Promotes the development, provision and accessibility of telehealth/telemedicine services in New York state; establishes a telehealth/telemedicine development and research grant fund.
TITLE OF BILL: An act to amend the public health law, in relation to promoting the development, provision and accessibility of telehealth/telemedicine services in New York state; and to amend the state finance law, in relation to establishing a New York state telehealth/telemedicine development and research grant fund
PURPOSE: This legislation would enact the "New York State telehealth/telemedicine development act" to coordinate and focus state policy and program planning for telehealth and telemedicine.
SUMMARY OF SPECIFIC PROVISIONS: This legislation would add a new article 27-L to the public health law, creating the "New York State telehealth/telemedicine act."
Section 2799-u establishes a telehealth/telemedicine development program to coordinate and focus state administrative responsibilities and planning efforts relative to telehealth telemedicine. This would involve the submission of an annual plan to the governor and legislature to include necessary recommendations for legislation, regulatory or budgetary support; the identification of barriers to the provision of an access to telehealth/telemedicine; an overview of relevant research being conduction.
The commissioner is also charged with identifying standards from the American Telemedicine Association, the Federal Food and Drug Administration, the public health law, the education law and other generally recognized standard setting or accrediting sources as the commissioner may determine necessary to ensure appropriate safeguards for the use of telehealth/telemedicine services are in place.
Section 2799-v authorizes funding and grants for eligible providers for the development of telehealth/telemedicine services in underserved geographic areas in the state, and where it is determined that the implementation of such telehealth/telemedicine services would improve patient access and quality of care.
Section 2799-w directs the health commissioner to promote and support clinical and programmatic research to develop effective and efficient application of telehealth/telemedicine methods. It also authorizes the commissioner to apply for governmental and philanthropic grants.
This legislation also amends the public health law to provide for the capital reimbursement for telehealth and telemedicine expenditures. It also creates the New York state telehealth/telemedicine development and research grant fund.
JUSTIFICATION: One measure of a community's quality of life is the availability, accessibility and quality of its health care services. The Internet and other electronic technologies have the potential to fundamentally reshape health care service delivery in ways that improve quality of and access to care in a cost-efficient manner. Technology can bring cutting-edge health care to any location, help reduce and prevent medication errors and enhance information about state-of-the-art health care. Large segments of New York's population
in rural and other medically under-served areas have difficulty accessing primary health care and specialty services as well as health education. Providers in these communities are often isolated from mentors, colleagues and information necessary to provide optimal patient care.
The proven potential of telehealth/telemedicine to both provide primary care access to underserved populations, as well as reduce hospitalizations of patients suffering from chronic disease, through the use of home care, warrants an increased focus on the application of such technology in our health care system.
The purpose of this bill is to serve as catalyst to expand and improve telehealth and telemedicine programs in communities across the State, through adoption of a state policy to direct telemedicine/telehealth health services in New York. Through an integrated telecommunications system, patients and providers across the continuum of care can have increased access to medical treatment and state-of the-art health care, as well as educational and professional training opportunities.
Congress has recognized these benefits in authorizing Medicare reimbursement for telemedicine Services. However, the issues are more complex at the state level because each state has the authority to set its own requirements for licensure and credentialing, as well as different rules for insurance and Medicaid programs.
It is well established that New York spends far more on Medicaid expenses than any other state, per capita. The legislature must seek long-term solutions that look to maintain quality of care, while lowering the utilization of non-ambulatory health care services that increase cost borne by our taxpayers. Breaking down the geographic barriers between patients and providers through telecommunications must lie at the heart of this effort.
PRIOR LEGISLATIVE HISTORY: Similar legislation (A.1766-A of 2009) creating a telehealth/telemedicine task force passed the Assembly in 2009. Introduced in 2009 as S.3918. S.652 of 2011-12
FISCAL IMPLICATIONS: To be determined.
EFFECTIVE DATE: Immediately, provided that section three shall take effect the first of April succeeding the date on which this act shall become law.
