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
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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:
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
EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD02532-04-4
S. 4337--B 2
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,
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
S. 4337--B 3
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;
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, 2015 and shall apply to
all policies and contracts issued, renewed, modified, altered or amended
on or after such date.
