Chapter 188

2016 -- H 7160 SUBSTITUTE B Enacted 06/28/2016

A N   A C T

RELATING TO INSURANCE -- THE TELEMEDICINE COVERAGE ACT

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

Date Introduced: January 14, 2016

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 81

THE TELEMEDICINE COVERAGE ACT

27-81-1. Title. -- This act shall be known as, and may be cited as, the "Telemedicine

Coverage Act".

27-81-2. Purpose. -- The general assembly hereby finds and declares that:

(1) The advancements and continued development of medical and communications

technology have had a profound impact on the practice of medicine and offer opportunities for

improving the delivery, cost, and accessibility of health care, particularly in the area of

telemedicine.

(2) Geography, weather, availability of specialists, transportation, and other factors can

create barriers to accessing the appropriate health care, including behavioral health care, and one

way to provide, ensure, or enhance access to health care given these barriers is through the

appropriate use of technology to allow health-care consumers access to qualified health-care

providers.

(3) There is a need in this state to embrace efforts that will encourage health insurers and

health-care providers to support the use of telemedicine, and that will also encourage all state

agencies to evaluate and amend their policies and rules to remove any regulatory barriers

prohibiting the use of telemedicine services.

27-81-3. Definitions. -- As used in this chapter:

(1) "Distant site" means a site at which a health-care provider is located while providing

health-care services by means of telemedicine.

(2) "Health care facility" means an institution providing health care services or a health

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

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

diagnostic, laboratory and imaging centers,; and rehabilitation and other therapeutic health

settings.

(3) "Health-care professional" means a physician or other health-care practitioner

licensed, accredited, or certified to perform specified health-care services consistent with state

law.

(4) "Health-care provider" means a health-care professional or a health-care facility.

(5) "Health-care services" means any services included in the furnishing to any individual

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

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

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

(6) "Health insurer" means any person, firm, or corporation offering and/or insuring

health care services on a prepaid basis, including, but not limited to, a nonprofit service

corporation, a health-maintenance organization, or an entity offering a policy of accident and

sickness insurance.

(7) "Health-maintenance organization" means a health-maintenance organization as

defined in chapter 41 of this title.

(8) "Nonprofit service corporation" means a nonprofit, hospital-service corporation as

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

chapter 20 of this title.

(9) "Originating site" means a site at which a patient is located at the time health-care

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

medically appropriate; provided, however, notwithstanding any other provision of law, health

insurers and health-care providers may agree to alternative siting arrangements deemed

appropriate by the parties.

(10) "Policy of accident and sickness insurance" means a policy of accident and sickness

insurance as defined in chapter 18 of this title.

(11) "Store-and-forward technology" means the technology used to enable the

transmission of a patient's medical information from an originating site to the health-care provider

at the distant site without the patient being present.

(12) "Telemedicine" means the delivery of clinical health-care services by means of real

time, two-way electronic audiovisual communications, including the application of secure video

conferencing or store-and-forward technology to provide or support health-care delivery, which

facilitate the assessment, diagnosis, treatment, and care management of a patient's health care

while such patient is at an originating site and the health-care provider is at a distant site,

consistent with applicable federal laws and regulations. Telemedicine does not include an audio-

only telephone conversation, email message, or facsimile transmission between the provider and

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

conditions.

27-81-4. Coverage of telemedicine services. -- (a) Each health insurer that issues

individual or group accident-and-sickness insurance policies for health-care services and/or

provides a health-care plan for health-care services shall provide coverage for the cost of such

covered health-care services provided through telemedicine services, as provided in this section.

(b) A health insurer shall not exclude a health-care service for coverage solely because

the health-care service is provided through telemedicine and is not provided through in-person

consultation or contact, so long as such health-care services are medically appropriate to be

provided through telemedicine services and, as such, may be subject to the terms and conditions

of a telemedicine agreement between the insurer and the participating health-care provider or

provider group.

(c) Benefit plans offered by a health insurer may impose a deductible, copayment, or

coinsurance requirement for a health-care service provided through telemedicine.

(d) The requirements of this section shall apply to all policies and health plans issued,

reissued, or delivered in the state of Rhode Island on and after January 1, 2018.

(e) This chapter shall not apply to: short-term travel, accident-only, limited or specified

disease; or individual conversion policies or health plans; nor to policies or health plans designed

for issuance to persons eligible for coverage under Title XVIII of the Social Security Act, known

as Medicare; or any other similar coverage under state or federal governmental plans.

27-81-5. Severability. -- If any provision of this chapter or of any rule or regulation

made under this chapter, or its application to any person or circumstance is held invalid by a court

of competent jurisdiction, the remainder of the chapter, rule, or regulation and the application of

the provision to other persons or circumstances shall not be affected by this invalidity. The

invalidity of any section or sections or parts of any section or sections shall not affect the validity

of the remainder of the chapter.

SECTION 2. This act shall take effect upon passage.

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LC003495/SUB B

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