STATE OF NEW YORK ________________________________________________________________________ 4023 2013-2014 Regular Sessions IN SENATE March 5, 2013 ___________Introduced by Sen. VALESKY -- read twice and ordered printed, and when printed to be committed to the Committee on Health AN ACT to amend the public health law, in relation to promoting the development, provision and accessibility of telehealth/telemedicine services in New York state; and to amend the state finance law, in relation to establishing a New York state telehealth/telemedicine development and research grant fund THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM- BLY, DO ENACT AS FOLLOWS: Section 1. This act shall be known and may be cited as the "New York state telehealth/telemedicine development act." S 2. The public health law is amended by adding a new article 27-L to read as follows: ARTICLE 27-L NEW YORK STATE TELEHEALTH/TELEMEDICINE DEVELOPMENT PROGRAM SECTION 2799-T. LEGISLATIVE INTENT. 2799-U. COORDINATION OF DEPARTMENT RESPONSIBILITIES FOR TELEHEALTH/TELEMEDICINE; ANNUAL PLAN. 2799-V. TELEHEALTH/TELEMEDICINE DEVELOPMENT; GRANTS FOR UNDER- SERVED AREAS AND POPULATIONS. 2799-W. TELEHEALTH/TELEMEDICINE RESEARCH. S 2799-T. LEGISLATIVE INTENT. THE LEGISLATURE RECOGNIZES THE DEMON- STRATED COST-EFFECTIVENESS, IMPROVEMENTS IN DISEASE MANAGEMENT AND IMPROVED PATIENT OUTCOMES RESULTING FROM THE PROVISION OF TELEHEALTH/TELEMEDICINE SERVICES. TELEHEALTH/TELEMEDICINE SERVICES ARE THOSE SERVICES WHICH UTILIZE ELECTRONIC TECHNOLOGY OVER A GEOGRAPHIC DISTANCE BETWEEN PATIENTS AND HEALTH CARE PROVIDERS FOR THE PURPOSES OF ASSESSMENT, MONITORING, INTERVENTION, CLINICAL MANAGEMENT AND/OR EDUCA- TION WITH PATIENTS. STUDIES HAVE CHRONICLED SIGNIFICANT REDUCTIONS IN HOSPITALIZATIONS AND OTHERWISE NECESSARY MEDICAL CARE AS A RESULT OF TELEHEALTH/TELEMEDICINE INTERVENTION. THE LEGISLATURE FURTHER RECOGNIZESEXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets [ ] is old law to be omitted. LBD06551-02-3 S. 4023 2
THAT GEOGRAPHY, WEATHER AND OTHER FACTORS CAN CREATE BARRIERS TO ACCESS- ING APPROPRIATE HEALTH AND MENTAL HEALTH CARE IN NEW YORK STATE AND THAT ONE WAY TO PROVIDE, ENSURE OR ENHANCE ACCESS TO CARE GIVEN THESE BARRIERS IS THROUGH THE APPROPRIATE USE OF TECHNOLOGY TO ALLOW HEALTH CARE CONSUMERS ACCESS TO QUALIFIED HEALTH CARE PROVIDERS AND INSTI- TUTIONS. IN ORDER TO PROMOTE THE ROLE AND CAPACITY OF TELEHEALTH/TELEMEDICINE TECHNOLOGY RELATIVE TO THESE PURPOSES, THE LEGISLATURE HEREBY ENACTS THE NEW YORK STATE TELEHEALTH/TELEMEDICINE DEVELOPMENT ACT TO ESTABLISH A TELEHEALTH/TELEMEDICINE DEVELOPMENT PROGRAM TO COORDINATE AND FOCUS STATE ADMINISTRATIVE RESPONSIBILITIES AS WELL AS STATE POLICY AND PROGRAM PLANNING FOR TELEHEALTH/TELEMEDICINE, PROVIDE FOR TELEHEALTH/TELEMEDICINE DEVELOPMENT IN UNDERSERVED GEOGRAPH- IC AREAS AND FOR NEW POPULATIONS, PROMOTE