S T A T E   O F   N E W   Y O R K
________________________________________________________________________

                                  2405

                       2015-2016 Regular Sessions

                            I N  S E N A T E

                            January 23, 2015
                               ___________

Introduced  by  Sen.  YOUNG  -- read twice and ordered printed, and when
  printed to be committed to the Committee on Rules

AN ACT to amend the public health law, the insurance law and the  social
  services  law,  in relation to the telehealth delivery of services; to
  amend chapter 550 of the laws of 2014, amending the public health law,
  the insurance law and the social services law, relating to  the  tele-
  health delivery of services, in relation to the effectiveness thereof;
  and  to  repeal  certain  provisions  of the public health law and the
  insurance law relating thereto

  THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND  ASSEM-
BLY, DO ENACT AS FOLLOWS:

  Section  1.  Paragraphs (o), (p), (q), (r) and (s) of subdivision 1 of
section 2 of the public health law are REPEALED.
  S 2. The public health law is amended by adding a new article 29-G  to
read as follows:
                               ARTICLE 29-G
                      TELEHEALTH DELIVERY OF SERVICES
SECTION 2999-CC. DEFINITIONS.
        2999-DD. TELEHEALTH DELIVERY OF SERVICES.
  S  2999-CC.  DEFINITIONS. AS USED IN THIS ARTICLE, THE FOLLOWING TERMS
SHALL HAVE THE FOLLOWING MEANINGS:
  1. "DISTANT SITE" MEANS A SITE  AT  WHICH  A  TELEHEALTH  PROVIDER  IS
LOCATED WHILE DELIVERING HEALTH CARE SERVICES BY MEANS OF TELEHEALTH.
  2. "TELEHEALTH PROVIDER" MEANS:
  (A) A PHYSICIAN LICENSED PURSUANT TO ARTICLE ONE HUNDRED THIRTY-ONE OF
THE EDUCATION LAW;
  (B)  A  PHYSICIAN  ASSISTANT  LICENSED PURSUANT TO ARTICLE ONE HUNDRED
THIRTY-ONE-B OF THE EDUCATION LAW;
  (C) A DENTIST LICENSED PURSUANT TO ARTICLE ONE HUNDRED THIRTY-THREE OF
THE EDUCATION LAW;

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD08463-01-5

              

