2023 -- S 0965

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LC002697

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     STATE OF RHODE ISLAND

IN GENERAL ASSEMBLY

JANUARY SESSION, A.D. 2023

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A N   A C T

RELATING TO INSURANCE -- THE TELEMEDICINE COVERAGE ACT

     

     Introduced By: Senators LaMountain, and Lauria

     Date Introduced: May 02, 2023

     Referred To: Senate Health & Human Services

     It is enacted by the General Assembly as follows:

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     SECTION 1. Section 27-81-3 of the General Laws in Chapter 27-81 entitled "The

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Telemedicine Coverage Act" is hereby amended to read as follows:

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     27-81-3. Definitions.

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     As used in this chapter:

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     (1) “Clinically appropriate” means care that is delivered in the appropriate medical setting.

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     (2) “Distant site” means a site at which a healthcare provider is located while providing

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healthcare services by means of telemedicine.

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     (3) “Healthcare facility” means an institution providing healthcare services or a healthcare

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setting, including, but not limited to: hospitals and other licensed, inpatient centers; ambulatory

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surgical or treatment centers; skilled nursing centers; residential treatment centers; diagnostic,

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laboratory and imaging centers; and rehabilitation and other therapeutic health settings.

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     (4) “Healthcare professional” means a physician or other healthcare practitioner licensed,

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accredited, or certified to perform specified healthcare services consistent with state law.

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     (5) “Healthcare provider” means a healthcare professional or a healthcare facility.

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     (6) “Healthcare services” means any services included in the furnishing to any individual

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of medical, podiatric, or dental care, or hospitalization, or incident to the furnishing of that care or

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hospitalization, and the furnishing to any person of any and all other services for the purpose of

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preventing, alleviating, curing, or healing human illness, injury, or physical disability.

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     (7) “Health insurer” means any person, firm, or corporation offering and/or insuring

 

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healthcare services on a prepaid basis, including, but not limited to, a nonprofit service corporation,

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a health maintenance organization, the Rhode Island Medicaid program, including its contracted

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managed care entities, or an entity offering a policy of accident and sickness insurance.

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     (8) “Health maintenance organization” means a health maintenance organization as defined

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in chapter 41 of this title.

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     (9) “Medically necessary” means medical, surgical, or other services required for the

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prevention, diagnosis, cure, or treatment of a health-related condition, including services necessary

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to prevent a decremental change in either medical or mental health status.

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     (10) “Nonprofit service corporation” means a nonprofit hospital service corporation as

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defined in chapter 19 of this title, or a nonprofit medical service corporation as defined in chapter

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20 of this title.

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     (11) “Originating site” means a site at which a patient is located at the time healthcare

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services are provided to them by means of telemedicine, which can include a patient’s home where

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medically necessary and clinically appropriate.

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     (12) “Patient-provider relationship” means a collaborative effort between a patient and a

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healthcare professional for the provision of healthcare services that may be established when the

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healthcare professional agrees to undertake diagnosis and treatment of the patient, and the patient

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agrees to be treated, whether or not there is an in-person encounter between the healthcare

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professional and patient. A patient-provider relationship may be established via either synchronous

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or asynchronous telemedicine technologies without any requirement of a prior in-person meeting,

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so long as the standard of care is met.

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     (13) “Policy of accident and sickness insurance” means a policy of accident and sickness

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insurance as defined in chapter 18 of this title.

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     (13)(14) “Rhode Island Medicaid program” means a state-administered, medical assistance

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program that is funded by the state and federal governments under Title XIX and Title XXI of the

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U.S. Social Security Act and any general or public laws and administered by the executive office

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of health and human services.

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     (14)(15) “Store-and-forward technology” means the technology used to enable the

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transmission of a patient’s medical information from an originating site to the healthcare provider

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at the distant site without the patient being present.

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     (15)(16) “Telemedicine” means the delivery of clinical healthcare services by use of real

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time, two-way synchronous audio, video, telephone-audio-only communications or electronic

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media or other telecommunications technology including, but not limited to: online adaptive

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interviews, remote patient monitoring devices, audiovisual communications, including the

 

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application of secure video conferencing or store-and-forward technology to provide or support

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healthcare delivery, which facilitate the assessment, diagnosis, counseling and prescribing

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treatment, and care management of a patient’s health care while such patient is at an originating

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site and the healthcare provider is at a distant site, consistent with applicable federal laws and

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regulations. “Telemedicine” does not include an email message or facsimile transmission between

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the provider and patient, or an automated computer program used to diagnose and/or treat ocular

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or refractive conditions.

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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 -- THE TELEMEDICINE COVERAGE ACT

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     This act would define a patient-provider relationship as when the healthcare professional

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agrees to undertake diagnosis and treatment of the patient and the patient agrees to be treated. This

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act further allows for a relationship to be established without any requirement of a prior in-person

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meeting so long as the standard of care is met.

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     This act would take effect upon passage.

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