A02552 Summary:

BILL NOA02552A
 
SAME ASSAME AS S02405
 
SPONSORRussell
 
COSPNSR
 
MLTSPNSR
 
Rpld S2 sub 1 (o) - (s), add Art 29-G SS2999-cc & 2999-dd, S4406-g, Pub Health L; rpld S3216 subS (i) 30, S3221 subS (k) 19, S4303 subS (oo), add SS3217-h & 4306-g, amd S3229, Ins L; amd S367-u, Soc Serv L; amd S7, Chap 550 of 2014
 
Relates to telehealth delivery of services.
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A02552 Actions:

BILL NOA02552A
 
01/16/2015referred to health
01/23/2015amend and recommit to health
01/23/2015print number 2552a
02/03/2015reported
02/05/2015advanced to third reading cal.14
02/09/2015passed assembly
02/09/2015delivered to senate
02/09/2015REFERRED TO RULES
02/25/2015SUBSTITUTED FOR S2405
02/25/2015PASSED SENATE
02/25/2015RETURNED TO ASSEMBLY
03/06/2015delivered to governor
03/13/2015signed chap.6
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A02552 Memo:

NEW YORK STATE ASSEMBLY
MEMORANDUM IN SUPPORT OF LEGISLATION
submitted in accordance with Assembly Rule III, Sec 1(f)
 
BILL NUMBER: A2552A
 
SPONSOR: Russell
  TITLE OF BILL: An act to amend the public health law, the insurance law and the social services law, in relation to the telehealth delivery of services; to amend chapter 550 of the laws of 2014, amending the public health law, the insurance law and the social services law, relat- ing to the telehealth delivery of services, in relation to the effec- tiveness thereof; and to repeal certain provisions of the public health law and the insurance law relating thereto   PURPOSE: To amend provisions in Chapter 550 of 2014.   SUMMARY OF PROVISIONS: This bill provides clarification to telehealth related definitions and insurance provisions related to requiring insurers and Medicaid to provide coverage for the provision of telehealth and telemedicine services. The bill also delays the effective date of Chapter 550 of 2014 until January 1, 2016.   JUSTIFICATION: These changes are necessary in order to allow for effective implementa- tion of Chapter 550 of 2014.   LEGISLATIVE HISTORY: New Bill.   FISCAL IMPLICATIONS: None.   EFFECTIVE DATE: Immediate.
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A02552 Text:



 
                STATE OF NEW YORK
        ________________________________________________________________________
 
                                         2552--A
 
                               2015-2016 Regular Sessions
 
                   IN ASSEMBLY
 
                                    January 16, 2015
                                       ___________
 
        Introduced  by M. of A. RUSSELL -- read once and referred to the Commit-
          tee on Health -- committee discharged, bill amended, ordered reprinted
          as amended and recommitted to said committee
 
        AN ACT to amend the public health law, the insurance law and the  social
          services  law,  in relation to the telehealth delivery of services; to
          amend chapter 550 of the laws of 2014, amending the public health law,
          the insurance law and the social services law, relating to  the  tele-
          health delivery of services, in relation to the effectiveness thereof;
          and  to  repeal  certain  provisions  of the public health law and the
          insurance law relating thereto
 
          The People of the State of New York, represented in Senate and  Assem-
        bly, do enact as follows:
 
     1    Section  1.  Paragraphs (o), (p), (q), (r) and (s) of subdivision 1 of
     2  section 2 of the public health law are REPEALED.
     3    § 2. The public health law is amended by adding a new article 29-G  to
     4  read as follows:
     5                                 ARTICLE 29-G
     6                        TELEHEALTH DELIVERY OF SERVICES
     7  Section 2999-cc. Definitions.
     8          2999-dd. Telehealth delivery of services.
     9    §  2999-cc.  Definitions. As used in this article, the following terms
    10  shall have the following meanings:
    11    1. "Distant site" means a site  at  which  a  telehealth  provider  is
    12  located while delivering health care services by means of telehealth.
    13    2. "Telehealth provider" means:
    14    (a) a physician licensed pursuant to article one hundred thirty-one of
    15  the education law;
    16    (b)  a  physician  assistant  licensed pursuant to article one hundred
    17  thirty-one-B of the education law;
    18    (c) a dentist licensed pursuant to article one hundred thirty-three of
    19  the education law;
 
