Senate Bill S5505

                            
 
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   5505
 
                        2021-2022 Regular Sessions
 
                             I N  S E N A T E
 
                               March 9, 2021
                                ___________
 
 Introduced  by Sens. RIVERA, HARCKHAM -- read twice and ordered printed,
   and when printed to be committed to the Committee on Health
 
 AN ACT to amend the public health law in relation  to  the  delivery  of
   health care services via telehealth
 
   THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section 1. Section 2999-cc of the public  health  law  is  amended  by
 adding a new subdivision 8 to read as follows:
   8.  "HEALTH  CARE  PLAN"  MEANS  AN  ENTITY  (OTHER THAN A HEALTH CARE
 PROVIDER) THAT APPROVES, PROVIDES, ARRANGES FOR, OR PAYS FOR HEALTH CARE
 SERVICES, INCLUDING BUT NOT LIMITED TO:
   (A) A HEALTH MAINTENANCE ORGANIZATION LICENSED  UNDER  ARTICLE  FORTY-
 THREE OF THE INSURANCE LAW;
   (B)  A HEALTH MAINTENANCE ORGANIZATION OR OTHER ORGANIZATION CERTIFIED
 UNDER ARTICLE FORTY-FOUR OF THIS CHAPTER;
   (C) AN INSURER OR CORPORATION SUBJECT TO THE INSURANCE LAW; AND
   (D) THE MEDICAL ASSISTANCE PROGRAM UNDER TITLE ELEVEN OF ARTICLE  FIVE
 OF  THE  SOCIAL SERVICES LAW ("MEDICAID"); THE CHILD HEALTH PLUS PROGRAM
 UNDER TITLE ONE-A OF ARTICLE TWENTY-FIVE OF THIS CHAPTER, AND THE  BASIC
 HEALTH  PROGRAM  UNDER SECTION THREE HUNDRED SIXTY-NINE-GG OF THE SOCIAL
 SERVICES LAW.
   § 2. Section 2999-dd of the public health law, as amended by section 4
 of subpart C of Part S of chapter 57 of the laws of 2018, subdivision  1
 as  amended  by chapter 124 of the laws of 2020, subdivisions 3 and 4 as
 added by chapter 328 of the laws of 2020, 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;
 provided  however,  reimbursement  for  additional  modalities, provider
 categories and originating sites specified in  accordance  with  section
 twenty-nine hundred ninety-nine-ee of this article, and audio-only tele-