S. 2405                             2

  (D) A NURSE PRACTITIONER LICENSED  PURSUANT  TO  ARTICLE  ONE  HUNDRED
THIRTY-NINE OF THE EDUCATION LAW;
  (E)  A  REGISTERED PROFESSIONAL NURSE LICENSED PURSUANT TO ARTICLE ONE
HUNDRED THIRTY-NINE OF THE EDUCATION LAW ONLY WHEN SUCH NURSE IS RECEIV-
ING PATIENT-SPECIFIC HEALTH INFORMATION OR MEDICAL  DATA  AT  A  DISTANT
SITE BY MEANS OF REMOTE PATIENT MONITORING;
  (F) A PODIATRIST LICENSED PURSUANT TO ARTICLE ONE HUNDRED FORTY-ONE OF
THE EDUCATION LAW;
  (G)   AN   OPTOMETRIST   LICENSED  PURSUANT  TO  ARTICLE  ONE  HUNDRED
FORTY-THREE OF THE EDUCATION LAW;
  (H)  A  PSYCHOLOGIST  LICENSED  PURSUANT  TO   ARTICLE   ONE   HUNDRED
FIFTY-THREE OF THE EDUCATION LAW;
  (I)   A  SOCIAL  WORKER  LICENSED  PURSUANT  TO  ARTICLE  ONE  HUNDRED
FIFTY-FOUR OF THE EDUCATION LAW;
  (J) A SPEECH LANGUAGE PATHOLOGIST OR AUDIOLOGIST LICENSED PURSUANT  TO
ARTICLE ONE HUNDRED FIFTY-NINE OF THE EDUCATION LAW;
  (K)  A  MIDWIFE  LICENSED PURSUANT TO ARTICLE ONE HUNDRED FORTY OF THE
EDUCATION LAW;
  (L) A PERSON WHO IS CERTIFIED AS A DIABETES EDUCATOR BY  THE  NATIONAL
CERTIFICATION  BOARD  FOR  DIABETES  EDUCATORS,  OR A SUCCESSOR NATIONAL
CERTIFICATION BOARD, OR PROVIDED BY SUCH A PROFESSIONAL  WHO  IS  AFFIL-
IATED WITH A PROGRAM CERTIFIED BY THE AMERICAN DIABETES ASSOCIATION, THE
AMERICAN  ASSOCIATION OF DIABETES EDUCATORS, THE INDIAN HEALTH SERVICES,
OR ANY OTHER NATIONAL ACCREDITATION ORGANIZATION APPROVED BY THE FEDERAL
CENTERS FOR MEDICARE AND MEDICAID SERVICES;
  (M) A PERSON WHO IS CERTIFIED AS AN ASTHMA EDUCATOR  BY  THE  NATIONAL
ASTHMA  EDUCATOR  CERTIFICATION  BOARD,  OR A SUCCESSOR NATIONAL CERTIF-
ICATION BOARD;
  (N) A PERSON WHO IS CERTIFIED AS A GENETIC COUNSELOR BY  THE  AMERICAN
BOARD  OF  GENETIC  COUNSELING,  OR  A  SUCCESSOR NATIONAL CERTIFICATION
BOARD;
  (O) A HOSPITAL AS DEFINED IN ARTICLE TWENTY-EIGHT OF THIS CHAPTER;
  (P) A HOME CARE SERVICES AGENCY AS DEFINED IN  ARTICLE  THIRTY-SIX  OF
THIS CHAPTER;
  (Q) A HOSPICE AS DEFINED IN ARTICLE FORTY OF THIS CHAPTER; AND
  (R)  ANY  OTHER PROVIDER AS DETERMINED BY THE COMMISSIONER PURSUANT TO
REGULATION.
  3. "ORIGINATING SITE" MEANS A SITE AT WHICH A PATIENT  IS  LOCATED  AT
THE  TIME  HEALTH  CARE SERVICES ARE DELIVERED TO HIM OR HER BY MEANS OF
TELEHEALTH. ORIGINATING SITES SHALL BE LIMITED  TO  FACILITIES  LICENSED
UNDER  ARTICLES  TWENTY-EIGHT  AND  FORTY OF THIS CHAPTER, FACILITIES AS
DEFINED IN SUBDIVISION SIX OF SECTION 1.03 OF THE  MENTAL  HYGIENE  LAW,
PRIVATE  PHYSICIAN'S  OFFICES  LOCATED WITHIN THE STATE OF NEW YORK AND,
WHEN A PATIENT IS RECEIVING HEALTH CARE  SERVICES  BY  MEANS  OF  REMOTE
PATIENT  MONITORING, THE PATIENT'S PLACE OF RESIDENCE LOCATED WITHIN THE
STATE OF NEW YORK OR OTHER TEMPORARY LOCATION LOCATED WITHIN OR  OUTSIDE
THE STATE OF NEW YORK.
  4.  "TELEHEALTH"  MEANS THE USE OF ELECTRONIC INFORMATION AND COMMUNI-
CATION TECHNOLOGIES BY  TELEHEALTH  PROVIDERS  TO  DELIVER  HEALTH  CARE
SERVICES,  WHICH  SHALL INCLUDE THE ASSESSMENT, DIAGNOSIS, CONSULTATION,
TREATMENT,  EDUCATION,  CARE  MANAGEMENT  AND/OR  SELF-MANAGEMENT  OF  A
PATIENT.  TELEHEALTH  SHALL NOT INCLUDE DELIVERY OF HEALTH CARE SERVICES
BY MEANS OF AUDIO-ONLY TELEPHONE COMMUNICATION, FACSIMILE  MACHINES,  OR
ELECTRONIC  MESSAGING  ALONE,  THOUGH  USE  OF THESE TECHNOLOGIES IS NOT
PRECLUDED IF USED IN CONJUNCTION WITH TELEMEDICINE,  STORE  AND  FORWARD
TECHNOLOGY,  OR REMOTE PATIENT MONITORING. FOR PURPOSES OF THIS SECTION,

