House Bill 4003 identifies certain terms relating to telemedicine services, one of which is “distant site” to mean the telehealth site there the provider is seeing the patient at a distance or consulting with a patient’ provider.
“Remote patient monitoring services” means the delivery of home health services using telecommunications technology to enhance the delivery of home health care, including monitoring of clinical patient data such as weight, blood pressure, pulse, pulse oximetry, blood glucose, and other condition-specific data; medication adherence monitoring; and interactive video conferencing with or without digital image upload.
“Telemedicine services” means the use of electronic technology or media, including interactive audio or video, for the purpose of diagnosing or treating a patient, providing remote patient monitoring services, or consulting with other health care providers regarding a patient’ diagnosis or treatment.
“Telemedicine services” does not include an audio-only telephone, electronic mail message, facsimile transmission, or online questionnaire.
An insurer may not exclude a service for coverage solely because the service is provided through telehealth services and is not provided through face-to-face consultation or contact between a health care provider and a patient for services appropriately provided through telemedicine services.
An insurer is not required to reimburse the treating provider or the consulting provider for technical fees or costs for the provision of telemedicine services. However, that insurer shall reimburse the treating provider or the consulting provider for the diagnosis, consultation, or treatment of the insured delivered through telemedicine services.
An insurer may offer a health plan containing a deductible, copayment, or coinsurance requirement for a healthcare service provided through telemedicine services, but the deductible, copayment, or coinsurance may not exceed the deductible, copayment, or coinsurance applicable if the same services were provided through face-to-face diagnosis, consultation or treatment.
An originating site may charge an insurer a facility fee of $10 or up to 10 percent of the charge for the services provided.
The coverage required by this section shall include the use of telemedicine technologies as it pertains to medically necessary remote patient monitoring services to the full extent that those services are available.