QUALITY AND SAFEGUARDS IN TELEHEALTH/TELEMEDICINE, PROMOTE AND ASSIST TELEHEALTH/TELEMEDICINE RESEARCH AND EVALUATION, ESTABLISH THE TELEHEALTH/TELEMEDICINE RESEARCH AND DEVELOPMENT FUND, AND PROVIDE FOR CAPITAL FINANCING. S 2799-U. COORDINATION OF DEPARTMENT RESPONSIBILITIES FOR TELEHEALTH/TELEMEDICINE; ANNUAL PLAN. 1. THE COMMISSIONER SHALL COORDI- NATE AND FOCUS THE DEPARTMENT'S DEVELOPMENTAL, ADMINISTRATIVE, RESEARCH AND EVALUATION RESPONSIBILITIES FOR TELEHEALTH/TELEMEDICINE SERVICES. 2. THE COMMISSIONER, IN CONSULTATION WITH ELIGIBLE PROVIDERS AS SPECI- FIED IN SUBDIVISION TWO OF SECTION TWENTY-SEVEN HUNDRED NINETY-NINE-V OF THIS ARTICLE, SHALL PREPARE AND SUBMIT AN ANNUAL PLAN TO SUPPORT THE PROVISION OF TELEHEALTH/TELEMEDICINE SERVICES PROVIDED PURSUANT TO SUBDIVISION THREE-C OF SECTION THIRTY-SIX HUNDRED FOURTEEN OF THIS CHAP- TER, AS WELL AS OTHER TELEHEALTH/TELEMEDICINE SERVICES FOR WHICH THE DEPARTMENT HAS DEVELOPMENTAL AND ADMINISTRATIVE RESPONSIBILITY. THE ANNUAL PLAN SHALL INCLUDE: (A) ANY NECESSARY RECOMMENDATIONS FOR LEGISLATIVE, ADMINISTRATIVE OR BUDGETARY SUPPORT FOR TELEHEALTH/TELEMEDICINE SERVICES; (B) THE IDENTIFICATION OF BARRIERS TO THE PROVISION OF AND ACCESS TO TELEHEALTH/TELEMEDICINE, INCLUDING EDUCATION AND TRAINING FOR BOTH PROVIDERS AND CONSUMERS, ELECTRONIC RECORDS INTERFACE, AND OTHER, AND THE METHODS BY WHICH THE DEPARTMENT WILL AID IN ADDRESSING SUCH BARRI- ERS; AND (C) AN ABSTRACT OF TELEHEALTH/TELEMEDICINE RESEARCH EITHER BEING OR TO BE CONDUCTED BY THE DEPARTMENT, OR FACILITATED BY THE DEPARTMENT AND BEING OR TO BE CONDUCTED BY PROVIDERS OR OTHER ENTITIES. 3. THE COMMISSIONER SHALL PROVIDE COPIES OF THE ANNUAL PLAN TO THE GOVERNOR, THE TEMPORARY PRESIDENT AND MINORITY LEADER OF THE SENATE AND THE SPEAKER AND MINORITY LEADER OF THE ASSEMBLY. 4. (A) THE COMMISSIONER, IN CONSULTATION WITH ELIGIBLE PROVIDERS AS SPECIFIED IN SUBDIVISION TWO OF SECTION TWENTY-SEVEN HUNDRED NINETY-NINE-V OF THIS ARTICLE, SHALL IDENTIFY STANDARDS DETERMINED TO BE NECESSARY FOR TELEHEALTH/TELEMEDICINE SERVICES UNDER THIS ARTICLE. SUCH STANDARDS, INCLUDING STANDARDS FOR THE PROTECTION OF PATIENT INFORMA- TION, SHALL BE IDENTIFIED FROM: (I) THE AMERICAN TELEMEDICINE ASSOCIATION, THE FEDERAL FOOD AND DRUG ADMINISTRATION AND/OR OTHER GENERALLY RECOGNIZED STANDARD-SETTING ORGAN- IZATIONS AS THE COMMISSIONER MAY DETERMINE; (II) TITLE EIGHT OF THE EDUCATION LAW AND REGULATIONS THERETO, THIS CHAPTER AND REGULATIONS THERETO AND, AS APPLICABLE, THE STANDARDS OF RELEVANT PROFESSIONAL OR ACCREDITING BODIES AS THE COMMISSIONER MAY DETERMINE, TO ENSURE THAT TELEHEALTH/TELEMEDICINE MONITORING IS CONDUCTED BY INDIVIDUALS IN ACCORDANCE WITH, AND AS LIMITED BY, THES. 4023 3
