senate Bill S4337A

Amended

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

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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

  • 21 / Mar / 2013
    • REFERRED TO HEALTH
  • 03 / Jun / 2013
    • AMEND AND RECOMMIT TO HEALTH
  • 03 / Jun / 2013
    • PRINT NUMBER 4337A
  • 12 / Jun / 2013
    • COMMITTEE DISCHARGED AND COMMITTED TO RULES
  • 12 / Jun / 2013
    • ORDERED TO THIRD READING CAL.1342
  • 13 / Jun / 2013
    • PASSED SENATE
  • 13 / Jun / 2013
    • DELIVERED TO ASSEMBLY
  • 13 / Jun / 2013
    • REFERRED TO HEALTH
  • 08 / Jan / 2014
    • DIED IN ASSEMBLY
  • 08 / Jan / 2014
    • RETURNED TO SENATE
  • 08 / Jan / 2014
    • REFERRED TO HEALTH
  • 23 / Jan / 2014
    • AMEND AND RECOMMIT TO HEALTH
  • 23 / Jan / 2014
    • PRINT NUMBER 4337B
  • 10 / Jun / 2014
    • COMMITTEE DISCHARGED AND COMMITTED TO RULES
  • 10 / Jun / 2014
    • ORDERED TO THIRD READING CAL.1245
  • 11 / Jun / 2014
    • PASSED SENATE
  • 11 / Jun / 2014
    • DELIVERED TO ASSEMBLY
  • 11 / Jun / 2014
    • REFERRED TO HEALTH

Summary

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

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Bill Details

Versions:
S4337
S4337A
S4337B
Legislative Cycle:
2013-2014
Current Committee:
Assembly Health
Law Section:
Public Health Law
Laws Affected:
Amd §2, Pub Health L; amd §§3216, 3221, 3229 & 4303, Ins L; amd §367-u, Soc Serv L
Versions Introduced in 2011-2012 Legislative Cycle:
S6969A

Sponsor Memo

BILL NUMBER:S4337A

TITLE OF BILL: An act to amend the public health law, the insurance
law and the social services law, in relation to the provision of
telehealth services

PURPOSE:

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

SUMMARY OF PROVISIONS:

Section one would amend subdivision 1 of section 2 of the public
health law to provide definitions for "distant site," "health care
provider," "originating site," "telehealth" and "telemedicine."

Section two, three, four, and five would amend various provisions of
the insurance law to require individual accident and health insurance,
group or blanket accident and health insurance, and medical expense
indemnity corporations or hospital service corporations that provide
hospital, medical or surgical care to also provide coverage for
telehealth and telemedicine services, provided that the telemedicine
services meet federal Medicare program requirements, and telehealth
services are covered to the same extent as the home telehealth program
provides under paragraph 3-c of subdivision 3614 of the public health
law. Such coverage is subject to contractual limits including annual
deductibles, coinsurance, utilization management, and other managed
care tools on par with the same services when not provided via
telemedicine or telehealth.

Section six would amend the social services law to prohibit the
exclusion of telehealth services from reimbursement under Medicaid
solely because the otherwise covered service was delivered by
telehealth.

Section seven states the enactment date.

JUSTIFICATION:

Telehealth, including telemedicine, can benefit patients, especially
rural patients, hampered by economic or geographic restrictions, in
many ways.

Due to significant quality and fiscal improvements, patients see fewer
hospitalizations and costly visits to emergency rooms; expanded access
to providers; faster, more convenient and timely treatment; better
continuity of care; better coordination of care; reduction of lost
work time and travel costs; and the ability to remain within support
networks and age in place at home.

Persons of all ages who suffer from chronic diseases will have the
opportunity to stay in their homes longer, abnormal events may be
detected before they turn into a hospital visit, vital signs can be
monitored remotely by registered nurses, patients can get help with
medication adherence and be encouraged to take ownership of their own


well-being by better understanding the correlation between their
choices and their health outcomes.

Patients can receive consultations at a provider's office, not just
from that provider, but from doctors, nurse practitioners, physician
assistants, dentists and psychiatrists across the state and world.

However, to ensure that the field of telehealth and telemedicine can
reach its full potential, these services must be reimbursed in the
same manner as those provided face to face. Any individual who would
otherwise be entitled to receive coverage for in-person
encounter-based monitoring or consulting services should be entitled
to receive such services through the use of remote monitoring or
remote consults using real-time audio-visual telecommunications.