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

                                                            LBD09895-01-1

 S. 5505                             2

 phone  communication  defined  in  regulations  promulgated  pursuant to
 subdivision four of section twenty-nine hundred ninety-nine-cc  of  this
 article,  shall be contingent upon federal financial participation.] (A)
 A HEALTH CARE SERVICE MAY BE DELIVERED BY MEANS OF TELEHEALTH BY A TELE-
 HEALTH  PROVIDER  OTHERWISE AUTHORIZED TO PERFORM THAT SERVICE. A HEALTH
 CARE SERVICE DELIVERED BY TELEHEALTH SHALL BE WITH THE  CONSENT  OF  THE
 PATIENT  OR A PERSON AUTHORIZED TO CONSENT FOR THE PATIENT.  THE CONSENT
 SHALL BE DOCUMENTED IN THE PATIENT'S MEDICAL RECORD.
   (B) IN-PERSON CONTACT BETWEEN A  TELEHEALTH  PROVIDER  AND  A  PATIENT
 PRIOR  TO  THE DELIVERY OF HEALTH CARE SERVICES VIA TELEHEALTH SHALL NOT
 BE REQUIRED, UNLESS THE PROVIDER DETERMINES IT TO BE  CLINICALLY  NECES-
 SARY.
   2. (A) A HEALTH CARE PLAN SHALL COVER A SERVICE, REGARDLESS OF WHETHER
 IT IS PROVIDED BY TELEHEALTH,  IF THE SERVICE WOULD OTHERWISE BE COVERED
 BY  THE  HEALTH  CARE PLAN AND  THE PROVIDER IS OTHERWISE COVERED BY THE
 HEALTH CARE PLAN.
   (B) A HEALTH CARE PLAN SHALL REIMBURSE A TREATING OR CONSULTING HEALTH
 CARE PROVIDER FOR HEALTH CARE SERVICES APPROPRIATELY DELIVERED BY  TELE-
 HEALTH  ON THE SAME BASIS, AT THE SAME RATE, AND TO THE SAME EXTENT THAT
 THE HEALTH CARE PLAN REIMBURSES FOR THE SERVICE  WHEN  PROVIDED  THROUGH
 IN-PERSON DIAGNOSIS, CONSULTATION, OR TREATMENT.
   (C)  A  HEALTH  CARE  PLAN  MAY  SUBJECT  THE COVERAGE OF A TELEHEALTH
 SERVICE TO COPAYMENTS, COINSURANCE OR DEDUCTIBLES IF THEY ARE  AT  LEAST
 AS  FAVORABLE  TO  THE  ENROLLEE  AS  WOULD  APPLY IF THE SERVICE IS NOT
 PROVIDED BY TELEHEALTH.
   (D)  THIS ARTICLE DOES NOT ALTER ANY OBLIGATION A HEALTH CARE PLAN MAY
 HAVE TO ENSURE THAT  ENROLLEES  HAVE  ACCESS  TO  ALL  COVERED  SERVICES
 THROUGH AN ADEQUATE NETWORK OF CONTRACTED PROVIDERS.
   (E)  WITH RESPECT TO HEALTH CARE PLANS UNDER PARAGRAPH (D) OF SUBDIVI-
 SION EIGHT OF SECTION 2999-CC OF THIS ARTICLE  (MEDICAID,  CHILD  HEALTH
 PLUS,  AND  THE  BASIC HEALTH PLAN), THIS ARTICLE SHALL ONLY APPLY WHERE
 THERE IS FEDERAL FINANCIAL PARTICIPATION.  THE COMMISSIONER  SHALL  MAKE
 STATE  PLAN  AMENDMENTS  AND SEEK FEDERAL WAIVERS AS NECESSARY TO OBTAIN
 THAT FEDERAL FINANCIAL PARTICIPATION.
   3. The department of health, the office of mental health,  the  office
 of  [alcoholism  and  substance  abuse  services] ADDICTION SERVICES AND
 SUPPORTS, and the office  for  people  with  developmental  disabilities
 shall  coordinate  on  the issuance of a single guidance document, to be
 updated as appropriate, that shall:  (a)  identify  any  differences  in
 regulations  or  policies issued by the agencies, including with respect
 to reimbursement [pursuant to section three hundred sixty-seven-u of the
 social services law]; and (b) be designed to assist  consumers,  provid-
 ers,  and health CARE plans in understanding and facilitating the appro-
 priate use of telehealth in addressing barriers to care.
   [3.] 4. THE AUTHORITY OF  THE  DEPARTMENT  OF  FINANCIAL  SERVICES  TO
 ESTABLISH  AND  ENFORCE MINIMUM STANDARDS FOR ACCIDENT AND HEALTH INSUR-
 ANCE UNDER ARTICLES THIRTY-TWO AND  FORTY-THREE  OF  THE  INSURANCE  LAW
 SHALL  INCLUDE  ENFORCEMENT  OF  TELEHEALTH  STANDARDS SET FORTH IN THIS
 ARTICLE.
   5. (a) Dental telehealth services shall adhere  to  the  standards  of
 appropriate  patient care required in other dental health care settings,
 including but not limited to appropriate patient examination, taking  of
 x-rays, and review of a patient's medical and dental history. All dental
 telehealth  providers  shall  identify themselves to patients, including
 providing the professional's New York state license  number.  No  dental
 telehealth  provider shall attempt to waive liability for its telehealth

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 services in advance of delivering such telehealth services and no dental
 telehealth provider shall attempt to prevent a patient from  filing  any
 complaint with any governmental agency or authority.
   (b)  This  subdivision shall not be construed to diminish requirements
 for other telehealth services.
   [4.] 6. Nothing in this article shall be deemed to allow any person to
 provide any service for which a license, registration, certification  or
 other  authorization  under title eight of the education law is required
 and which the person does not possess.
   § 3. If any provision of this act, or any application of any provision
 of this act, is held to be invalid, or to  violate  or  be  inconsistent
 with  any  federal law or regulation, that shall not affect the validity
 or effectiveness of any other provision of this act,  or  of  any  other
 application  of  any  provision  of  this act, which can be given effect
 without that provision or application; and to that end,  the  provisions
 and applications of this act are severable.
   § 4. This act shall take effect January 1, 2022 and shall apply to all
 policies  and contracts issued, renewed, modified, altered or amended on
 or after such date.  Effective immediately, the commissioner of  health,
 the  superintendent of the department of financial services, the commis-
 sioner of the office of mental health, the commissioner of the office of
 addiction services and supports, and the commissioner of the office  for
 people  with  developmental disabilities shall make regulations and take
 other actions reasonably necessary to implement this act on that date.