S T A T E   O F   N E W   Y O R K
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                                 9129--A

                          I N  A S S E M B L Y

                             March 19, 2014
                               ___________

Introduced  by M. of A. RUSSELL, SANTABARBARA, STIRPE, ROBERTS, BARRETT,
  LIFTON, BRINDISI, GUNTHER, LUPARDO -- Multi-Sponsored by -- M.  of  A.
  DUPREY,  P. LOPEZ -- read once and referred to the Committee on Health
  -- committee discharged, bill amended, ordered  reprinted  as  amended
  and recommitted to said committee

AN  ACT to amend the public health law, the insurance law and the social
  services law, in relation to the provision of telehealth services

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

  Section  1.    Subdivision  1 of section 2 of the public health law is
amended by adding five new paragraphs (o), (p), (q), (r) and (s) to read
as follows:
  (O) DISTANT SITE. THE TERM "DISTANT SITE" MEANS  A  SITE  AT  WHICH  A
HEALTH  CARE PROVIDER IS LOCATED WHILE PROVIDING HEALTH CARE SERVICES BY
MEANS OF TELEMEDICINE  OR  TELEHEALTH;  UNLESS  THE  TERM  IS  OTHERWISE
DEFINED WITH RESPECT TO THE PROVISION IN WHICH IT IS USED.
  (P)  HEALTH  CARE  PROVIDER.  THE  TERM "HEALTH CARE PROVIDER" MEANS A
PERSON LICENSED PURSUANT TO ARTICLE ONE HUNDRED THIRTY-ONE, ONE  HUNDRED
THIRTY-ONE-B,  ONE  HUNDRED  THIRTY-THREE,  ONE HUNDRED THIRTY-NINE, ONE
HUNDRED FORTY, ONE  HUNDRED  FORTY-ONE,  ONE  HUNDRED  FORTY-THREE,  ONE
HUNDRED  FORTY-FOUR,  ONE HUNDRED FIFTY-THREE, ONE HUNDRED FIFTY-FOUR OR
ONE HUNDRED FIFTY-NINE OF THE EDUCATION LAW, ACTING WITHIN  HIS  OR  HER
SCOPE  OF  PRACTICE, INCLUDING ANY LAWFUL PRACTICE ENTITY OF SUCH HEALTH
CARE PRACTITIONERS; A HOSPITAL AS DEFINED  IN  ARTICLE  TWENTY-EIGHT  OF
THIS CHAPTER; HOME CARE SERVICES AGENCY AS DEFINED IN ARTICLE THIRTY-SIX
OF  THIS CHAPTER; OR A HOSPICE AS DEFINED IN ARTICLE FORTY OF THIS CHAP-
TER; UNLESS THE TERM IS OTHERWISE DEFINED BY LAW  WITH  RESPECT  TO  THE
PROVISION IN WHICH IT IS USED.
  (Q)  ORIGINATING  SITE.  THE  TERM  "ORIGINATING SITE" MEANS A SITE AT
WHICH A PATIENT IS LOCATED AT THE TIME HEALTH CARE SERVICES ARE PROVIDED
TO HIM OR HER BY MEANS OF TELEMEDICINE OR TELEHEALTH, UNLESS THE TERM IS
OTHERWISE DEFINED WITH RESPECT TO THE PROVISION IN  WHICH  IT  IS  USED.
PROVIDED,  HOWEVER, NOTWITHSTANDING ANY OTHER PROVISION OF LAW, INSURERS
AND PROVIDERS MAY AGREE TO ALTERNATIVE SITING ARRANGEMENTS DEEMED APPRO-
PRIATED BY THE PARTIES.
  (R) TELEHEALTH. THE TERM "TELEHEALTH"  MEANS  DELIVERING  HEALTH  CARE
SERVICES   BY  MEANS  OF  INFORMATION  AND  COMMUNICATIONS  TECHNOLOGIES
              