Enabling health care professionals to make use of available technology
will empower them to better serve their patients and enhance health
patient outcomes.

Cost-efficient quality healthcare will be preserved by permitting
telemedicine and telehealth services to be subject to the same
limitations as those same services would be when not given via
telemedicine or telehealth.

LEGISLATIVE HISTORY:

2012: S.6969-A PASSED SENATE: A.9833-A Committed to Health Committee

FISCAL IMPLICATIONS:

Undetermined.

EFFECTIVE DATE:

Effective January 1, 2014 and shall apply to all policies and
contracts issued, renewed, modified, altered or amended on or after
such date.

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

                                 4337--A

                       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

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:

  Section  1.    Subdivision  1 of section 2 of the public health law is
amended by adding five new paragraphs (o), (p), (q), (r) and (s) to read
as follows:
  (O) DISTANT SITE. THE TERM "DISTANT SITE" MEANS  A  SITE  AT  WHICH  A
HEALTH  CARE PROVIDER IS LOCATED WHILE PROVIDING HEALTH CARE SERVICES BY
MEANS OF A FEDERAL FOOD AND DRUG ADMINISTRATION APPROVED AND INTEROPERA-
BLE TELECOMMUNICATIONS SYSTEM.
  (P) HEALTH CARE PROVIDER. THE TERM  "HEALTH  CARE  PROVIDER"  MEANS  A
PERSON  LICENSED PURSUANT TO ARTICLE ONE HUNDRED THIRTY-ONE, ONE HUNDRED
THIRTY-ONE-B, ONE HUNDRED THIRTY-THREE,  ONE  HUNDRED  THIRTY-NINE,  ONE
HUNDRED  FORTY,  ONE  HUNDRED  FORTY-ONE,  ONE  HUNDRED FORTY-THREE, ONE
HUNDRED FORTY-FOUR, ONE HUNDRED FIFTY-THREE, ONE HUNDRED  FIFTY-FOUR  OR
ONE  HUNDRED  FIFTY-NINE  OF  THE  EDUCATION  LAW; A PHYSICIANS PRACTICE
GROUP; A HOSPITAL; A CERTIFIED HOME HEALTH  AGENCY;  A  LONG  TERM  HOME
HEALTH  CARE PROGRAM;  A FEDERALLY QUALIFIED HEALTH CENTER AS DEFINED IN
42 U.S.C. 1395X (AA)(4); AND  A LICENSED HOME CARE SERVICE AGENCY.
  (Q) ORIGINATING SITE. THE TERM "ORIGINATING  SITE"  MEANS  A  SITE  AT
WHICH A PATIENT IS LOCATED AT THE TIME HEALTH CARE SERVICES ARE PROVIDED
TO  HIM  OR  HER  BY  MEANS  OF  A  FEDERAL FOOD AND DRUG ADMINISTRATION
APPROVED AND INTEROPERABLE TELECOMMUNICATIONS SYSTEM.
  (R) TELEHEALTH. THE TERM "TELEHEALTH" MEANS  THE  MODE  OF  DELIVERING
HEALTH CARE SERVICES BY MEANS OF INFORMATION AND COMMUNICATIONS TECHNOL-

