Removes originating site restriction requirements for the purposes of administering telehealth and/or telemedicine services

Summary of provisions

Section 1 amends paragraphs (r) and (s) of subdivision 1 of § 2 of the public health law to include mental health care services in the definitions of telehelath and telemedicine services and require such services be granted when necessary to patients.

Section 2 amends paragraph 30 of subsection (i) of § 3216 of the insurance law to require every insurance policy delivered or issued in this state to provide comprehensive coverage of telemedicine or telehealth services and removes originating site restrictions on such coverage.

Section 3 amends paragraph 19 of subsection (k) of § 3221 of the insurance law to remove any originating site restriction requirements and provides that telemedicine or telehealth services are to be covered in a manner consisted with those established for the same services when not provided via telemedicine or telehealth.

Section 4 amends subsection (oo) of § 4303 of the insurance law to remove any originating site restriction requirements.

Section 5 amends paragraph (d) of subdivision 1 of § 2805-u of the public health law to include mental health care at outpatient clinics or OASAS outpatient clinics as a component of telemedicine, irrespective of originating site and distant site disparities.

Section 6 provides the effective date.

Existing law

Existing law defines telehealth and telemedicine as the delivery of health care services by means of information and communications technologies consisting of telephones, remote patient motoring devices or other electronic means which facilitate the assessment, diagnosis, consultation, treatment, education, care management, and self management of a patient's health care which such patient is at the originating site and the health care provider is at a distant site. This definition does not include mental health care services, nor does it require that these services be offered by service providers or covered by insurers. Additionally, the existing law provides that telemedicine and telehealth services are only provided when a patient is at an originating site and the health care provider is at a distant site, as defined by the statute.

Justification

In 2014 the Public Health Law and the Insurance Law were amended to include the delivery of telemedicine and telehealth services in New York State. These programs provide health care services through information and communications technologies consisting of telephones, remote patient monitoring devices or other electronic means which facilitate the assessment, diagnosis, consultation, treatment, education, care management, and self management of a patient's health care. The statute also requires insurers and medical assistance for needy persons that deliver or issue policies providing comprehensive coverage for hospital, medical, or surgical care, shall make available, and if requested by a policy holder, provide coverage which are otherwise covered under the policy that are provided via telemedicine, or telehealth services.

While the objectives and effects of this legislation are certainly laudable and invaluable to those patients requiring telemedicine or telehealth services, this statute fails to contemplate mental health care and outpatient clinic services. Furthermore, these services are subject to originating site restriction requirements. This legislation seeks to remedy these issues by authorizing the delivery and coverage of mental health care and outpatient clinic services and removes originating site restriction requirements.

Rural communities are significant beneficiaries of telemedicine and telehealth services. Adding mental health outpatient and OASAS clinics to the scope of services provided through telehealth and telemedicine would have a major impact on thousands of cases. In the North Country, clinicians can be as far as three hours away. Providing these services through the mechanisms authorized by telehealth and telemedicine would greatly reduce these patients' costs. Treatment is also more effective and successful when rendered consistently. By including mental health care at outpatient clinics and OASAS outpatient clinics within the purview of telemedicine and telelhealth services the patients requiring those services, that may be inhibited by distance, have the opportunity to receive the services they need and consequently increase their likelihood of successful management or recovery. For all of these reasons it is imperative that this bill is enacted.

Legislative history

New bill.

Fiscal implications

To be determined.

Effective date

This act shall take effect on the sixtieth day after it shall have become a law.