S T A T E   O F   N E W   Y O R K
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                                 6972--A

                       2013-2014 Regular Sessions

                          I N  A S S E M B L Y

                             April 29, 2013
                               ___________

Introduced by M. of A. GABRYSZAK, PALMESANO -- read once and referred 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-
OGIES  CONSISTING  OF  TELEPHONES,  REMOTE PATIENT MONITORING DEVICES OR
OTHER ELECTRONIC  MEANS  WHICH  FACILITATE  THE  ASSESSMENT,  DIAGNOSIS,

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD02532-03-3
              

A. 6972--A                          2

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
HEALTH  LAW,  which shall provide total benefits in an amount determined
by regulations of the superintendent;

A. 6972--A                          3

  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.