S T A T E O F N E W Y O R K
________________________________________________________________________
4839
2021-2022 Regular Sessions
I N A S S E M B L Y
February 8, 2021
___________
Introduced by M. of A. GUNTHER -- read once and referred to the Commit-
tee on Health
AN ACT to amend the public health law and the insurance law, in relation
to requiring services provided by telehealth reimbursed at the same
rate as an in-office visit
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 is amended by
adding a new subdivision 5 to read as follows:
5. NOTWITHSTANDING ANY PROVISION OF LAW TO THE CONTRARY AND PURSUANT
TO REGULATIONS PROMULGATED BY THE COMMISSIONER, TELEHEALTH SERVICES, AS
DEFINED BY SECTION TWENTY-NINE HUNDRED NINETY-NINE-CC OF THIS ARTICLE
AND ALL REGULATIONS PROMULGATED THEREUNDER, INCLUDING ANY ADDITIONAL
PROVIDER CATEGORIES AND ORIGINATING SITES SPECIFIED IN ACCORDANCE WITH
SECTION TWENTY-NINE HUNDRED NINETY-NINE-EE OF THIS ARTICLE, SHALL BE
REIMBURSED AT THE SAME RATE AS AN IN-OFFICE VISIT.
§ 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) (1) 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 may subject the coverage of a
service delivered via telehealth to co-payments, coinsurance or deduct-
ibles provided that they are at least as favorable to the insured as
those established for the same service when not delivered via tele-
health. An insurer may subject the coverage of a service delivered via
telehealth to reasonable utilization management and quality assurance
EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD02942-02-1
A. 4839 2
requirements that are consistent with those established for the same
service when not delivered via telehealth.
(2) AN INSURER SHALL REIMBURSE FOR A SERVICE THAT IS OTHERWISE COVERED
UNDER A POLICY THAT PROVIDES COMPREHENSIVE COVERAGE FOR HOSPITAL,
MEDICAL OR SURGICAL CARE AND IS DELIVERED VIA TELEHEALTH, AS THAT TERM
IS DEFINED IN SUBSECTION (B) OF THIS SECTION, ON THE SAME BASIS AND AT
THE SAME RATE AS THE INSURER WOULD APPLY TO THOSE SERVICES IF THE
SERVICES HAD BEEN DELIVERED IN PERSON.
§ 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) (1) A corporation shall not exclude from coverage a service that
is otherwise covered under a contract that provides comprehensive cover-
age for hospital, medical or surgical care because the service is deliv-
ered 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 may subject the coverage of a
service delivered via telehealth to co-payments, coinsurance or deduct-
ibles provided that they are at least as favorable to the insured as
those established for the same service when not delivered via tele-
health. A corporation may subject the coverage of a service delivered
via telehealth to reasonable utilization management and quality assur-
ance requirements that are consistent with those established for the
same service when not delivered via telehealth.
(2) A CORPORATION SHALL REIMBURSE FOR A SERVICE THAT IS OTHERWISE
COVERED UNDER A POLICY THAT PROVIDES COMPREHENSIVE COVERAGE FOR HOSPI-
TAL, MEDICAL OR SURGICAL CARE AND IS DELIVERED VIA TELEHEALTH, AS THAT
TERM IS DEFINED IN SUBSECTION (B) OF THIS SECTION, ON THE SAME BASIS AND
AT THE SAME RATE AS THE INSURER WOULD APPLY TO THOSE SERVICES IF THE
SERVICES HAD BEEN DELIVERED IN PERSON.
§ 4. This act shall take effect immediately.