APPLICABLE SCOPE OF PRACTICE, LICENSURE AND/OR CREDENTIALING PROVISIONS OF SUCH LAWS AND STANDARDS. (B) THE COMMISSIONER MAY INCORPORATE, WITHIN THE ANNUAL PLAN SUBMITTED PURSUANT TO SUBDIVISION TWO OF THIS SECTION, RECOMMENDATIONS FOR ANY ADDITIONAL STANDARDS OR REQUIREMENTS FOR TELEHEALTH/TELEMEDICINE SERVICES AS MAY BE NECESSARY UNDER THIS ARTICLE. S 2799-V. TELEHEALTH/TELEMEDICINE DEVELOPMENT; GRANTS FOR UNDERSERVED AREAS AND POPULATIONS. 1. SUBJECT TO THE AVAILABILITY OF FUNDING FROM SECTION NINETY-NINE-U OF THE STATE FINANCE LAW, FUNDS MADE AVAILABLE IN THE GENERAL FUND OR ANY OTHER FUNDS MADE AVAILABLE THEREFOR, THE DEPART- MENT SHALL PROVIDE GRANTS TO ELIGIBLE PROVIDERS FOR: (A) THE DEVELOPMENT OF TELEHEALTH/TELEMEDICINE SERVICES IN GEOGRAPHIC AREAS OF THE STATE DEEMED BY THE DEPARTMENT TO BE UNDERSERVED ON THE BASIS OF A LACK OF PROVIDERS PURSUANT TO THIS ARTICLE; (B) THE DEVELOPMENT OF TELEHEALTH/TELEMEDICINE SERVICES IN GEOGRAPHIC AREAS OF THE STATE DEEMED BY THE DEPARTMENT TO BE UNDERSERVED ON THE BASIS OF THE LACK OF TELEHEALTH/TELEMEDICINE SERVICES IN THE AREA; (C) THE DEVELOPMENT OF TELEHEALTH/TELEMEDICINE SERVICES FOR NEW POPU- LATIONS, WHERE EVIDENCE SUGGESTS THE PROVISION OF SUCH SERVICES WOULD FACILITATE THE MANAGEMENT OF PATIENT CARE, ACCESS TO CARE AND/OR COST-EFFECTIVENESS OF CARE; (D) THE DEVELOPMENT OF TELEHEALTH/TELEMEDICINE SERVICES FOR NEW CONDI- TIONS, WHERE EVIDENCE SUGGESTS THE PROVISION OF SUCH SERVICES WOULD FACILITATE THE MANAGEMENT OF SUCH CONDITIONS, ACCESS TO CARE AND/OR COST-EFFECTIVENESS OF CARE; (E) THE DEVELOPMENT OF TELEHEALTH/TELEMEDICINE SERVICES TO EVALUATE THE POTENTIAL BENEFITS OF NEW TELEHEALTH/TELEMEDICINE TECHNOLOGY, FOR PATIENT CARE, ACCESS TO CARE AND/OR COST-EFFECTIVENESS OF CARE; OR (F) SUCH OTHER PURPOSES AS THE DEPARTMENT MAY IDENTIFY. 2. ELIGIBLE PROVIDERS SHALL INCLUDE THOSE LICENSED, CERTIFIED OR AUTHORIZED UNDER ARTICLE TWENTY-EIGHT, THIRTY-SIX OR FORTY OF THIS CHAP- TER OR UNDER SECTION FORTY-FOUR HUNDRED THREE-F OF THIS CHAPTER OR PHYSICIANS LICENSED UNDER ARTICLE ONE HUNDRED THIRTY-ONE OF TITLE EIGHT OF THE EDUCATION LAW; PROVIDED HOWEVER THAT ELIGIBILITY UNDER THIS SECTION TO PROVIDE TELEHEALTH/TELEMEDICINE SERVICES SHALL BE CONSISTENT WITH THE AUTHORITY FOR THE PROVISION OF CARE OTHERWISE PROVIDED PURSUANT TO ARTICLE TWENTY-EIGHT, THIRTY-SIX OR FORTY OF THIS CHAPTER OR UNDER SECTION FORTY-FOUR HUNDRED THREE-F OF THIS CHAPTER OR TITLE EIGHT OF THE EDUCATION LAW. 3. THE DEPARTMENT, IN CONSULTATION WITH ELIGIBLE PROVIDERS AS SPECI- FIED IN SUBDIVISION TWO OF THIS SECTION, SHALL ESTABLISH THE FORMS AND PROCESS FOR THE SUBMISSION AND APPROVAL OF GRANT APPLICATIONS PURSUANT TO THIS SUBDIVISION. S 2799-W. TELEHEALTH/TELEMEDICINE RESEARCH. 1. THE COMMISSIONER SHALL PROMOTE AND SUPPORT CLINICAL AND PROGRAMMATIC RESEARCH BY PROVIDERS AND OTHER ENTITIES TO FURTHER EVALUATE, REFINE AND/OR DEVELOP EFFECTIVE AND EFFICIENT APPLICATION OF TELEHEALTH/TELEMEDICINE METHODS AND TECHNOLOGY TO POPULATIONS, CONDITIONS AND CIRCUMSTANCES. THE COMMISSIONER SHALL MAKE AVAILABLE DATA AND TECHNICAL ASSISTANCE FOR SUCH RESEARCH, PROVIDED THAT ANY DATA MADE AVAILABLE MUST NOT CONTAIN INDIVIDUALLY IDENTIFYING INFORMATION. 