What's happening
This bill requires insurers to reimburse telehealth services at the same rate as in-person services in New York.
Why it matters
Could increase access to care. for rural, disabled, or mobility-limited patients by removing financial disincentives for providers to offer telehealth services, potentially broadening where and how care is delivered.
May encourage more providers to offer telehealth appointments. , since they will be paid the same as for in-person visits, which could help address shortages of certain specialists or reduce long wait times.
Could reduce out-of-pocket costs. for patients if insurers are required to set co-pays and deductibles for telehealth visits at least as favorably as for in-person visits, making virtual care more financially accessible.
Sets a precedent for parity in telehealth reimbursement. , which might influence future regulatory actions in New York or other states, and shape how healthcare adapts to new technologies long-term.
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Who cares
Headline styles
Equal Pay for Telehealth
Plain English, a few words. Used as the page title.
Sponsors
1 Co-sponsor
History
- Print number 834a
- Amend and recommit to health
- Referred to health
- Referred to health
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 Assembly Committee · Insurance · Sponsor Addie Jenne
Full text
2 pagesUnderlined is new[Struck] is removedOfficial text on nysenate.gov ↗
STATE OF NEW YORK
834--A
2017-2018 Regular Sessions
IN SENATE
January 5, 2017
Introduced by Sens. YOUNG, RITCHIE -- read twice and ordered printed, and when printed to be committed to the Committee on Health -- recommitted to the Committee on Health in accordance with Senate Rule 6, sec. 8 -- 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 they are at least as favorable to the insured as those established for
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD06234-04-8
S. 834--A 2
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.
Sponsor's memo
Title of bill
An act to amend the public health law and the insurance law, in relation to rates of reimbursement for telehealth services
Purpose
To ensure telehealth services, especially those that operate in rural areas of New York State where there are healthcare provider shortages, are not disincentivized.
Summary of provisions
Section 1 amends the public health law so that insurers shall reimburse a telehealth provider for covered services via telehealth on the same basis and rate as for services that are not delivered via telehealth.
Section 2 amends the insurance law so that an insurer shall reimburse a telehealth provider for covered services via telehealth on the same basis and rate as for services that are not delivered via telehealth.
Section 3 amends the insurance law so that a corporation shall reimburse a telehealth provider for covered services via telehealth on the same basis and rate as for services that are not delivered via telehealth
Section 4 amends the public health law so that a health maintenance organization shall reimburse a telehealth provider for covered services via telehealth on the same basis and rate as for services that are not delivered via telehealth
Section 5 provides the effective date.
Justification
Although telehealth services have expanded greatly in New York State, ambiguity in the current law has allowed certain insurance companies to interpret a legal obligation to coverage parity exclusively without payment parity. This has resulted in a situation that disincentivizes specialty providers from working to expand telehealth services in parts of the state that need it most. Requiring both coverage and payment parity is a common sense fix to this issue.
Legislative history
2017: S.834/A.1421-A Referred to Health 2016: S.7953/A.10500 Referred to Health
Fiscal implications
To be determined.
Effective date
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.
Summaries, headlines and scores are AI-generated from the official bill text. How we score bills. Source: NYS Open Legislation.