2014 -- H 7717

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LC004345

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     STATE OF RHODE ISLAND

IN GENERAL ASSEMBLY

JANUARY SESSION, A.D. 2014

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A N   A C T

     RELATING TO INSURANCE -- USE OF TELEMEDICINE HEALTHCARE

MODERNIZATION ACT

     Introduced By: Representatives Kennedy, Naughton, Johnston, Keable, and Kazarian

     Date Introduced: February 27, 2014

     Referred To: House Corporations

     It is enacted by the General Assembly as follows:

     SECTION 1. Title 27 of the General Laws entitled "INSURANCE" is hereby amended

by adding thereto the following chapter:

CHAPTER 18.8

TELEMEDICINE HEALTHCARE MODERNIZATION ACT

     27-18.8-1. Definition. -- "Telemedicine" means the use of synchronous video

conferencing, remote patient monitoring, and asynchronous health images, or other health

transmissions supported by mobile devices (mHealth) or other telecommunications technology by

a healthcare provider to deliver healthcare services at a site other than the site where the provider

is located relating to the healthcare diagnosis or treatment of a patient.

     27-18.8-2. Private coverage. -- Health insurers, healthcare subscription plans, and health

maintenance organizations shall provide coverage for the cost of telemedicine services when the

services are appropriately provided through such means. A health plan offered to employees and

their covered dependents under chapters 18, 19, 20 and 41 of this title may not deny coverage on

the basis that the coverage is provided through telemedicine if the healthcare service would be

covered were it provided through in-person consultation between the covered person and a

healthcare provider.

     27-18.8-3. Utilization review. -- Decisions denying coverage of services provided via

telemedicine shall be subject to utilization review procedures.

     27-18.8-4. Exceptions. -- The requirements of this chapter shall apply to all insurance

policies, contracts, and plans delivered, issued for delivery, reissued, or at any time thereafter

when any term of the policy, contract, or plan is changed or any premium adjustment is made.

This chapter does not apply to short-term travel, accident-only, limited or specified disease, or

individual conversion policies or contracts, or to policies or contracts designed for issuance to

persons eligible for coverage under Medicare, or any other similar coverage under state or federal

governmental plans.

     27-18.8-5. Medicaid. -- The state's Medicaid plan shall not deny coverage on the basis

that coverage is provided through telemedicine if the healthcare service would be covered were it

provided through in-person consultation between the recipient and a healthcare provider.

Coverage for healthcare services provided through telemedicine must be determined in a manner

consistent with coverage for healthcare services provided through in-person consultation.

Specifically included is statewide coverage, services originating from a recipients home or

wherever else they may be, all health professionals are authorized to provide services by a

telehealth method to the extent otherwise covered in the state's plan, and timely asynchronous

telehealth services.

     27-18.8-6. Health home. -- The department of health shall require by December 31, 2014

a statewide medical assistance benefit of a health home for individuals with chronic conditions

(defined under 42 U.S.C. 1396a).

     27-18.8-7. Reporting. -- The department of health shall lead an interagency study and

report to the general assembly within twelve (12) months on comprehensive plans that include

telehealth services and multi-payer coverage, and reimbursement for stroke diagnosis, high-risk

pregnancies and premature births, and emergency services.

     27-18.8-8. Professional licensing. -- The state's health professional licensing boards shall

modify, as necessary, requirements for telemedicine provided practices to be the same as for in-

person practices, and to allow a professional to consult with an out-of-state peer professional,

such as a sub-specialist, without the need for an additional state license.

     SECTION 2. This act shall take effect upon passage.

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EXPLANATION

BY THE LEGISLATIVE COUNCIL

OF

A N   A C T

     RELATING TO INSURANCE -- USE OF TELEMEDICINE HEALTHCARE

MODERNIZATION ACT

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     This act would authorize the provision of healthcare services by "telemedicine", as

therein defined, on the same basis as face-to-face consultation, where appropriate, and require

healthcare insurers to adjust their coverage protocols accordingly.

     This act would take effect upon passage.

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