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD02532-02-3

S. 4337--A                          2

OGIES  CONSISTING  OF  TELEPHONES,  REMOTE PATIENT MONITORING DEVICES OR
OTHER ELECTRONIC  MEANS  WHICH  FACILITATE  THE  ASSESSMENT,  DIAGNOSIS,
CONSULTATION,  TREATMENT, EDUCATION, CARE MANAGEMENT AND SELF MANAGEMENT
OF A PATIENT'S HEALTH CARE WHILE SUCH PATIENT IS AT THE ORIGINATING SITE
AND  THE  HEALTH  CARE  PROVIDER  IS  AT A DISTANT SITE. SUCH TERM SHALL
INCLUDE TELEMEDICINE.
  (S) TELEMEDICINE. THE TERM "TELEMEDICINE" MEANS THE DELIVERY OF  CLIN-
ICAL HEALTH CARE SERVICES BY MEANS OF REAL TIME TWO-WAY ELECTRONIC AUDIO
VISUAL   COMMUNICATIONS  WHICH  FACILITATE  THE  ASSESSMENT,  DIAGNOSIS,
CONSULTATION, TREATMENT, EDUCATION, CARE MANAGEMENT AND SELF  MANAGEMENT
OF A PATIENT'S HEALTH CARE WHILE SUCH PATIENT IS AT THE ORIGINATING SITE
AND THE HEALTH CARE PROVIDER IS AT A DISTANT SITE.
  S 2. Subsection (i) of section 3216 of the insurance law is amended by
adding a new paragraph 30 to read as follows:
  (30) EVERY POLICY DELIVERED OR ISSUED FOR DELIVERY IN THIS STATE WHICH
PROVIDES  COVERAGE  FOR  HOSPITAL,  MEDICAL  OR SURGICAL CARE SHALL MAKE
AVAILABLE, AND IF REQUESTED BY A POLICY  HOLDER,  PROVIDE  COVERAGE  FOR
SERVICES  WHICH ARE OTHERWISE COVERED UNDER THE POLICY THAT ARE PROVIDED
VIA TELEMEDICINE, AS DEFINED IN SECTION TWO OF THE  PUBLIC  HEALTH  LAW,
PROVIDED  THAT SUCH SERVICES MEET THE REQUIREMENTS OF FEDERAL LAW, RULES
AND REGULATIONS FOR MEDICARE, AND FOR THOSE TELEHEALTH SERVICES THAT ARE
REQUIRED TO BE PROVIDED PURSUANT TO SUBDIVISION THREE-C OF SECTION THIR-
TY-SIX HUNDRED FOURTEEN  OF  THE  PUBLIC  HEALTH  LAW.    SUCH  COVERAGE
REQUIRED  BY  THIS  PARAGRAPH  MAY  BE SUBJECT TO ANNUAL DEDUCTIBLES AND
COINSURANCE, AND OTHER TERMS AND CONDITIONS OF COVERAGE, INCLUDING,  BUT
NOT  LIMITED TO, UTILIZATION MANAGEMENT AND OTHER MANAGED CARE TOOLS, AS
ARE CONSISTENT WITH THOSE ESTABLISHED FOR THE  SAME  SERVICES  WHEN  NOT
PROVIDED VIA TELEMEDICINE OR TELEHEALTH.
  S 3. Subsection (k) of section 3221 of the insurance law is amended by
adding a new paragraph 19 to read as follows:
  (19) EVERY GROUP OR BLANKET POLICY DELIVERED OR ISSUED FOR DELIVERY IN
THIS  STATE  WHICH  PROVIDES  COVERAGE FOR HOSPITAL, MEDICAL OR SURGICAL
CARE SHALL MAKE AVAILABLE, AND IF REQUESTED BY THE  GROUP  POLICYHOLDER,
PROVIDE  COVERAGE  FOR  SERVICES  WHICH  ARE OTHERWISE COVERED UNDER THE
POLICY THAT ARE PROVIDED VIA TELEMEDICINE, AS DEFINED IN SECTION TWO  OF
THE PUBLIC HEALTH LAW, PROVIDED THAT SUCH SERVICES MEET THE REQUIREMENTS
OF  FEDERAL  LAW, RULES AND REGULATIONS FOR MEDICARE, AND FOR TELEHEALTH
SERVICES THAT ARE, AT A MINIMUM, THOSE REQUIRED TO BE PROVIDED  PURSUANT
TO  SUBDIVISION  THREE-C  OF  SECTION THIRTY-SIX HUNDRED FOURTEEN OF THE
PUBLIC HEALTH LAW.   SUCH COVERAGE REQUIRED BY  THIS  PARAGRAPH  MAY  BE
SUBJECT  TO  ANNUAL  DEDUCTIBLES  AND  COINSURANCE,  AND OTHER TERMS AND
CONDITIONS OF COVERAGE,  INCLUDING,  BUT  NOT  LIMITED  TO,  UTILIZATION
MANAGEMENT  AND  OTHER  MANAGED CARE TOOLS, AS ARE CONSISTENT WITH THOSE
ESTABLISHED FOR THE SAME SERVICES WHEN NOT PROVIDED VIA TELEMEDICINE  OR
TELEHEALTH.
  S  4.   Paragraph 2 of subsection (a) of section 3229 of the insurance
law, as amended by chapter 659 of the laws of 1997, is amended  to  read
as follows:
  (2)  a  home  care benefit with personal care, nursing care, adult day
health care [and], respite  care  services,  TELEMEDICINE  SERVICES,  AS
DEFINED  IN  SECTION  TWO  OF  THE PUBLIC HEALTH LAW, PROVIDED THAT SUCH
TELEMEDICINE SERVICES ARE PURSUANT TO AN AGREEMENT  BETWEEN  A  PROVIDER
PARTICIPATING  IN  THE  INSURER'S  NETWORK AND THE INSURER, AND MEET THE
REQUIREMENTS OF FEDERAL LAW, RULES AND  REGULATIONS  FOR  MEDICARE,  AND
THOSE  TELEHEALTH  SERVICES THAT ARE REQUIRED TO BE PROVIDED PURSUANT TO
SUBDIVISION THREE-C OF SECTION THIRTY-SIX HUNDRED FOURTEEN OF THE PUBLIC

