S T A T E O F N E W Y O R K
________________________________________________________________________
7852
I N S E N A T E
June 13, 2014
___________
Introduced by Sen. YOUNG -- read twice and ordered printed, and when
printed to be committed to the Committee on Rules
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 TELEMEDICINE OR TELEHEALTH; UNLESS THE TERM IS OTHERWISE
DEFINED WITH RESPECT TO THE PROVISION IN WHICH IT IS USED.
(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, ACTING WITHIN HIS OR HER
SCOPE OF PRACTICE, INCLUDING ANY LAWFUL PRACTICE ENTITY OF SUCH HEALTH
CARE PRACTITIONERS; A HOSPITAL AS DEFINED IN ARTICLE TWENTY-EIGHT OF
THIS CHAPTER; HOME CARE SERVICES AGENCY AS DEFINED IN ARTICLE THIRTY-SIX
OF THIS CHAPTER; OR A HOSPICE AS DEFINED IN ARTICLE FORTY OF THIS CHAP-
TER; UNLESS THE TERM IS OTHERWISE DEFINED BY LAW WITH RESPECT TO THE
PROVISION IN WHICH IT IS USED.
(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 TELEMEDICINE OR TELEHEALTH, UNLESS THE TERM IS
OTHERWISE DEFINED WITH RESPECT TO THE PROVISION IN WHICH IT IS USED.
PROVIDED, HOWEVER, NOTWITHSTANDING ANY OTHER PROVISION OF LAW, INSURERS
AND PROVIDERS MAY AGREE TO ALTERNATIVE SITING ARRANGEMENTS DEEMED APPRO-
PRIATED BY THE PARTIES.
(R) TELEHEALTH. THE TERM "TELEHEALTH" MEANS DELIVERING HEALTH CARE
SERVICES BY MEANS OF INFORMATION AND COMMUNICATIONS TECHNOLOGIES
EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD02532-10-4
S. 7852 2
CONSISTING OF TELEPHONES, REMOTE PATIENT MONITORING DEVICES OR OTHER
ELECTRONIC MEANS WHICH FACILITATE THE ASSESSMENT, DIAGNOSIS, CONSULTA-
TION, 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; CONSISTENT WITH APPLICA-
BLE FEDERAL LAW AND REGULATIONS; UNLESS THE TERM IS OTHERWISE DEFINED BY
LAW WITH RESPECT TO THE PROVISION IN WHICH IT IS USED.
(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, INCLUDING THE APPLICATION OF SECURE VIDEO CONFER-
ENCING OR STORE AND FORWARD TECHNOLOGY TO PROVIDE OR SUPPORT HEALTHCARE
DELIVERY, 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; CONSISTENT WITH APPLICABLE FEDERAL
LAW AND REGULATIONS; UNLESS THE TERM IS OTHERWISE DEFINED BY LAW WITH
RESPECT TO THE PROVISION IN WHICH IT IS USED.
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 COMPREHENSIVE 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 (A) 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 (OTHER THAN ANY ORIGI-
NATING SITE RESTRICTION REQUIREMENTS); OR (B) TELEHEALTH SERVICES, AS
DEFINED IN SECTION TWO OF THE PUBLIC HEALTH LAW, PROVIDED THAT SUCH
SERVICES ARE CONSISTENT WITH SUBDIVISION THREE-C OF SECTION THIRTY-SIX
HUNDRED FOURTEEN OF THE PUBLIC HEALTH LAW. THE PROVIDER OF SUCH SERVICES
SHALL MEET THE TERMS AND CONDITIONS (TO THE EXTENT NOT INCONSISTENT WITH
THIS PARAGRAPH) OF HIS OR HER CONTRACT WITH THE INSURER. 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 COMPREHENSIVE 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 (A) 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
(OTHER THAN ANY ORIGINATING SITE RESTRICTION REQUIREMENTS); OR (B) TELE-
HEALTH SERVICES, AS DEFINED IN SECTION TWO OF THE PUBLIC HEALTH LAW,
PROVIDED THAT SUCH SERVICES ARE CONSISTENT WITH SUBDIVISION THREE-C OF
SECTION THIRTY-SIX HUNDRED FOURTEEN OF THE PUBLIC HEALTH LAW. THE
PROVIDER OF SUCH SERVICES SHALL MEET THE TERMS AND CONDITIONS (TO THE
EXTENT NOT INCONSISTENT WITH THIS PARAGRAPH) OF HIS OR HER CONTRACT WITH
THE INSURER. 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
S. 7852 3
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, OR
TELEHEALTH SERVICES, AS DEFINED BY SECTION TWO OF THE PUBLIC HEALTH LAW,
PROVIDED THAT SUCH SERVICES ARE CONSISTENT WITH SUBDIVISION THREE-C OF
SECTION THIRTY-SIX HUNDRED FOURTEEN OF THE PUBLIC HEALTH LAW. THE
PROVIDER OF SUCH SERVICES SHALL MEET THE TERMS AND CONDITIONS (TO THE
EXTENT NOT INCONSISTENT WITH THIS PARAGRAPH) OF HIS OR HER CONTRACT WITH
THE INSURER, 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 COMPREHENSIVE COVERAGE FOR HOSPITAL, MEDICAL OR SURGICAL CARE
SHALL MAKE AVAILABLE AND, IF REQUESTED BY A CONTRACT HOLDER, PROVIDE
COVERAGE FOR SERVICES WHICH ARE OTHERWISE COVERED UNDER THE POLICY THAT
ARE PROVIDED (1) 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 (OTHER THAN ANY ORIGI-
NATING SITE RESTRICTION REQUIREMENTS); OR (2) TELEHEALTH SERVICES, AS
DEFINED IN SECTION TWO OF THE PUBLIC HEALTH LAW, PROVIDED THAT SUCH
SERVICES ARE CONSISTENT WITH SUBDIVISION THREE-C OF SECTION THIRTY-SIX
HUNDRED FOURTEEN OF THE PUBLIC HEALTH LAW. THE PROVIDER OF SUCH SERVICES
SHALL MEET THE TERMS AND CONDITIONS (TO THE EXTENT NOT INCONSISTENT WITH
THIS SUBSECTION) OF HIS OR HER CONTRACT WITH THE INSURER. 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, AS DEFINED BY SECTION TWO OF THE PUBLIC HEALTH LAW,
THAT ARE, AT A MINIMUM, THOSE REQUIRED TO BE PROVIDED PURSUANT TO SUBDI-
VISION 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.
