S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   3526
 
                        2023-2024 Regular Sessions
 
                             I N  S E N A T E
 
                             January 31, 2023
                                ___________
 
 Introduced by Sen. FERNANDEZ -- read twice and ordered printed, and when
   printed to be committed to the Committee on Health
 
 AN ACT to amend the public health law and the insurance law, in relation
   to requiring services provided by telehealth be 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.
                                                            LBD08235-02-3
 S. 3526                             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; provided, however,
 section two of this act shall take effect on the same date as the rever-
 sion of subsection (a)  of  section  3217-h  of  the  insurance  law  as
 provided  in  section  7 of part V of chapter 57 of the laws of 2022, as
 amended; and provided, further, that section three  of  this  act  shall
 take  effect  on  the  same  date  as the reversion of subsection (a) of
 section 4306-g of the insurance law as provided in section 7 of  part  V
 of chapter 57 of the laws of 2022, as amended.