Assembly Bill A10500

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

                                  10500

                          I N  A S S E M B L Y

                              May 31, 2016
                               ___________

Introduced  by M. of A. RUSSELL -- read once and referred to the Commit-
  tee on Insurance

AN ACT to amend the public health law and the insurance law, in relation
  to rates of reimbursement for telehealth services

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

  Section 1. Section 2999-dd of the public health law, as added by chap-
ter 6 of the laws of 2015, is amended to read as follows:
  S  2999-dd.  Telehealth  delivery of services. 1. Health care services
delivered by means of telehealth  shall  be  entitled  to  reimbursement
under section three hundred sixty-seven-u of the social services law.
  2.  AN  INSURER  SHALL  REIMBURSE  A  TELEHEALTH  PROVIDER FOR COVERED
SERVICES DELIVERED VIA TELEHEALTH ON THE SAME BASIS AND AT THE SAME RATE
AS ESTABLISHED FOR THE SAME SERVICE WHEN NOT DELIVERED VIA TELEHEALTH.
  S 2. Subsection (a) of section 3217-h of the insurance law,  as  added
by chapter 6 of the laws of 2015, is amended to read as follows:
  (a)  An  insurer  shall  not  exclude  from coverage a service that is
otherwise covered under a policy that  provides  comprehensive  coverage
for  hospital, medical or surgical care because the service is delivered
via telehealth, as that term  is  defined  in  subsection  (b)  of  this
section;  provided, however, that an insurer may exclude from coverage a
service by a health care provider where the provider  is  not  otherwise
covered  under  the  policy.  An  insurer SHALL REIMBURSE THE TELEHEALTH
PROVIDER FOR COVERED SERVICES DELIVERED VIA TELEHEALTH ON THE SAME BASIS
AND AT THE SAME RATE AS ESTABLISHED FOR THE SAME SERVICE WHEN NOT DELIV-
ERED VIA TELEHEALTH; AND may subject the coverage of a service delivered
via telehealth to co-payments, coinsurance or deductibles provided  that
they  are  at least as favorable to the insured as those established for
the same service when not  delivered  via  telehealth.  An  insurer  may
subject the coverage of a service delivered via telehealth to reasonable
utilization  management  and  quality  assurance  requirements  that are
consistent with those established for the same service when  not  deliv-
ered via telehealth.

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD15675-02-6
              

A. 10500                            2

  S  3.  Subsection (a) of section 4306-g of the insurance law, as added
by chapter 6 of the laws of 2015, is amended to read as follows:
  (a)  A  corporation  shall not exclude from coverage a service that is
otherwise covered under a contract that provides comprehensive  coverage
for  hospital, medical or surgical care because the service is delivered
via telehealth, as that term  is  defined  in  subsection  (b)  of  this
section; provided, however, that a corporation may exclude from coverage
a  service by a health care provider where the provider is not otherwise
covered under the contract.   A corporation SHALL  REIMBURSE  THE  TELE-
HEALTH  PROVIDER  FOR  COVERED  SERVICES DELIVERED VIA TELEHEALTH ON THE
SAME BASIS AND AT THE SAME RATE AS ESTABLISHED FOR THE SAME SERVICE WHEN
NOT DELIVERED VIA TELEHEALTH; AND may subject the coverage of a  service
delivered  via  telehealth  to  co-payments,  coinsurance or deductibles
provided that they are at least as favorable to  the  insured  as  those
established  for  the  same service when not delivered via telehealth. A
corporation may subject the coverage of a service  delivered  via  tele-
health  to  reasonable  utilization  management  and  quality  assurance
requirements that are consistent with those  established  for  the  same
service when not delivered via telehealth.
  S  4.  Subdivision  1  of  section 4406-g of the public health law, as
added by chapter 6 of the laws of 2015, is amended to read as follows:
  1. A health maintenance organization shall not exclude from coverage a
service that is otherwise covered under an enrollee contract of a health
maintenance organization because the  service  is  delivered  via  tele-
health,  as  that  term  is  defined in subdivision two of this section;
provided, however, that a health maintenance  organization  may  exclude
from  coverage a service by a health care provider where the provider is
not otherwise covered under the enrollee contract.  A health maintenance
organization  SHALL  REIMBURSE  THE  TELEHEALTH  PROVIDER  FOR   COVERED
SERVICES DELIVERED VIA TELEHEALTH ON THE SAME BASIS AND AT THE SAME RATE
AS  ESTABLISHED  FOR THE SAME SERVICE WHEN NOT DELIVERED VIA TELEHEALTH;
AND may subject the coverage of a service delivered  via  telehealth  to
co-payments,  coinsurance or deductibles provided that they are at least
as favorable to the enrollee as those established for the  same  service
when not delivered via telehealth. A health maintenance organization may
subject the coverage of a service delivered via telehealth to reasonable
utilization  management  and  quality  assurance  requirements  that are
consistent with those established for the same service when  not  deliv-
ered via telehealth.
  S  5.  This  act  shall take effect immediately and shall apply to all
policies and contracts issued, renewed, modified, altered or amended  on
or after January 1, 2016.