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REFERENCE TITLE: insurance; telemedicine |
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State of Arizona Senate Fifty-fourth Legislature First Regular Session 2019
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SB 1089 |
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Introduced by Senators Carter: Allen S, Bowie, Bradley, Brophy McGee, Navarrete; Representatives Barto, Butler, Cobb, Fernandez, Griffin, Hernandez A, Udall
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AN ACT
Amending sections 20‑841.09, 20‑1057.13, 20‑1376.05 and 20‑1406.05, Arizona Revised Statutes; relating to telemedicine.
(TEXT OF BILL BEGINS ON NEXT PAGE)
Be it enacted by the Legislature of the State of Arizona:
Section 1. Section 20-841.09, Arizona Revised Statutes, is amended to read:
20-841.09. Telemedicine; coverage of health care services; definition
A. All contracts issued, delivered or renewed on or after January 1, 2018 by a corporation must provide coverage for health care services that are provided through telemedicine if the health care service would be covered were it provided through in‑person consultation between the subscriber and a health care provider and provided to a subscriber receiving the service in this state. The contract may limit the coverage to those health care providers who are members of the corporation's provider network. A corporation may not exclude a health care provider who is a member of the corporation's provider network from coverage and may not restrict or deny coverage of telemedicine based solely on the communication technology, network or application used to deliver telemedicine services.
B. This section does not prevent a corporation from imposing deductibles, copayment or coinsurance requirements for a health care service provided through telemedicine if the deductible, copayment or coinsurance does not exceed the deductible, copayment or coinsurance applicable to an in‑person consultation for the same health care service.
C. Services provided through telemedicine or resulting from a telemedicine consultation shall comply with Arizona licensure requirements, accreditation standards and any practice guidelines of a national association of medical professionals promoting access to medical care for consumers via telecommunications technology or other qualified medical professional societies to ensure quality of care and telemedicine practice rules adopted by health care regulatory boards in this state.
D. A corporation may not impose any unique conditions for coverage on services that are provided through telemedicine, including imposing any originating site restrictions, distinguishing between patients in rural or urban locations or limiting coverage to a subset of medical conditions, medical specialties or settings.
D. E. This section does not apply to limited benefit coverage as defined in section 20‑1137.
E. F. For the purposes of this section, :
1. "Health care services" means services provided for the following conditions or in the following settings:
(a) Trauma.
(b) Burn.
(c) Cardiology.
(d) Infectious diseases.
(e) Mental health disorders.
(f) Neurologic diseases including strokes.
(g) Dermatology.
(h) Pulmonology.
(i) Beginning January 1, 2020, urology.
(j) Beginning January 1, 2019, pain medicine.
(k) Beginning January 1, 2019, substance abuse.
2. "telemedicine":
(a) 1. Means the interactive use of audio, video or other electronic media, including asynchronous store‑and‑forward technologies and remote patient monitoring technologies, for the purpose of diagnosis, consultation or treatment.
(b) 2. Does not include the sole use of an audio‑only telephone, a video‑only system, a facsimile machine, instant messages or electronic mail.
Sec. 2. Section 20-1057.13, Arizona Revised Statutes, is amended to read:
20-1057.13. Telemedicine; coverage of health care services; definition
A. An evidence of coverage issued, delivered or renewed by a health care services organization on or after January 1, 2018 must provide coverage for health care services that are provided through telemedicine if the health care service would be covered were it provided through in‑person consultation between the enrollee and a health care provider and provided to an enrollee receiving the service in this state. The evidence of coverage may limit the coverage to those health care providers who are members of the health care services organization's provider network. A health care services organization may not exclude a health care provider who is a member of the health care services organization's provider network from coverage and may not restrict or deny coverage of telemedicine based solely on the communication technology, network or application used to deliver telemedicine services.
B. This section does not prevent a health care services organization from imposing deductibles, copayment or coinsurance requirements for a health care service provided through telemedicine if the deductible, copayment or coinsurance does not exceed the deductible, copayment or coinsurance applicable to an in‑person consultation for the same health care service.
C. Services provided through telemedicine or resulting from a telemedicine consultation shall comply with Arizona licensure requirements, accreditation standards and any practice guidelines of a national association of medical professionals promoting access to medical care for consumers via telecommunications technology or other qualified medical professional societies to ensure quality of care and telemedicine practice rules adopted by health care regulatory boards in this state.
D. A health care services organization may not impose any unique conditions for coverage on services that are provided through telemedicine, including imposing any originating site restrictions, distinguishing between patients in rural or urban locations or limiting coverage to a subset of medical conditions, medical specialties or settings.
D. E. This section does not apply to limited benefit coverage as defined in section 20‑1137.
E. F. For the purposes of this section, :
1. "Health care services" means services provided for the following conditions or in the following settings:
(a) Trauma.
(b) Burn.
(c) Cardiology.
(d) Infectious diseases.
(e) Mental health disorders.
(f) Neurologic diseases including strokes.
(g) Dermatology.
(h) Pulmonology.
(i) Beginning January 1, 2020, urology.
(j) Beginning January 1, 2019, pain medicine.
(k) Beginning January 1, 2019, substance abuse.