2. THE COMMISSIONER IS AUTHORIZED TO APPLY FOR SUCH GOVERNMENTAL, PHILANTHROPIC AND OTHER GRANTS THAT MAY BE AVAILABLE FOR SUCH RESEARCH. MONIES FROM SUCH GRANTS SHALL BE DEPOSITED IN THE NEW YORK STATE TELEHEALTH/TELEMEDICINE DEVELOPMENT AND RESEARCH GRANT FUND ESTABLISHED BY SECTION NINETY-NINE-U OF THE STATE FINANCE LAW.S. 4023 4
3. THE DEPARTMENT SHALL CONSULT WITH ELIGIBLE PROVIDERS, AS SPECIFIED IN SUBDIVISION TWO OF SECTION TWENTY-SEVEN HUNDRED NINETY-NINE-V OF THIS ARTICLE IN THE IMPLEMENTATION OF THIS SECTION. S 3. Section 3614 of the public health law is amended by adding a new subdivision 3-d to read as follows: 3-D. CAPITAL REIMBURSEMENT FOR TELEHEALTH/TELEMEDICINE. THE DEPARTMENT SHALL INCLUDE IN THE REIMBURSEMENT RATES ESTABLISHED PURSUANT TO THIS SECTION A COST ALLOWANCE FOR THE REIMBURSEMENT OF CAPITAL COSTS FOR THE DEVELOPMENT, OPERATION AND PROVISION OF TELEHEALTH/TELEMEDICINE SERVICES, INCLUDING THE LINKAGE OF TELEHEALTH/TELEMEDICINE AND ELECTRON- IC MEDICAL RECORDS. THE METHODOLOGY FOR THE INCLUSION OF THE ALLOWANCE SHALL BE DEVELOPED IN CONSULTATION WITH THE ELIGIBLE PROVIDERS FOR TELEHEALTH/TELEMEDICINE PURSUANT TO SECTION TWENTY-SEVEN HUNDRED NINE- TY-NINE-U OF THIS CHAPTER. S 4. The state finance law is amended by adding a new section 99-u to read as follows: S 99-U. NEW YORK STATE TELEHEALTH/TELEMEDICINE DEVELOPMENT AND RESEARCH GRANT FUND. 1. THERE IS HEREBY ESTABLISHED IN THE JOINT CUSTODY OF THE STATE COMPTROLLER AND COMMISSIONER OF TAXATION AND FINANCE A SPECIAL FUND TO BE KNOWN AS THE "NEW YORK STATE TELEHEALTH/TELEMEDICINE DEVELOPMENT AND RESEARCH FUND". 2. SUCH FUND SHALL CONSIST OF ALL MONIES APPROPRIATED FOR THE PURPOSE OF SUCH FUND AND ANY GRANT, GIFT OR BEQUEST MADE FOR PURPOSES OF DEVEL- OPMENT OR GRANTS FOR TELEHEALTH/TELEMEDICINE SERVICES PURSUANT TO SECTION TWENTY-SEVEN HUNDRED NINETY-NINE-V OF THE PUBLIC HEALTH LAW. 3. MONIES OF THE FUND SHALL BE AVAILABLE TO THE COMMISSIONER OF HEALTH FOR THE PURPOSE OF PROVIDING DEVELOPMENT AND RESEARCH GRANTS FOR TELEHEALTH/TELEMEDICINE PURSUANT TO SECTION TWENTY-SEVEN HUNDRED NINE- TY-NINE-V OF THE PUBLIC HEALTH LAW. 4. THE MONIES OF THE FUND SHALL BE PAID OUT ON THE AUDIT AND WARRANT OF THE COMPTROLLER ON VOUCHERS CERTIFIED OR APPROVED BY THE COMMISSIONER OF HEALTH, OR BY AN OFFICER OR EMPLOYEE OF THE DEPARTMENT OF HEALTH DESIGNATED BY SUCH COMMISSIONER. S 5. This act shall take effect immediately; provided, that section three of this act shall take effect on the first of April next succeed- ing the date on which this act shall have become law; provided further, however, that the commissioner of health shall be authorized to take all necessary steps to implement this section by such date.