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SS/SB 262 - Under this act, health carriers issuing or renewing health benefit plans on or after January 1, 2014, shall not deny coverage for a health care service on the basis that the service was provided through telemedicine if the same service would be covered when delivered in person. Under the act, a health carrier may not exclude an otherwise covered health care service from coverage solely because the service is provided through telemedicine rather than face-to-face consultation or contact between a health care provider and a patient. Subject to approval by the health carrier, health care services may be provided by telemedicine providers without any prior face-to-face consultation or contact between a health care provider and a patient. The act does not requires a health carrier to reimburse a telemedicine provider or a consulting provider for technological fees or costs for the provision of telemedicine services. However, a health carrier must reimburse an telemedicine provider for the diagnosis, consultation, or treatment of an insured delivered through telemedicine on the same basis that the health carrier covers the service when it is delivered in person. Under the act, a health care service provided through telemedicine services shall not be subject to any greater deductible, copayment, or coinsurance amount than would be applicable if the same health care service was provided through face-to-face diagnosis, consultation, or treatment. The act allows health carriers to undertake utilization review to determine the appropriateness of telemedicine as a means of delivering a health care service. Utilization review determinations, however, must be made in the same manner as those regarding the same service when it is delivered in person. The act allows a health carrier or health benefit plan to limit coverage for health care services that are provided through telemedicine to health care providers that are in a network approved by the plan or the health carrier. The provisions of the act do not apply to certain types of supplemental insurance policies such as accident-only policies or Medicare supplement policies. The act has an effective date of January 1, 2014. STEPHEN WITTE
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