2. "telemedicine":
(a) 1. Means the interactive use of audio, video or other electronic media, including asynchronous store‑and‑forward technologies and remote patient monitoring technologies, for the purpose of diagnosis, consultation or treatment.
(b) 2. Does not include the sole use of an audio‑only telephone, a video‑only system, a facsimile machine, instant messages or electronic mail.
Sec. 3. Section 20-1376.05, Arizona Revised Statutes, is amended to read:
20-1376.05. Telemedicine; coverage of health care services; definition
A. All policies issued, delivered or renewed by a disability insurer on or after January 1, 2018 must provide coverage for health care services that are provided through telemedicine if the health care service would be covered were it provided through in‑person consultation between the insured and a health care provider and provided to an insured receiving the service in this state. The policy may limit the coverage to those health care providers who are members of the disability insurer's provider network. A disability insurer may not exclude a health care provider who is a member of the insurer's provider network from coverage and may not restrict or deny coverage of telemedicine based solely on the communication technology, network or application used to deliver telemedicine services.
B. This section does not prevent a disability insurer from imposing deductibles, copayment or coinsurance requirements for a health care service provided through telemedicine if the deductible, copayment or coinsurance does not exceed the deductible, copayment or coinsurance applicable to an in‑person consultation for the same health care service.
C. Services provided through telemedicine or resulting from a telemedicine consultation shall comply with Arizona licensure requirements, accreditation standards and any practice guidelines of a national association of medical professionals promoting access to medical care for consumers via telecommunications technology or other qualified medical professional societies to ensure quality of care and telemedicine practice rules adopted by health care regulatory boards in this state.
D. A disability insurer may not impose any unique conditions for coverage on services that are provided through telemedicine, including imposing any originating site restrictions, distinguishing between patients in rural or urban locations or limiting coverage to a subset of medical conditions, medical specialties or settings.
D. E. This section does not apply to limited benefit coverage as defined in section 20‑1137.
E. F. For the purposes of this section, :
1. "Health care services" means services provided for the following conditions or in the following settings:
(a) Trauma.
(b) Burn.
(c) Cardiology.
(d) Infectious diseases.
(e) Mental health disorders.
(f) Neurologic diseases including strokes.
(g) Dermatology.
(h) Pulmonology.
(i) Beginning january 1, 2020, urology.
(j) Beginning January 1, 2019, pain medicine.
(k) Beginning January 1, 2019, substance abuse.
2. "telemedicine":
(a) 1. Means the interactive use of audio, video or other electronic media, including asynchronous store‑and‑forward technologies and remote patient monitoring technologies, for the purpose of diagnosis, consultation or treatment.
(b) 2. Does not include the sole use of an audio‑only telephone, a video‑only system, a facsimile machine, instant messages or electronic mail.
Sec. 4. Section 20-1406.05, Arizona Revised Statutes, is amended to read:
20-1406.05. Telemedicine; coverage of health care services; definition
A. All policies issued, delivered or renewed by a group disability insurer or a blanket disability insurer on or after January 1, 2018 must provide coverage for health care services that are provided through telemedicine if the health care service would be covered were it provided through in‑person consultation between the insured and a health care provider and provided to an insured receiving the service in this state. The policy may limit the coverage to those health care providers who are members of the insurer's provider network. A Blanket disability insurer may not exclude a health care provider who is a member of the insurer's provider network from coverage and may not restrict or deny coverage of telemedicine based solely on the communication technology, network or application used to deliver telemedicine services.
B. This section does not prevent a group or blanket disability insurer from imposing deductibles, copayment or coinsurance requirements for a health care service provided through telemedicine if the deductible, copayment or coinsurance does not exceed the deductible, copayment or coinsurance applicable to an in‑person consultation for the same health care service.
C. Services provided through telemedicine or resulting from a telemedicine consultation shall comply with Arizona licensure requirements, accreditation standards and any practice guidelines of a national association of medical professionals promoting access to medical care for consumers via telecommunications technology or other qualified medical professional societies to ensure quality of care and telemedicine practice rules adopted by health care regulatory boards in this state.
D. A blanket disability insurer may not impose any unique conditions for coverage on services that are provided through telemedicine, including imposing any originating site restrictions, distinguishing between patients in rural or urban locations or limiting coverage to a subset of medical conditions, medical specialties or settings.
D. E. This section does not apply to limited benefit coverage as defined in section 20‑1137.
E. F. For the purposes of this section, :
1. "Health care services" means services provided for the following conditions or in the following settings:
(a) Trauma.
(b) Burn.
(c) Cardiology.
(d) Infectious diseases.
(e) Mental health disorders.
(f) Neurologic diseases including strokes.
(g) Dermatology.
(h) Pulmonology.
(i) Beginning january 1, 2020, urology.
(j) Beginning January 1, 2019, pain medicine.
(k) Beginning January 1, 2019, substance abuse.
2. "telemedicine":
(a) 1. Means the interactive use of audio, video or other electronic media, including asynchronous store‑and‑forward technologies and remote patient monitoring technologies, for the purpose of diagnosis, consultation or treatment.
(b) 2. Does not include the sole use of an audio‑only telephone, a video‑only system, a facsimile machine, instant messages or electronic mail.
Sec. 5. Effective date
This act is effective from and after December 31, 2019.