         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD07659-03-5

        A. 2552--A                          2
 
     1    (d) a nurse practitioner licensed  pursuant  to  article  one  hundred
     2  thirty-nine of the education law;
     3    (e)  a  registered professional nurse licensed pursuant to article one
     4  hundred thirty-nine of the education law only when such nurse is receiv-
     5  ing patient-specific health information or medical  data  at  a  distant
     6  site by means of remote patient monitoring;
     7    (f) a podiatrist licensed pursuant to article one hundred forty-one of
     8  the education law;
     9    (g)  an  optometrist  licensed  pursuant to article one hundred forty-
    10  three of the education law;
    11    (h) a psychologist licensed pursuant to  article  one  hundred  fifty-
    12  three of the education law;
    13    (i)  a  social  worker licensed pursuant to article one hundred fifty-
    14  four of the education law;
    15    (j) a speech language pathologist or audiologist licensed pursuant  to
    16  article one hundred fifty-nine of the education law;
    17    (k)  a  midwife  licensed pursuant to article one hundred forty of the
    18  education law;
    19    (l) a person who is certified as a diabetes educator by  the  National
    20  Certification  Board  for  Diabetes  Educators,  or a successor national
    21  certification board, or provided by such a professional  who  is  affil-
    22  iated with a program certified by the American Diabetes Association, the
    23  American  Association of Diabetes Educators, the Indian Health Services,
    24  or any other national accreditation organization approved by the federal
    25  centers for medicare and medicaid services;
    26    (m) a person who is certified as an asthma educator  by  the  National
    27  Asthma  Educator  Certification  Board,  or a successor national certif-
    28  ication board;
    29    (n) a person who is certified as a genetic counselor by  the  American
    30  Board  of  Genetic  Counseling,  or  a  successor national certification
    31  board;
    32    (o) a hospital as defined in article twenty-eight of this chapter;
    33    (p) a home care services agency as defined in  article  thirty-six  of
    34  this chapter;
    35    (q) a hospice as defined in article forty of this chapter; and
    36    (r)  any  other provider as determined by the commissioner pursuant to
    37  regulation.
    38    3. "Originating site" means a site at which a patient  is  located  at
    39  the  time  health  care services are delivered to him or her by means of
    40  telehealth. Originating sites shall be limited  to  facilities  licensed
    41  under  articles  twenty-eight  and  forty of this chapter, facilities as
    42  defined in subdivision six of section 1.03 of the  mental  hygiene  law,
    43  private  physician's  offices  located within the state of New York and,
    44  when a patient is receiving health care  services  by  means  of  remote
    45  patient  monitoring, the patient's place of residence located within the
    46  state of New York or other temporary location located within or  outside
    47  the state of New York.
    48    4.  "Telehealth"  means the use of electronic information and communi-
    49  cation technologies by  telehealth  providers  to  deliver  health  care
    50  services,  which  shall include the assessment, diagnosis, consultation,
    51  treatment,  education,  care  management  and/or  self-management  of  a
    52  patient.  Telehealth  shall not include delivery of health care services
    53  by means of audio-only telephone communication, facsimile  machines,  or
    54  electronic  messaging  alone,  though  use  of these technologies is not
    55  precluded if used in conjunction with telemedicine,  store  and  forward
    56  technology,  or remote patient monitoring. For purposes of this section,