S. 2405                             3

TELEHEALTH SHALL BE LIMITED TO TELEMEDICINE, STORE AND FORWARD TECHNOLO-
GY, AND REMOTE PATIENT MONITORING. THIS SUBDIVISION SHALL  NOT  PRECLUDE
THE  DELIVERY  OF  HEALTH CARE SERVICES BY MEANS OF "HOME TELEHEALTH" AS
USED IN SECTION THIRTY-SIX HUNDRED FOURTEEN OF THIS CHAPTER.
  5.  "TELEMEDICINE"  MEANS  THE  USE OF SYNCHRONOUS, TWO-WAY ELECTRONIC
AUDIO VISUAL COMMUNICATIONS TO DELIVER CLINICAL  HEALTH  CARE  SERVICES,
WHICH  SHALL  INCLUDE  THE  ASSESSMENT,  DIAGNOSIS,  AND  TREATMENT OF A
PATIENT, WHILE SUCH PATIENT IS AT THE ORIGINATING SITE AND A  TELEHEALTH
PROVIDER IS AT A DISTANT SITE.
  6.  "STORE  AND FORWARD TECHNOLOGY" MEANS THE ASYNCHRONOUS, ELECTRONIC
TRANSMISSION  OF  A  PATIENT'S  HEALTH  INFORMATION  IN  THE   FORM   OF
PATIENT-SPECIFIC  DIGITAL  IMAGES  AND/OR  PRE-RECORDED  VIDEOS  FROM  A
PROVIDER AT AN ORIGINATING SITE TO A TELEHEALTH PROVIDER  AT  A  DISTANT
SITE.
  7.  "REMOTE  PATIENT MONITORING" MEANS THE USE OF SYNCHRONOUS OR ASYN-
CHRONOUS  ELECTRONIC  INFORMATION  AND  COMMUNICATION  TECHNOLOGIES   TO
COLLECT  PERSONAL  HEALTH INFORMATION AND MEDICAL DATA FROM A PATIENT AT
AN ORIGINATING SITE THAT IS TRANSMITTED TO A TELEHEALTH  PROVIDER  AT  A
DISTANT  SITE  FOR USE IN THE TREATMENT AND MANAGEMENT OF MEDICAL CONDI-
TIONS THAT REQUIRE FREQUENT MONITORING. SUCH CONDITIONS  SHALL  INCLUDE,
BUT  NOT  BE  LIMITED  TO,  CONGESTIVE  HEART FAILURE, DIABETES, CHRONIC
OBSTRUCTIVE PULMONARY  DISEASE,  WOUND  CARE,  POLYPHARMACY,  MENTAL  OR
BEHAVIORAL  PROBLEMS,  AND  TECHNOLOGY-DEPENDENT CARE SUCH AS CONTINUOUS
OXYGEN, VENTILATOR CARE, TOTAL PARENTERAL NUTRITION OR ENTERAL  FEEDING.
REMOTE  PATIENT  MONITORING  SHALL  BE  ORDERED  BY A PHYSICIAN LICENSED
PURSUANT TO ARTICLE ONE HUNDRED THIRTY-ONE OF THE EDUCATION LAW, A NURSE
PRACTITIONER LICENSED PURSUANT TO ARTICLE ONE HUNDRED THIRTY-NINE OF THE
EDUCATION LAW, OR A MIDWIFE LICENSED PURSUANT  TO  ARTICLE  ONE  HUNDRED
FORTY OF THE EDUCATION LAW, WITH WHICH THE PATIENT HAS A SUBSTANTIAL AND
ONGOING RELATIONSHIP.
  S  2999-DD.  TELEHEALTH  DELIVERY  OF  SERVICES.  HEALTH CARE SERVICES
DELIVERED BY MEANS OF TELEHEALTH  SHALL  BE  ENTITLED  TO  REIMBURSEMENT
UNDER SECTION THREE HUNDRED SIXTY-SEVEN-U OF THE SOCIAL SERVICES LAW.
  S  3.  Paragraph 30 of subsection (i) of section 3216 of the insurance
law, as added by chapter 550 of the laws of 2014, is REPEALED.
  S 4. The insurance law is amended by adding a new  section  3217-h  to
read as follows:
  S  3217-H.  TELEHEALTH  DELIVERY OF SERVICES. (A) AN INSURER SHALL NOT
EXCLUDE FROM COVERAGE A SERVICE THAT IS OTHERWISE COVERED UNDER A POLICY
THAT PROVIDES COMPREHENSIVE COVERAGE FOR HOSPITAL, MEDICAL  OR  SURGICAL
CARE  BECAUSE  THE  SERVICE IS DELIVERED VIA TELEHEALTH, AS THAT TERM IS
DEFINED IN SUBSECTION (B) OF THIS SECTION; PROVIDED,  HOWEVER,  THAT  AN
INSURER  MAY  EXCLUDE  FROM COVERAGE A SERVICE BY A HEALTH CARE PROVIDER
WHERE THE PROVIDER IS NOT OTHERWISE COVERED UNDER THE POLICY. AN INSURER
MAY SUBJECT THE COVERAGE  OF  A  SERVICE  DELIVERED  VIA  TELEHEALTH  TO
CO-PAYMENTS,  COINSURANCE OR DEDUCTIBLES PROVIDED THAT THEY ARE AT LEAST
AS FAVORABLE TO THE INSURED AS THOSE ESTABLISHED FOR  THE  SAME  SERVICE
WHEN  NOT  DELIVERED VIA TELEHEALTH. AN INSURER MAY SUBJECT THE COVERAGE
OF A SERVICE DELIVERED VIA TELEHEALTH TO REASONABLE UTILIZATION  MANAGE-
MENT  AND  QUALITY ASSURANCE REQUIREMENTS THAT ARE CONSISTENT WITH THOSE
ESTABLISHED FOR THE SAME SERVICE WHEN NOT DELIVERED VIA TELEHEALTH.
  (B) FOR PURPOSES OF THIS SECTION, "TELEHEALTH" MEANS THE USE OF  ELEC-
TRONIC  INFORMATION  AND  COMMUNICATION  TECHNOLOGIES  BY  A HEALTH CARE
PROVIDER TO DELIVER HEALTH CARE SERVICES TO AN INSURED INDIVIDUAL  WHILE
SUCH  INDIVIDUAL  IS  LOCATED  AT A SITE THAT IS DIFFERENT FROM THE SITE
WHERE THE HEALTH CARE PROVIDER IS LOCATED.

