLE,  THE  STANDARDS  OF
RELEVANT  PROFESSIONAL  OR  ACCREDITING  BODIES  AS THE COMMISSIONER MAY
DETERMINE,  TO  ENSURE  THAT   TELEHEALTH/TELEMEDICINE   MONITORING   IS

S. 4023--A                          3

CONDUCTED  BY  INDIVIDUALS  IN  ACCORDANCE  WITH, AND AS LIMITED BY, THE
APPLICABLE SCOPE OF PRACTICE, LICENSURE AND/OR CREDENTIALING  PROVISIONS
OF SUCH LAWS AND STANDARDS.
  (B) THE COMMISSIONER MAY INCORPORATE, WITHIN THE ANNUAL PLAN SUBMITTED
PURSUANT  TO  SUBDIVISION  TWO  OF THIS SECTION, RECOMMENDATIONS FOR ANY
ADDITIONAL  STANDARDS  OR   REQUIREMENTS   FOR   TELEHEALTH/TELEMEDICINE
SERVICES AS MAY BE NECESSARY UNDER THIS ARTICLE.
  S  2799-V. TELEHEALTH/TELEMEDICINE DEVELOPMENT; GRANTS FOR UNDERSERVED
AREAS AND POPULATIONS. 1. SUBJECT TO THE AVAILABILITY  OF  FUNDING  FROM
SECTION  NINETY-NINE-U OF THE STATE FINANCE LAW, FUNDS MADE AVAILABLE IN
THE GENERAL FUND OR ANY OTHER FUNDS MADE AVAILABLE THEREFOR, THE DEPART-
MENT SHALL PROVIDE GRANTS TO ELIGIBLE PROVIDERS FOR:
  (A) THE DEVELOPMENT OF TELEHEALTH/TELEMEDICINE SERVICES IN  GEOGRAPHIC
AREAS  OF  THE  STATE  DEEMED BY THE DEPARTMENT TO BE UNDERSERVED ON THE
BASIS OF A LACK OF PROVIDERS PURSUANT TO THIS ARTICLE;
  (B) THE DEVELOPMENT OF TELEHEALTH/TELEMEDICINE SERVICES IN  GEOGRAPHIC
AREAS  OF  THE  STATE  DEEMED BY THE DEPARTMENT TO BE UNDERSERVED ON THE
BASIS OF THE LACK OF TELEHEALTH/TELEMEDICINE SERVICES IN THE AREA;
  (C) THE DEVELOPMENT OF TELEHEALTH/TELEMEDICINE SERVICES FOR NEW  POPU-
LATIONS,  WHERE  EVIDENCE  SUGGESTS THE PROVISION OF SUCH SERVICES WOULD
FACILITATE THE  MANAGEMENT  OF  PATIENT  CARE,  ACCESS  TO  CARE  AND/OR
COST-EFFECTIVENESS OF CARE;
  (D) THE DEVELOPMENT OF TELEHEALTH/TELEMEDICINE SERVICES FOR NEW CONDI-
TIONS,  WHERE  EVIDENCE  SUGGESTS  THE  PROVISION OF SUCH SERVICES WOULD
FACILITATE THE MANAGEMENT OF SUCH  CONDITIONS,  ACCESS  TO  CARE  AND/OR
COST-EFFECTIVENESS OF CARE;
  (E)  THE  DEVELOPMENT  OF TELEHEALTH/TELEMEDICINE SERVICES TO EVALUATE
THE POTENTIAL BENEFITS OF NEW  TELEHEALTH/TELEMEDICINE  TECHNOLOGY,  FOR
PATIENT CARE, ACCESS TO CARE AND/OR COST-EFFECTIVENESS OF CARE; OR
  (F) SUCH OTHER PURPOSES AS THE DEPARTMENT MAY IDENTIFY.
  2.  ELIGIBLE  PROVIDERS  SHALL  INCLUDE  THOSE  LICENSED, CERTIFIED OR
AUTHORIZED UNDER ARTICLE TWENTY-EIGHT, THIRTY-SIX OR FORTY OF THIS CHAP-
TER OR UNDER SECTION FORTY-FOUR  HUNDRED  THREE-F  OF  THIS  CHAPTER  OR
PHYSICIANS  LICENSED UNDER ARTICLE ONE HUNDRED THIRTY-ONE OF TITLE EIGHT
OF THE EDUCATION LAW;  PROVIDED  HOWEVER  THAT  ELIGIBILITY  UNDER  THIS
SECTION  TO PROVIDE TELEHEALTH/TELEMEDICINE SERVICES SHALL BE CONSISTENT
WITH THE AUTHORITY FOR THE PROVISION OF CARE OTHERWISE PROVIDED PURSUANT
TO ARTICLE TWENTY-EIGHT, THIRTY-SIX OR FORTY OF THIS  CHAPTER  OR  UNDER
SECTION FORTY-FOUR HUNDRED THREE-F OF THIS CHAPTER OR TITLE EIGHT OF THE
EDUCATION LAW.
  3.  THE  DEPARTMENT, IN CONSULTATION WITH ELIGIBLE PROVIDERS AS SPECI-
FIED IN SUBDIVISION TWO OF THIS SECTION, SHALL ESTABLISH THE  FORMS  AND
PROCESS  FOR  THE SUBMISSION AND APPROVAL OF GRANT APPLICATIONS PURSUANT
TO THIS SUBDIVISION.
  S 2799-W. TELEHEALTH/TELEMEDICINE RESEARCH. 1. THE COMMISSIONER  SHALL
PROMOTE  AND SUPPORT CLINICAL AND PROGRAMMATIC RESEARCH BY PROVIDERS AND
OTHER ENTITIES TO FURTHER EVALUATE, REFINE AND/OR DEVELOP EFFECTIVE  AND
EFFICIENT  APPLICATION OF TELEHEALTH/TELEMEDICINE METHODS AND TECHNOLOGY
TO POPULATIONS, CONDITIONS AND  CIRCUMSTANCES.  THE  COMMISSIONER  SHALL
MAKE AVAILABLE DATA AND TECHNICAL ASSISTANCE FOR SUCH RESEARCH, PROVIDED
THAT  ANY  DATA MADE AVAILABLE MUST NOT CONTAIN INDIVIDUALLY IDENTIFYING
INFORMATION.
  2. THE COMMISSIONER IS AUTHORIZED  TO  APPLY  FOR  SUCH  GOVERNMENTAL,
PHILANTHROPIC  AND OTHER GRANTS THAT MAY BE AVAILABLE FOR SUCH RESEARCH.
MONIES FROM SUCH GRANTS  SHALL  BE  DEPOSITED  IN  THE  NEW  YORK  STATE

