What's happening
This bill requires insurers in New York to reimburse telehealth services at the same rate as in-person services.
Why it matters
Expanding access to care. By ensuring telehealth services are reimbursed at the same rate as in-person visits, the bill removes a financial barrier that may have discouraged providers from offering remote care, making it more viable for patients in rural or underserved areas to access needed services.
Promoting parity and fairness. The legislation mandates that insurers, HMOs, and health corporations cannot treat telehealth as a lesser form of care—both in coverage and payment—helping to reduce stigma and positioning telehealth as a legitimate, standard healthcare option.
Potential impact on healthcare costs and utilization. Since telehealth visits will be reimbursed equally, providers may be incentivized to offer more remote visits, potentially increasing overall utilization. While this can improve patient convenience and access, it could also affect insurance premiums and healthcare system costs depending on usage patterns.
Standardizing patient cost-sharing. The bill requires copays, coinsurance, and deductibles for telehealth to be at least as favorable as for in-person services, ensuring patients don’t face higher out-of-pocket expenses for choosing virtual care.
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Who cares
Headline styles
Equal Pay for Telehealth
Plain English, a few words. Used as the page title.
Sponsors
No co-sponsors yet.
History
- Print number 1421b
- Amend and recommit to insurance
- Referred to insurance
- Print number 1421a
- Amend and recommit to insurance
- Referred to insurance
Companion bill
The same bill in the other chamber. A bill becomes law when one version passes both houses and the governor signs it, so either number can carry it.
Equal Pay for Telehealth
In Senate Committee · Health · Sponsor Catharine Young
Full text
2 pagesUnderlined is new[Struck] is removedOfficial text on nysenate.gov ↗
STATE OF NEW YORK
1421--B
2017-2018 Regular Sessions
IN ASSEMBLY
January 12, 2017
Introduced by M. of A. JENNE -- read once and referred to the Committee on Insurance -- committee discharged, bill amended, ordered reprinted as amended and recommitted to said committee -- recommitted to the Committee on Insurance in accordance with Assembly Rule 3, sec. 2 -committee discharged, bill amended, ordered reprinted as amended and recommitted to said committee
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 Assembly, do enact as follows:
Section 1. Section 2999-dd of the public health law, as added by chapter 6 of the laws of 2015, 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.
2. An insurer shall reimburse a telehealth provider for covered services delivered via telehealth on the same basis and at the same rate as established for the same service when not delivered via telehealth.
§ 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) 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 shall reimburse the telehealth provider for covered services delivered via telehealth on the same basis and at the same rate as established for the same service when not delivered via telehealth; and may subject the coverage of a service delivered via telehealth to co-payments, coinsurance or deductibles provided that
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD06234-05-8
A. 1421--B 2
they are at least as favorable to the insured as those established for the same service when not delivered via telehealth. An insurer may subject the coverage of a service delivered via telehealth to reasonable utilization management and quality assurance requirements that are consistent with those established for the same service when not delivered via telehealth.
§ 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) A corporation shall not exclude from coverage a service that is otherwise covered under a contract 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 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 shall reimburse the telehealth provider for covered services delivered via telehealth on the same basis and at the same rate as established for the same service when not delivered via telehealth; and may subject the coverage of a service delivered via telehealth to co-payments, coinsurance or deductibles provided that they are at least as favorable to the insured as those established for the same service when not delivered via telehealth. A corporation may subject the coverage of a service delivered via telehealth to reasonable utilization management and quality assurance requirements that are consistent with those established for the same service when not delivered via telehealth.
§ 4. Subdivision 1 of section 4406-g of the public health law, as added by chapter 6 of the laws of 2015, is amended to read as follows:
1. A health maintenance organization shall not exclude from coverage a service that is otherwise covered under an enrollee contract of a health maintenance organization because the service is delivered via telehealth, as that term is defined in subdivision two of this section; provided, however, that a health maintenance organization may exclude from coverage a service by a health care provider where the provider is not otherwise covered under the enrollee contract. A health maintenance organization shall reimburse the telehealth provider for covered services delivered via telehealth on the same basis and at the same rate as established for the same service when not delivered via telehealth; and may subject the coverage of a service delivered via telehealth to co-payments, coinsurance or deductibles provided that they are at least as favorable to the enrollee as those established for the same service when not delivered via telehealth. A health maintenance organization may subject the coverage of a service delivered via telehealth to reasonable utilization management and quality assurance requirements that are consistent with those established for the same service when not delivered via telehealth.
§ 5. This act shall take effect immediately and shall apply to all policies and contracts issued, renewed, modified, altered or amended on or after January 1, 2018.
Reflowed for reading: line numbers and page breaks removed. Cite the official text.
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