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD02532-11-4

A. 9129--A                          2

CONSISTING OF TELEPHONES, REMOTE PATIENT  MONITORING  DEVICES  OR  OTHER
ELECTRONIC  MEANS  WHICH FACILITATE THE ASSESSMENT, DIAGNOSIS, CONSULTA-
TION, TREATMENT, EDUCATION, CARE MANAGEMENT AND  SELF  MANAGEMENT  OF  A
PATIENT'S  HEALTH CARE WHILE SUCH PATIENT IS AT THE ORIGINATING SITE AND
THE HEALTH CARE PROVIDER IS AT A DISTANT SITE; CONSISTENT WITH  APPLICA-
BLE FEDERAL LAW AND REGULATIONS; UNLESS THE TERM IS OTHERWISE DEFINED BY
LAW WITH RESPECT TO THE PROVISION IN WHICH IT IS USED.
  (S)  TELEMEDICINE. THE TERM "TELEMEDICINE" MEANS THE DELIVERY OF CLIN-
ICAL HEALTH CARE SERVICES BY MEANS OF REAL TIME TWO-WAY ELECTRONIC AUDIO
VISUAL COMMUNICATIONS, INCLUDING THE APPLICATION OF SECURE VIDEO CONFER-
ENCING OR STORE AND FORWARD TECHNOLOGY TO PROVIDE OR SUPPORT  HEALTHCARE
DELIVERY,  WHICH  FACILITATE  THE  ASSESSMENT,  DIAGNOSIS, CONSULTATION,
TREATMENT, EDUCATION, CARE MANAGEMENT AND SELF MANAGEMENT OF A PATIENT'S
HEALTH CARE WHILE SUCH PATIENT IS AT THE ORIGINATING SITE AND THE HEALTH
CARE PROVIDER IS AT A DISTANT SITE; CONSISTENT WITH  APPLICABLE  FEDERAL
LAW  AND  REGULATIONS;  UNLESS THE TERM IS OTHERWISE DEFINED BY LAW WITH
RESPECT TO THE PROVISION IN WHICH IT IS USED.
  S 2. Subsection (i) of section 3216 of the insurance law is amended by
adding a new paragraph 30 to read as follows:
  (30) EVERY POLICY DELIVERED OR ISSUED FOR DELIVERY IN THIS STATE WHICH
PROVIDES COMPREHENSIVE COVERAGE FOR HOSPITAL, MEDICAL OR  SURGICAL  CARE
SHALL  MAKE  AVAILABLE  AND,  IF  REQUESTED  BY A POLICY HOLDER, PROVIDE
COVERAGE FOR SERVICES WHICH ARE OTHERWISE COVERED UNDER THE POLICY  THAT
ARE  PROVIDED  (A)  VIA  TELEMEDICINE,  AS DEFINED IN SECTION TWO OF THE
PUBLIC HEALTH LAW, PROVIDED THAT SUCH SERVICES MEET THE REQUIREMENTS  OF
FEDERAL  LAW,  RULES AND REGULATIONS FOR MEDICARE (OTHER THAN ANY ORIGI-
NATING SITE RESTRICTION REQUIREMENTS); OR (B)  TELEHEALTH  SERVICES,  AS
DEFINED  IN  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.  SUCH COVERAGE
REQUIRED BY THIS PARAGRAPH MAY BE  SUBJECT  TO  ANNUAL  DEDUCTIBLES  AND
COINSURANCE,  AND OTHER TERMS AND CONDITIONS OF COVERAGE, INCLUDING, BUT
NOT LIMITED TO, UTILIZATION MANAGEMENT AND OTHER MANAGED CARE TOOLS,  AS
ARE  CONSISTENT  WITH  THOSE  ESTABLISHED FOR THE SAME SERVICES WHEN NOT
PROVIDED VIA TELEMEDICINE OR TELEHEALTH.
  S 3. Subsection (k) of section 3221 of the insurance law is amended by
adding a new paragraph 19 to read as follows:
  (19) EVERY GROUP OR BLANKET POLICY DELIVERED OR ISSUED FOR DELIVERY IN
THIS STATE WHICH PROVIDES COMPREHENSIVE COVERAGE FOR  HOSPITAL,  MEDICAL
OR  SURGICAL  CARE  SHALL  MAKE AVAILABLE AND, IF REQUESTED BY THE GROUP
POLICYHOLDER, PROVIDE COVERAGE FOR SERVICES WHICH ARE OTHERWISE  COVERED
UNDER  THE  POLICY THAT ARE PROVIDED (A) VIA TELEMEDICINE, AS DEFINED IN
SECTION TWO OF THE PUBLIC HEALTH LAW, PROVIDED THAT SUCH  SERVICES  MEET
THE  REQUIREMENTS  OF  FEDERAL  LAW,  RULES AND REGULATIONS FOR MEDICARE
(OTHER THAN ANY ORIGINATING SITE RESTRICTION REQUIREMENTS); OR (B) TELE-
HEALTH SERVICES, AS DEFINED IN 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. SUCH COVERAGE REQUIRED BY THIS PARAGRAPH MAY BE SUBJECT  TO
ANNUAL  DEDUCTIBLES  AND  COINSURANCE, AND OTHER TERMS AND CONDITIONS OF
COVERAGE, INCLUDING, BUT NOT  LIMITED  TO,  UTILIZATION  MANAGEMENT  AND

