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 Assem- bly, do enact as follows: 1 Section 1. Section 2999-dd of the public health law is amended by 2 adding a new subdivision 3 to read as follows: 3 3. An insurer shall reimburse a telehealth provider for covered 4 services delivered via telehealth on the same basis and at the same rate 5 as established for the same service when not delivered via telehealth. 6 § 2. Subsection (a) of section 3217-h of the insurance law, as added 7 by chapter 6 of the laws of 2015, is amended to read as follows: 8 (a) An insurer shall not exclude from coverage a service that is 9 otherwise covered under a policy that provides comprehensive coverage 10 for hospital, medical or surgical care because the service is delivered 11 via telehealth, as that term is defined in subsection (b) of this 12 section; provided, however, that an insurer may exclude from coverage a 13 service by a health care provider where the provider is not otherwise 14 covered under the policy. An insurer shall reimburse the telehealth 15 provider for covered services delivered via telehealth on the same basis 16 and at the same rate as established for the same service when not deliv- 17 ered via telehealth; and may subject the coverage of a service delivered 18 via telehealth to co-payments, coinsurance or deductibles provided that 19 they are at least as favorable to the insured as those established for 20 the same service when not delivered via telehealth. An insurer may 21 subject the coverage of a service delivered via telehealth to reasonable 22 utilization management and quality assurance requirements that are 23 consistent with those established for the same service when not deliv- 24 ered via telehealth. EXPLANATION--Matter in italics (underscored) is new; matter in brackets [ ] is old law to be omitted. LBD03942-01-9

S. 1043 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, 2019.

Relates to rates of reimbursement for telehealth services

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