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S07953 Summary:

BILL NOS07953
 
SAME ASSAME AS A10500
 
SPONSORYOUNG
 
COSPNSRRITCHIE
 
MLTSPNSR
 
Amd §§2999-dd & 4406-g, Pub Health L; amd §§3217-h & 4306-g, Ins L
 
Relates to rates of reimbursement for telehealth services; requires insurers to reimburse telehealth providers at the same rate as they would if the services had been provided in person.
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S07953 Text:



 
                STATE OF NEW YORK
        ________________________________________________________________________
 
                                          7953
 
                    IN SENATE
 
                                      May 31, 2016
                                       ___________
 
        Introduced  by  Sen.  YOUNG  -- 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 rates of reimbursement for telehealth services
 
          The People of the State of New York, represented in Senate and  Assem-
        bly, do enact as follows:

     1    Section 1. Section 2999-dd of the public health law, as added by chap-
     2  ter 6 of the laws of 2015, is amended to read as follows:
     3    §  2999-dd.  Telehealth  delivery of services. 1. Health care services
     4  delivered by means of telehealth  shall  be  entitled  to  reimbursement
     5  under section three hundred sixty-seven-u of the social services law.
     6    2.  An  insurer  shall  reimburse  a  telehealth  provider for covered
     7  services delivered via telehealth on the same basis and at the same rate
     8  as established for the same service when not delivered via telehealth.
     9    § 2. Subsection (a) of section 3217-h of the insurance law,  as  added
    10  by chapter 6 of the laws of 2015, is amended to read as follows:
    11    (a)  An  insurer  shall  not  exclude  from coverage a service that is
    12  otherwise covered under a policy that  provides  comprehensive  coverage
    13  for  hospital, medical or surgical care because the service is delivered
    14  via telehealth, as that term  is  defined  in  subsection  (b)  of  this
    15  section;  provided, however, that an insurer may exclude from coverage a
    16  service by a health care provider where the provider  is  not  otherwise
    17  covered  under  the  policy.  An  insurer shall reimburse the telehealth
    18  provider for covered services delivered via telehealth on the same basis
    19  and at the same rate as established for the same service when not deliv-
    20  ered via telehealth; and may subject the coverage of a service delivered
    21  via telehealth to co-payments, coinsurance or deductibles provided  that
    22  they  are  at least as favorable to the insured as those established for
    23  the same service when not  delivered  via  telehealth.  An  insurer  may
    24  subject the coverage of a service delivered via telehealth to reasonable
    25  utilization  management  and  quality  assurance  requirements  that are
    26  consistent with those established for the same service when  not  deliv-
    27  ered via telehealth.
 
         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD15675-02-6

        S. 7953                             2
 
     1    §  3.  Subsection (a) of section 4306-g of the insurance law, as added
     2  by chapter 6 of the laws of 2015, is amended to read as follows:
     3    (a)  A  corporation  shall not exclude from coverage a service that is
     4  otherwise covered under a contract that provides comprehensive  coverage
     5  for  hospital, medical or surgical care because the service is delivered
     6  via telehealth, as that term  is  defined  in  subsection  (b)  of  this
     7  section; provided, however, that a corporation may exclude from coverage
     8  a  service by a health care provider where the provider is not otherwise
     9  covered under the contract.   A corporation shall  reimburse  the  tele-
    10  health  provider  for  covered  services delivered via telehealth on the
    11  same basis and at the same rate as established for the same service when
    12  not delivered via telehealth; and may subject the coverage of a  service
    13  delivered  via  telehealth  to  co-payments,  coinsurance or deductibles
    14  provided that they are at least as favorable to  the  insured  as  those
    15  established  for  the  same service when not delivered via telehealth. A
    16  corporation may subject the coverage of a service  delivered  via  tele-
    17  health  to  reasonable  utilization  management  and  quality  assurance
    18  requirements that are consistent with those  established  for  the  same
    19  service when not delivered via telehealth.
    20    §  4.  Subdivision  1  of  section 4406-g of the public health law, as
    21  added by chapter 6 of the laws of 2015, is amended to read as follows:
    22    1. A health maintenance organization shall not exclude from coverage a
    23  service that is otherwise covered under an enrollee contract of a health
    24  maintenance organization because the  service  is  delivered  via  tele-
    25  health,  as  that  term  is  defined in subdivision two of this section;
    26  provided, however, that a health maintenance  organization  may  exclude
    27  from  coverage a service by a health care provider where the provider is
    28  not otherwise covered under the enrollee contract.  A health maintenance
    29  organization  shall  reimburse  the  telehealth  provider  for   covered
    30  services delivered via telehealth on the same basis and at the same rate
    31  as  established  for the same service when not delivered via telehealth;
    32  and may subject the coverage of a service delivered  via  telehealth  to
    33  co-payments,  coinsurance or deductibles provided that they are at least
    34  as favorable to the enrollee as those established for the  same  service
    35  when not delivered via telehealth. A health maintenance organization may
    36  subject the coverage of a service delivered via telehealth to reasonable
    37  utilization  management  and  quality  assurance  requirements  that are
    38  consistent with those established for the same service when  not  deliv-
    39  ered via telehealth.
    40    §  5.  This  act  shall take effect immediately and shall apply to all
    41  policies and contracts issued, renewed, modified, altered or amended  on
    42  or after January 1, 2016.
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