A. 9129--A                          3

OTHER  MANAGED  CARE TOOLS, AS ARE CONSISTENT WITH THOSE ESTABLISHED FOR
THE SAME SERVICES WHEN NOT PROVIDED VIA TELEMEDICINE OR TELEHEALTH.
  S  4.   Paragraph 2 of subsection (a) of section 3229 of the insurance
law, as amended by chapter 659 of the laws of 1997, 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  5.  Section  4303  of  the insurance law is amended by adding a new
subsection (oo) to read as follows:
  (OO) EVERY CONTRACT ISSUED BY A MEDICAL EXPENSE INDEMNITY CORPORATION,
A HOSPITAL SERVICE CORPORATION OR A  HEALTH  SERVICE  CORPORATION  WHICH
PROVIDES  COMPREHENSIVE  COVERAGE FOR HOSPITAL, MEDICAL OR SURGICAL CARE
SHALL MAKE AVAILABLE AND, IF REQUESTED BY  A  CONTRACT  HOLDER,  PROVIDE
COVERAGE  FOR SERVICES WHICH ARE OTHERWISE COVERED UNDER THE POLICY THAT
ARE PROVIDED (1) VIA TELEMEDICINE, AS DEFINED  IN  SECTION  TWO  OF  THE
PUBLIC  HEALTH LAW, PROVIDED THAT SUCH SERVICES MEET THE REQUIREMENTS OF
FEDERAL LAW, RULES AND REGULATIONS FOR MEDICARE (OTHER THAN  ANY  ORIGI-
NATING  SITE  RESTRICTION  REQUIREMENTS); OR (2) TELEHEALTH SERVICES, AS
DEFINED IN 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 SUBSECTION) OF HIS OR HER CONTRACT WITH THE INSURER. SUCH  COVERAGE
REQUIRED  BY  THIS  SUBSECTION  MAY BE SUBJECT TO ANNUAL DEDUCTIBLES AND
COINSURANCE, AND OTHER TERMS AND CONDITIONS OF COVERAGE, INCLUDING,  BUT
NOT  LIMITED TO, UTILIZATION MANAGEMENT AND OTHER MANAGED CARE TOOLS, AS
ARE CONSISTENT WITH THOSE ESTABLISHED FOR THE  SAME  SERVICES  WHEN  NOT
PROVIDED VIA TELEMEDICINE OR TELEHEALTH.
  S  6.    The opening paragraph of section 367-u of the social services
law is designated subdivision 1 and a new subdivision 2 is added to read
as follows:
  2. SUBJECT TO THE APPROVAL OF THE DIRECTOR OF THE BUDGET, THE  COMMIS-
SIONER  SHALL  NOT  EXCLUDE FROM THE PAYMENT OF MEDICAL ASSISTANCE FUNDS
THE PROVISION OF MEDICAL CARE THROUGH TELEMEDICINE SERVICES, AS  DEFINED
IN  SECTION  TWO  OF  THE PUBLIC HEALTH LAW, PROVIDED THAT SUCH SERVICES
MEET THE REQUIREMENTS OF FEDERAL LAW,  RULES  AND  REGULATIONS  FOR  THE
PROVISION  OF  MEDICAL  ASSISTANCE PURSUANT TO THIS TITLE, AND FOR TELE-
HEALTH SERVICES, AS DEFINED BY SECTION TWO OF  THE  PUBLIC  HEALTH  LAW,
THAT ARE, AT A MINIMUM, THOSE REQUIRED TO BE PROVIDED PURSUANT TO SUBDI-
VISION  THREE-C  OF  SECTION  THIRTY-SIX  HUNDRED FOURTEEN OF THE PUBLIC
HEALTH LAW.
  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.