        A. 2552--A                          3
 
     1  telehealth shall be limited to telemedicine, store and forward technolo-
     2  gy, and remote patient monitoring. This subdivision shall  not  preclude
     3  the  delivery  of  health care services by means of "home telehealth" as
     4  used in section thirty-six hundred fourteen of this chapter.
     5    5.  "Telemedicine"  means  the  use of synchronous, two-way electronic
     6  audio visual communications to deliver clinical  health  care  services,
     7  which  shall  include  the  assessment,  diagnosis,  and  treatment of a
     8  patient, while such patient is at the originating site and a  telehealth
     9  provider is at a distant site.
    10    6.  "Store  and forward technology" means the asynchronous, electronic
    11  transmission of a patient's health information in the form  of  patient-
    12  specific digital images and/or pre-recorded videos from a provider at an
    13  originating site to a telehealth provider at a distant site.
    14    7.  "Remote  patient monitoring" means the use of synchronous or asyn-
    15  chronous  electronic  information  and  communication  technologies   to
    16  collect  personal  health information and medical data from a patient at
    17  an originating site that is transmitted to a telehealth  provider  at  a
    18  distant  site  for use in the treatment and management of medical condi-
    19  tions that require frequent monitoring. Such conditions  shall  include,
    20  but  not  be  limited  to,  congestive  heart failure, diabetes, chronic
    21  obstructive pulmonary  disease,  wound  care,  polypharmacy,  mental  or
    22  behavioral  problems,  and  technology-dependent care such as continuous
    23  oxygen, ventilator care, total parenteral nutrition or enteral  feeding.
    24  Remote  patient  monitoring  shall  be  ordered  by a physician licensed
    25  pursuant to article one hundred thirty-one of the education law, a nurse
    26  practitioner licensed pursuant to article one hundred thirty-nine of the
    27  education law, or a midwife licensed pursuant  to  article  one  hundred
    28  forty of the education law, with which the patient has a substantial and
    29  ongoing relationship.
    30    §  2999-dd.  Telehealth  delivery  of  services.  Health care services
    31  delivered by means of telehealth  shall  be  entitled  to  reimbursement
    32  under section three hundred sixty-seven-u of the social services law.
    33    §  3.  Paragraph 30 of subsection (i) of section 3216 of the insurance
    34  law, as added by chapter 550 of the laws of 2014, is REPEALED.
    35    § 4. The insurance law is amended by adding a new  section  3217-h  to
    36  read as follows:
    37    §  3217-h.  Telehealth  delivery of services. (a) An insurer shall not
    38  exclude from coverage a service that is otherwise covered under a policy
    39  that provides comprehensive coverage for hospital, medical  or  surgical
    40  care  because  the  service is delivered via telehealth, as that term is
    41  defined in subsection (b) of this section; provided,  however,  that  an
    42  insurer  may  exclude  from coverage a service by a health care provider
    43  where the provider is not otherwise covered under the policy. An insurer
    44  may subject the coverage  of  a  service  delivered  via  telehealth  to
    45  co-payments,  coinsurance or deductibles provided that they are at least
    46  as favorable to the insured as those established for  the  same  service
    47  when  not  delivered via telehealth. An insurer may subject the coverage
    48  of a service delivered via telehealth to reasonable utilization  manage-
    49  ment  and  quality assurance requirements that are consistent with those
    50  established for the same service when not delivered via telehealth.
    51    (b) For purposes of this section, "telehealth" means the use of  elec-
    52  tronic  information  and  communication  technologies  by  a health care
    53  provider to deliver health care services to an insured individual  while
    54  such  individual  is  located  at a site that is different from the site
    55  where the health care provider is located.

