S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                    365
 
                        2023-2024 Regular Sessions
 
                           I N  A S S E M B L Y
 
                              January 6, 2023
                                ___________
 
 Introduced  by  M.  of  A. L. ROSENTHAL -- read once and referred to the
   Committee on Insurance
 
 AN ACT to amend the insurance law, the public health law and the  social
   services  law,  in relation to requiring coverage for delivery through
   store and forward technology

   THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND  ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section 1. Legislative findings and declaration. The Legislature here-
 by  finds  that  there is a serious health concern in insurance policies
 denying coverage for contraceptive care. The Legislature also finds that
 throughout the COVID-19 pandemic, telemedicine has  been  essential  for
 patients across the state to receive care safely.
   This  Act  enacts various provisions requiring that insurance policies
 cover services provided  through  telemedicine,  including  requirements
 that  insurers  provide coverage for contraceptive care, that will allow
 patients across the  state  to  receive  care  and  limit  the  risk  of
 infection of COVID-19 throughout the pandemic.
   § 2. Subsection (a) of section 3217-h of the insurance law, as amended
 by  section 3 of part V of chapter 57 of the laws of 2022, is amended to
 read as follows:
   (a) (1) 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, OR  PRESCRIPTION  DRUGS  because
 the  service  is  delivered  via telehealth OR THROUGH STORE AND FORWARD
 TECHNOLOGY, as [that term is] SUCH TERMS ARE 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] AND IN SECTION TWENTY-NINE HUNDRED
 NINETY-NINE-CC OF THE PUBLIC HEALTH LAW.  An  insurer  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
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD01398-02-3
              

 A. 365                              2
 
 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 management and quality assur-
 ance  requirements  that  are  consistent with those established for the
 same service when not delivered via telehealth.
   (2) An insurer that  provides  comprehensive  coverage  for  hospital,
 medical  or  surgical care shall reimburse covered services delivered by
 means of telehealth on the same basis, at the same rate, and to the same
 extent that such services  are  reimbursed  when  delivered  in  person;
 provided that reimbursement of covered services delivered via telehealth
 shall  not  require  reimbursement of costs not actually incurred in the
 provision of the telehealth services, including charges related  to  the
 use  of a clinic or other facility when neither the originating site nor
 distant site occur within the clinic or other facility.
   (3) An insurer that  provides  comprehensive  coverage  for  hospital,
 medical,  or surgical care with a network of health care providers shall
 ensure that such network is adequate to meet  the  telehealth  needs  of
 insured individuals for services covered under the policy when medically
 appropriate.
   § 2-a. Subsection (a) of section 3217-h of the insurance law, as added
 by chapter 6 of the laws of 2015, is amended to read as follows:
   (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, OR PRESCRIPTION DRUGS because
 the service is delivered via telehealth OR  THROUGH  STORE  AND  FORWARD
 TECHNOLOGY,  as  [that term is] SUCH TERMS ARE 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] AND IN SECTION  TWENTY-NINE  HUNDRED
 NINETY-NINE-CC  OF  THE  PUBLIC HEALTH LAW.   An insurer 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
 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 management and  quality  assur-
 ance  requirements  that  are  consistent with those established for the
 same service when not delivered via telehealth.
   § 3. Subsection (i) of section 3216 of the insurance law is amended by
 adding a new paragraph 39 to read as follows:
   (39) EVERY POLICY WHICH PROVIDES COVERAGE FOR PRESCRIPTION DRUGS SHALL
 INCLUDE COVERAGE FOR THE COST OF CONTRACEPTIVE  CARE  DELIVERED  THROUGH
 STORE  AND  FORWARD  TECHNOLOGY  AS  AUTHORIZED  BY  SECTION TWENTY-NINE
 HUNDRED NINETY-NINE-CC OF THE PUBLIC HEALTH LAW.
   § 4. Subsection (l) of section 3221 of the insurance law is amended by
 adding a new paragraph 22 to read as follows:
   (22) EVERY POLICY WHICH PROVIDES COVERAGE FOR PRESCRIPTION DRUGS SHALL
 INCLUDE COVERAGE FOR THE COST OF CONTRACEPTIVE  CARE  DELIVERED  THROUGH
 STORE  AND  FORWARD  TECHNOLOGY  IN  ACCORDANCE WITH SECTION TWENTY-NINE
 HUNDRED NINETY-NINE-CC OF THE PUBLIC HEALTH LAW.
   § 5. Section 4303 of the insurance law is  amended  by  adding  a  new
 subsection (uu) to read as follows:
   (UU)  EVERY  CONTRACT  ISSUED  BY  A HOSPITAL SERVICE CORPORATION OR A
 HEALTH SERVICE CORPORATION  WHICH  PROVIDES  COVERAGE  FOR  PRESCRIPTION
 DRUGS  SHALL  INCLUDE COVERAGE FOR THE COST OF CONTRACEPTIVE CARE DELIV-
 ERED THROUGH STORE AND FORWARD TECHNOLOGY AS THAT  TERM  IS  DEFINED  IN
 SECTION TWENTY-NINE HUNDRED NINETY-NINE-CC OF THE PUBLIC HEALTH LAW.
 A. 365                              3
 
