2015 -- H 5177

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LC000529

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     STATE OF RHODE ISLAND

IN GENERAL ASSEMBLY

JANUARY SESSION, A.D. 2015

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A N   A C T

     RELATING TO INSURANCE -- USE OF TELEMEDICINE HEALTHCARE

MODERNIZATION ACT

     

     Introduced By: Representatives Kennedy, Shekarchi, Marshall, Azzinaro, and Keable

     Date Introduced: January 21, 2015

     Referred To: House Corporations

     It is enacted by the General Assembly as follows:

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

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by adding thereto the following chapter:

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CHAPTER 18.8

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TELEMEDICINE HEALTHCARE MODERNIZATION ACT

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

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

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

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

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

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

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

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

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

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

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

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healthcare provider.

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

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telemedicine shall be subject to utilization review procedures.

 

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

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

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

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

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

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

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governmental plans.

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

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

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

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

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

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

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

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

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telehealth services.

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     27-18.8-6. Health home. -- The department of health shall require by December 31, 2015

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

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

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

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

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

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pregnancies and premature births, and emergency services.

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

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

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

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

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     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

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

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healthcare insurers to adjust their coverage protocols accordingly.

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     This act would take effect upon passage.

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