S. 2405                             4

  S 5. Paragraph 19 of subsection (k) of section 3221 of  the  insurance
law, as added by chapter 550 of the laws of 2014, is REPEALED.
  S  6.  Paragraph  2 of subsection (a) of section 3229 of the insurance
law, as amended by chapter 550 of the laws of 2014, is amended  to  read
as follows:
  (2)  a  home  care benefit with personal care, nursing care, adult day
health care[,] AND respite care  services,  [telemedicine  services,  as
defined  in  section  two  of  the public health law, provided that such
telemedicine services are pursuant to an agreement  between  a  provider
participating  in  the  insurer's  network and the insurer, and meet the
requirements of federal law, rules  and  regulations  for  Medicare,  or
telehealth services, as defined by section two of the public health law,
provided  that  such services are consistent with subdivision three-c of
section thirty-six hundred  fourteen  of  the  public  health  law.  The
provider  of  such  services shall meet the terms and conditions (to the
extent not inconsistent with this paragraph) of his or her contract with
the insurer,] which shall provide total benefits in an amount determined
by regulations of the superintendent;
  S 7. Subsection (oo) of section 4303 of the insurance law is REPEALED.
  S 8. The insurance law is amended by adding a new  section  4306-g  to
read as follows:
  S 4306-G. TELEHEALTH DELIVERY OF SERVICES. (A) A CORPORATION SHALL NOT
EXCLUDE  FROM  COVERAGE  A  SERVICE  THAT  IS  OTHERWISE COVERED UNDER A
CONTRACT THAT PROVIDES COMPREHENSIVE COVERAGE FOR HOSPITAL,  MEDICAL  OR
SURGICAL  CARE  BECAUSE THE SERVICE IS DELIVERED VIA TELEHEALTH, AS THAT
TERM IS DEFINED IN SUBSECTION (B) OF THIS  SECTION;  PROVIDED,  HOWEVER,
THAT  A CORPORATION MAY EXCLUDE FROM COVERAGE A SERVICE BY A HEALTH CARE
PROVIDER WHERE THE PROVIDER IS NOT OTHERWISE COVERED UNDER THE CONTRACT.
A CORPORATION MAY SUBJECT THE COVERAGE OF A SERVICE DELIVERED VIA  TELE-
HEALTH TO CO-PAYMENTS, COINSURANCE OR DEDUCTIBLES PROVIDED THAT THEY ARE
AT  LEAST  AS FAVORABLE TO THE INSURED AS THOSE ESTABLISHED FOR THE SAME
SERVICE WHEN NOT DELIVERED VIA TELEHEALTH. A CORPORATION MAY SUBJECT THE
COVERAGE OF A SERVICE DELIVERED VIA TELEHEALTH TO REASONABLE UTILIZATION
MANAGEMENT AND QUALITY ASSURANCE REQUIREMENTS THAT ARE  CONSISTENT  WITH
THOSE  ESTABLISHED  FOR  THE  SAME  SERVICE WHEN NOT DELIVERED VIA TELE-
HEALTH.
  (B) FOR PURPOSES OF THIS SECTION, "TELEHEALTH" MEANS THE USE OF  ELEC-
TRONIC  INFORMATION  AND  COMMUNICATION  TECHNOLOGIES  BY  A HEALTH CARE
PROVIDER TO DELIVER HEALTH CARE SERVICES TO AN INSURED INDIVIDUAL  WHILE
SUCH  INDIVIDUAL  IS  LOCATED  AT A SITE THAT IS DIFFERENT FROM THE SITE
WHERE THE HEALTH CARE PROVIDER IS LOCATED.
  S 9. The public health law is amended by adding a new  section  4406-g
to read as follows:
  S  4406-G.  TELEHEALTH  DELIVERY  OF SERVICES. 1. A HEALTH MAINTENANCE
ORGANIZATION SHALL NOT EXCLUDE FROM COVERAGE A SERVICE THAT IS OTHERWISE
COVERED UNDER AN ENROLLEE CONTRACT OF A HEALTH MAINTENANCE  ORGANIZATION
BECAUSE THE SERVICE IS DELIVERED VIA TELEHEALTH, AS THAT TERM IS DEFINED
IN  SUBDIVISION  TWO  OF  THIS SECTION; PROVIDED, HOWEVER, THAT A HEALTH
MAINTENANCE ORGANIZATION MAY EXCLUDE FROM COVERAGE A SERVICE BY A HEALTH
CARE PROVIDER WHERE THE PROVIDER IS  NOT  OTHERWISE  COVERED  UNDER  THE
ENROLLEE  CONTRACT.  A  HEALTH  MAINTENANCE ORGANIZATION MAY SUBJECT THE
COVERAGE OF A SERVICE DELIVERED VIA TELEHEALTH TO  CO-PAYMENTS,  COINSU-
RANCE OR DEDUCTIBLES PROVIDED THAT THEY ARE AT LEAST AS FAVORABLE TO THE
ENROLLEE  AS  THOSE  ESTABLISHED FOR THE SAME SERVICE WHEN NOT DELIVERED
VIA TELEHEALTH. A HEALTH MAINTENANCE ORGANIZATION MAY SUBJECT THE COVER-
AGE OF A SERVICE DELIVERED  VIA  TELEHEALTH  TO  REASONABLE  UTILIZATION