S. 4337--A                          3

HEALTH LAW, which shall provide total benefits in an  amount  determined
by regulations of the superintendent;
  S  5.  Section  4303  of  the insurance law is amended by adding a new
subsection (oo) to read as follows:
  (OO) EVERY CONTRACT ISSUED BY A MEDICAL EXPENSE INDEMNITY CORPORATION,
A HOSPITAL SERVICE CORPORATION OR A  HEALTH  SERVICE  CORPORATION  WHICH
PROVIDES  COVERAGE  FOR  HOSPITAL,  MEDICAL  OR SURGICAL CARE SHALL MAKE
AVAILABLE, IF REQUESTED BY  A  CONTRACT  HOLDER,  PROVIDE  COVERAGE  FOR
SERVICES  WHICH ARE OTHERWISE COVERED UNDER THE POLICY THAT ARE PROVIDED
VIA TELEMEDICINE, AS DEFINED IN SECTION TWO OF THE  PUBLIC  HEALTH  LAW,
PROVIDED  THAT SUCH SERVICES MEET THE REQUIREMENTS OF FEDERAL LAW, RULES
AND REGULATIONS FOR MEDICARE, AND FOR THOSE TELEHEALTH SERVICES THAT ARE
REQUIRED TO BE PROVIDED PURSUANT TO SUBDIVISION THREE-C OF SECTION THIR-
TY-SIX HUNDRED FOURTEEN  OF  THE  PUBLIC  HEALTH  LAW.    SUCH  COVERAGE
REQUIRED  BY  THIS  SUBSECTION  MAY BE SUBJECT TO ANNUAL DEDUCTIBLES AND
COINSURANCE, AND OTHER TERMS AND CONDITIONS OF COVERAGE, INCLUDING,  BUT
NOT  LIMITED TO, UTILIZATION MANAGEMENT AND OTHER MANAGED CARE TOOLS, AS
ARE CONSISTENT WITH THOSE ESTABLISHED FOR THE  SAME  SERVICES  WHEN  NOT
PROVIDED VIA TELEMEDICINE OR TELEHEALTH.
  S  6.    The opening paragraph of section 367-u of the social services
law is designated subdivision 1 and a new subdivision 2 is added to read
as follows:
  2. SUBJECT TO THE APPROVAL OF THE DIRECTOR OF THE BUDGET, THE  COMMIS-
SIONER  SHALL  NOT  EXCLUDE FROM THE PAYMENT OF MEDICAL ASSISTANCE FUNDS
THE PROVISION OF MEDICAL CARE THROUGH TELEMEDICINE SERVICES, AS  DEFINED
IN  SECTION  TWO  OF  THE PUBLIC HEALTH LAW, PROVIDED THAT SUCH SERVICES
MEET THE REQUIREMENTS OF FEDERAL LAW,  RULES  AND  REGULATIONS  FOR  THE
PROVISION  OF  MEDICAL  ASSISTANCE PURSUANT TO THIS TITLE, AND FOR TELE-
HEALTH SERVICES THAT ARE, AT A MINIMUM, THOSE REQUIRED  TO  BE  PROVIDED
PURSUANT  TO  SUBDIVISION THREE-C OF SECTION THIRTY-SIX HUNDRED FOURTEEN
OF THE PUBLIC HEALTH LAW.
  S 7.  This act shall take effect January 1, 2014 and  shall  apply  to
all policies and contracts issued, renewed, modified, altered or amended
on or after such date.

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