        A. 2552--A                          4
 
     1    § 5. Paragraph 19 of subsection (k) of section 3221 of  the  insurance
     2  law, as added by chapter 550 of the laws of 2014, is REPEALED.
     3    §  6.  Paragraph  2 of subsection (a) of section 3229 of the insurance
     4  law, as amended by chapter 550 of the laws of 2014, is amended  to  read
     5  as follows:
     6    (2)  a  home  care benefit with personal care, nursing care, adult day
     7  health care[,] and respite care  services,  [telemedicine  services,  as
     8  defined  in  section  two  of  the public health law, provided that such
     9  telemedicine services are pursuant to an agreement  between  a  provider
    10  participating  in  the  insurer's  network and the insurer, and meet the
    11  requirements of federal law, rules  and  regulations  for  Medicare,  or
    12  telehealth services, as defined by section two of the public health law,
    13  provided  that  such services are consistent with subdivision three-c of
    14  section thirty-six hundred  fourteen  of  the  public  health  law.  The
    15  provider  of  such  services shall meet the terms and conditions (to the
    16  extent not inconsistent with this paragraph) of his or her contract with
    17  the insurer,] which shall provide total benefits in an amount determined
    18  by regulations of the superintendent;
    19    § 7. Subsection (oo) of section 4303 of the insurance law is REPEALED.
    20    § 8. The insurance law is amended by adding a new  section  4306-g  to
    21  read as follows:
    22    § 4306-g. Telehealth delivery of services. (a) A corporation shall not
    23  exclude  from  coverage  a  service  that  is  otherwise covered under a
    24  contract that provides comprehensive coverage for hospital,  medical  or
    25  surgical  care  because the service is delivered via telehealth, as that
    26  term is defined in subsection (b) of this  section;  provided,  however,
    27  that  a corporation may exclude from coverage a service by a health care
    28  provider where the provider is not otherwise covered under the contract.
    29  A corporation may subject the coverage of a service delivered via  tele-
    30  health to co-payments, coinsurance or deductibles provided that they are
    31  at  least  as favorable to the insured as those established for the same
    32  service when not delivered via telehealth. A corporation may subject the
    33  coverage of a service delivered via telehealth to reasonable utilization
    34  management and quality assurance requirements that are  consistent  with
    35  those  established  for  the  same  service when not delivered via tele-
    36  health.
    37    (b) For purposes of this section, "telehealth" means the use of  elec-
    38  tronic  information  and  communication  technologies  by  a health care
    39  provider to deliver health care services to an insured individual  while
    40  such  individual  is  located  at a site that is different from the site
    41  where the health care provider is located.
    42    § 9. The public health law is amended by adding a new  section  4406-g
    43  to read as follows:
    44    §  4406-g.  Telehealth  delivery  of services. 1. A health maintenance
    45  organization shall not exclude from coverage a service that is otherwise
    46  covered under an enrollee contract of a health maintenance  organization
    47  because the service is delivered via telehealth, as that term is defined
    48  in  subdivision  two  of  this section; provided, however, that a health
    49  maintenance organization may exclude from coverage a service by a health
    50  care provider where the provider is  not  otherwise  covered  under  the
    51  enrollee  contract.  A  health  maintenance organization may subject the
    52  coverage of a service delivered via telehealth to  co-payments,  coinsu-
    53  rance or deductibles provided that they are at least as favorable to the
    54  enrollee  as  those  established for the same service when not delivered
    55  via telehealth. A health maintenance organization may subject the cover-
    56  age of a service delivered  via  telehealth  to  reasonable  utilization

        A. 2552--A                          5
 
     1  management  and  quality assurance requirements that are consistent with
     2  those established for the same service  when  not  delivered  via  tele-
     3  health.
     4    2.  For  purposes of this section, "telehealth" means the use of elec-
     5  tronic information and  communication  technologies  by  a  health  care
     6  provider  to  deliver  health  care  services  to an enrollee while such
     7  enrollee is located at a site that is different from the site where  the
     8  health care provider is located.
     9    §  10.  Subdivision  2 of section 367-u of the social services law, as
    10  added by chapter 550 of the laws of 2014, is amended to read as follows:
    11    2. Subject to federal financial participation and the approval of  the
    12  director  of  the  budget,  the  commissioner shall not exclude from the
    13  payment of medical assistance funds the [provision] delivery of [medical
    14  care] health care services through [telemedicine  services]  telehealth,
    15  as  defined  in  [section  two] subdivision four of section two thousand
    16  nine hundred ninety-nine-cc of the public  health  law[,  provided  that
    17  such].  Such  services shall meet the requirements of federal law, rules
    18  and regulations for the provision of medical assistance pursuant to this
    19  title[, and for telehealth services, as defined by section  two  of  the
    20  public health law, that are, at a minimum, those required to be provided
    21  pursuant  to  subdivision three-c of section thirty-six hundred fourteen
    22  of the public health law].
    23    § 11. Section 7 of chapter 550 of  the  laws  of  2014,  amending  the
    24  public health law, the insurance law and the social services law, relat-
    25  ing  to  the  telehealth  delivery  of  services,  is amended to read as
    26  follows:
    27    § 7. This act shall take effect January 1, [2015 and  shall  apply  to
    28  all policies and contracts issued, renewed, modified, altered or amended
    29  on or after such date] 2016.
    30    §  12.  This act shall take effect immediately, provided that sections
    31  one through ten of this act shall take effect on the same  date  and  in
    32  the  same  manner  as  chapter  550  of  the laws of 2014, takes effect,
    33  provided, however, that sections four, eight and nine of this act  shall
    34  apply  to  all policies and contracts issued, renewed, modified, altered
    35  or amended on or after January  1,  2016,  and  provided  further  that,
    36  effective  immediately,  the  commissioner  of  health  is authorized to
    37  issue, amend or repeal any regulations as necessary  to  implement  this
    38  act on or before such effective date.
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