The New York State Senate

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

                                  1421

                       2017-2018 Regular Sessions

                          I N  A S S E M B L Y

                            January 12, 2017
                               ___________

Introduced  by M. of A. JENNE -- read once and referred to the Committee
  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:
  §  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.
  § 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

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

                                                           LBD06234-02-7

A. 1421                             2

consistent with those established for the same service when  not  deliv-
ered via telehealth.
  §  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.
  § 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.
  § 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.

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

                                 1421--A

                       2017-2018 Regular Sessions

                          I N  A S S E M B L Y

                            January 12, 2017
                               ___________

Introduced  by M. of A. JENNE -- read once and referred to the Committee
  on Insurance -- committee discharged, bill amended, ordered  reprinted
  as amended and recommitted to said committee

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:
  § 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.
  §  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

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

                                                           LBD06234-03-7

A. 1421--A                          2

utilization management  and  quality  assurance  requirements  that  are
consistent  with  those established for the same service when not deliv-
ered via telehealth.
  §  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.
  § 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.
  § 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, 2017.