   § 6. Subsection (a) of section 4306-g of the insurance law, as amended
 by  section 4 of part V of chapter 57 of the laws of 2022, is amended to
 read as follows:
   (a)  (1)  A corporation shall not exclude from coverage a service that
 is otherwise covered under a contract that provides comprehensive cover-
 age for hospital,  medical  or  surgical  care,  OR  PRESCRIPTION  DRUGS
 because  the service is delivered via telehealth[,] OR THROUGH STORE AND
 FORWARD  TECHNOLOGY  as  [that  term  is]  SUCH  TERMS  ARE  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] AND IN SECTION
 TWENTY-NINE HUNDRED NINETY-NINE-CC OF THE PUBLIC HEALTH LAW.   A  corpo-
 ration 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. A corporation may subject the cover-
 age 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.
   (2)  A  corporation that provides comprehensive coverage for hospital,
 medical or surgical care shall reimburse covered services  delivered  by
 means of telehealth on the same basis, at the same rate, and to the same
 extent  that  such  services  are  reimbursed  when delivered in person;
 provided that reimbursement of covered services delivered via telehealth
 shall not require reimbursement of costs not actually  incurred  in  the
 provision  of  the telehealth services, including charges related to the
 use of a clinic or other facility when neither the originating site  nor
 the  distant  site occur within the clinic or other facility. The super-
 intendent may promulgate regulations to implement the provisions of this
 section.
   (3) A corporation that provides comprehensive coverage  for  hospital,
 medical,  or surgical care with a network of health care providers shall
 ensure that such network is adequate to meet  the  telehealth  needs  of
 insured individuals for services covered under the policy when medically
 appropriate.
   § 6-a. Subsection (a) of section 4306-g of the insurance law, as added
 by chapter 6 of the laws of 2015, is amended to read as follows:
   (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, OR PRESCRIPTION DRUGS because
 the service is delivered via telehealth[,] OR THROUGH STORE AND  FORWARD
 TECHNOLOGY as [that term is] SUCH TERMS ARE 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] AND IN SECTION TWENTY-NINE HUNDRED
 NINETY-NINE-CC  OF THE PUBLIC HEALTH LAW.  A corporation 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
 insured as those established for the same service when not delivered via
 telehealth.  A  corporation may subject the coverage of a service deliv-
 ered via telehealth to reasonable  utilization  management  and  quality
 assurance  requirements  that  are consistent with those established for
 the same service when not delivered via telehealth.
   § 7. Subdivision 6 of section 2999-cc of the  public  health  law,  as
 added by chapter 6 of the laws of 2015, is amended to read as follows:
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   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]
 FROM an originating site to a telehealth provider at a distant site.
   §  8.  Subdivision  2  of  section 365-a of the social services law is
 amended by adding a new paragraph (kk) to read as follows:
   (KK) CARE AND SERVICES PROVIDED BY A TELEHEALTH PROVIDER  PURSUANT  TO
 SECTION TWENTY-NINE HUNDRED NINETY-NINE-CC OF THE PUBLIC HEALTH LAW.
   §  9. This act shall take effect immediately; provided that the amend-
 ments to subsection (a) of section 3217-h of the insurance law  made  by
 section two of this act shall be subject to the expiration and reversion
 of such subdivision pursuant to section 7 of part V of chapter 57 of the
 laws  of 2022, as amended, when upon such date the provisions of section
 two-a of this act shall take effect; provided, further,  the  amendments
 to subsection (a) of section 4306-g of the insurance law made by section
 six of this act shall be subject to the expiration and reversion of such
 subsection  pursuant to section 7 of part V of chapter 57 of the laws of
 2022, as amended, when upon such date the provisions of section six-a of
 this act shall take effect.