S. 2405                             5

MANAGEMENT  AND  QUALITY ASSURANCE REQUIREMENTS THAT ARE CONSISTENT WITH
THOSE ESTABLISHED FOR THE SAME SERVICE  WHEN  NOT  DELIVERED  VIA  TELE-
HEALTH.
  2.  FOR  PURPOSES OF THIS SECTION, "TELEHEALTH" MEANS THE USE OF ELEC-
TRONIC INFORMATION AND  COMMUNICATION  TECHNOLOGIES  BY  A  HEALTH  CARE
PROVIDER  TO  DELIVER  HEALTH  CARE  SERVICES  TO AN ENROLLEE WHILE SUCH
ENROLLEE IS LOCATED AT A SITE THAT IS DIFFERENT FROM THE SITE WHERE  THE
HEALTH CARE PROVIDER IS LOCATED.
  S  10.  Subdivision  2 of section 367-u of the social services law, as
added by chapter 550 of the laws of 2014, is amended to read as follows:
  2. Subject to FEDERAL FINANCIAL PARTICIPATION AND the approval of  the
director  of  the  budget,  the  commissioner shall not exclude from the
payment of medical assistance funds the [provision] DELIVERY of [medical
care] HEALTH CARE SERVICES through [telemedicine  services]  TELEHEALTH,
as  defined  in  [section  two] SUBDIVISION FOUR OF SECTION TWO THOUSAND
NINE HUNDRED NINETY-NINE-CC of the public  health  law[,  provided  that
such].  SUCH  services SHALL meet the requirements of federal law, rules
and regulations for the provision of medical assistance pursuant to this
title[, and for telehealth services, as defined by section  two  of  the
public health law, that are, at a minimum, those required to be provided
pursuant  to  subdivision three-c of section thirty-six hundred fourteen
of the public health law].
  S 11. Section 7 of chapter 550 of  the  laws  of  2014,  amending  the
public health law, the insurance law and the social services law, relat-
ing  to  the  telehealth  delivery  of  services,  is amended to read as
follows:
  S 7. This act shall take effect January 1, [2015 and  shall  apply  to
all policies and contracts issued, renewed, modified, altered or amended
on or after such date] 2016.
  S  12.  This act shall take effect immediately, provided that sections
one through ten of this act shall take effect on the same  date  and  in
the  same  manner  as  chapter  550  of  the laws of 2014, takes effect,
provided, however, that sections four, eight and nine of this act  shall
apply  to  all policies and contracts issued, renewed, modified, altered
or amended on or after January  1,  2016,  and  provided  further  that,
effective  immediately,  the  commissioner  of  health  is authorized to
issue, amend or repeal any regulations as necessary  to  implement  this
act on or before such effective date.