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
Equalizing reimbursement for telehealth and in-person care. could encourage more health care providers to offer remote services, potentially improving access for patients in rural areas, those with disabilities, or anyone facing barriers to in-person visits.
By removing financial disincentives for telehealth, patients may experience shorter wait times and increased flexibility in scheduling appointments, which could support better continuity of care and health outcomes.
Insurers can still apply utilization management and quality assurance standards to telehealth services. as long as those standards are consistent with in-person care—meaning cost containment and care quality oversight remain intact while expanding telehealth parity.
This law applies to a broad range of insurance products (private insurers, HMOs, and nonprofit health plans), ensuring wide-reaching impact across the state’s insurance market and potentially setting a precedent for other states considering similar measures.
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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
- Recommit, enacting clause stricken
- Referred to health
Full text
2 pagesUnderlined is new[Struck] is removedOfficial text on nysenate.gov ↗
STATE OF NEW YORK
1043
2019-2020 Regular Sessions
IN SENATE
January 10, 2019
Introduced by Sens. YOUNG, RITCHIE -- 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 Assembly, do enact as follows:
Section 1. Section 2999-dd of the public health law is amended by adding a new subdivision 3 to read as follows:
3. 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 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.
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD03942-01-9
S. 1043 2
§ 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, 2019.
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
2017,2018: S.834-A/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, 2019.
Summaries, headlines and scores are AI-generated from the official bill text. How we score bills. Source: NYS Open Legislation.