S. 4023--A                          4

TELEHEALTH/TELEMEDICINE  DEVELOPMENT AND RESEARCH GRANT FUND ESTABLISHED
BY SECTION NINETY-NINE-U OF THE STATE FINANCE LAW.
  3.  THE DEPARTMENT SHALL CONSULT WITH ELIGIBLE PROVIDERS, AS SPECIFIED
IN SUBDIVISION TWO OF SECTION TWENTY-SEVEN HUNDRED NINETY-NINE-V OF THIS
ARTICLE IN THE IMPLEMENTATION OF THIS SECTION.
  S 3. Section 3614 of the public health law is amended by adding a  new
subdivision 3-d to read as follows:
  3-D. CAPITAL REIMBURSEMENT FOR TELEHEALTH/TELEMEDICINE. THE DEPARTMENT
SHALL  INCLUDE  IN  THE REIMBURSEMENT RATES ESTABLISHED PURSUANT TO THIS
SECTION A COST ALLOWANCE FOR THE REIMBURSEMENT OF CAPITAL COSTS FOR  THE
DEVELOPMENT,   OPERATION   AND   PROVISION   OF  TELEHEALTH/TELEMEDICINE
SERVICES, INCLUDING THE LINKAGE OF TELEHEALTH/TELEMEDICINE AND ELECTRON-
IC MEDICAL RECORDS. THE METHODOLOGY FOR THE INCLUSION OF  THE  ALLOWANCE
SHALL  BE  DEVELOPED  IN  CONSULTATION  WITH  THE ELIGIBLE PROVIDERS FOR
TELEHEALTH/TELEMEDICINE PURSUANT TO SECTION TWENTY-SEVEN  HUNDRED  NINE-
TY-NINE-U OF THIS CHAPTER.
  S  4. The state finance law is amended by adding a new section 99-u to
read as follows:
  S  99-U.  NEW  YORK  STATE  TELEHEALTH/TELEMEDICINE  DEVELOPMENT   AND
RESEARCH GRANT FUND. 1. THERE IS HEREBY ESTABLISHED IN THE JOINT CUSTODY
OF  THE  STATE  COMPTROLLER  AND  COMMISSIONER OF TAXATION AND FINANCE A
SPECIAL FUND TO BE KNOWN AS THE "NEW YORK STATE  TELEHEALTH/TELEMEDICINE
DEVELOPMENT AND RESEARCH FUND".
  2.  SUCH FUND SHALL CONSIST OF ALL MONIES APPROPRIATED FOR THE PURPOSE
OF SUCH FUND AND ANY GRANT, GIFT OR BEQUEST MADE FOR PURPOSES OF  DEVEL-
OPMENT  OR  GRANTS  FOR  TELEHEALTH/TELEMEDICINE  SERVICES  PURSUANT  TO
SECTION TWENTY-SEVEN HUNDRED NINETY-NINE-V OF THE PUBLIC HEALTH LAW.
  3. MONIES OF THE FUND SHALL BE AVAILABLE TO THE COMMISSIONER OF HEALTH
FOR THE  PURPOSE  OF  PROVIDING  DEVELOPMENT  AND  RESEARCH  GRANTS  FOR
TELEHEALTH/TELEMEDICINE  PURSUANT  TO SECTION TWENTY-SEVEN HUNDRED NINE-
TY-NINE-V OF THE PUBLIC HEALTH LAW.
  4. THE MONIES OF THE FUND SHALL BE PAID OUT ON THE AUDIT  AND  WARRANT
OF THE COMPTROLLER ON VOUCHERS CERTIFIED OR APPROVED BY THE COMMISSIONER
OF  HEALTH,  OR  BY  AN  OFFICER OR EMPLOYEE OF THE DEPARTMENT OF HEALTH
DESIGNATED BY SUCH COMMISSIONER.
  S 5. This act shall take effect immediately;  provided,  that  section
three  of this act shall take effect on the first of April next succeed-
ing the date on which this act shall have become law; provided  further,
however, that the commissioner of health shall be authorized to take all
necessary steps to implement this section by such date.

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