NEW YORK STATE ASSEMBLY MEMORANDUM IN SUPPORT OF LEGISLATION submitted in accordance with Assembly Rule III, Sec 1(f)
BILL NUMBER: A6256
TITLE OF BILL:
An act to amend the public health law in relation to the delivery of
health care services via telehealth
To provide for payment parity between the delivery of health care
services via telehealth and services delivered in a traditional in-per-
son environment and to provide for patient protections
SUMMARY OF PROVISIONS:
Section 1: amends section 2999-cc of the public health law to add a new
subdivision 8, to define and explain the role of a "health care plan"
for the purposes of this section.
Section 2: amends section 2999-dd of the public health law to require
patient consent for the use of telehealth services; to require that the
reimbursement rate for the delivery of such services shall be the same
as if such services were delivered in person; to require that a health
care plan ensure that enrollees have access to all covered services; and
to specify authority for violations.
Section 3: to provide that if an' provisions of this act are found to be
in violation of, or inconsistent with, federal law or regulations, such
provisions and applications of this act will be severable.
Section 4: establishes the effective date.
Even prior to the COVID-19 pandemic it was clear that many parts of the
state lack access to basic healthcare services. In many communities the
nearest family physician, dentist, OBGYN, mental health practitioner, or
pediatrician may be as far as an hour away. In rural communities, the
issue is exacerbated by a lack of reliable and functional public trans-
portation. For the people living in these communities, telehealth is an
effective tool to ensure that they can access basic healthcare services.
The COVID-19 Pandemic has underlined these shortcomings in our health-
care system. In the face of the pandemic, New Yorkers have been asked to
stay home and follow strict social distancing guidelines; we have asked
employees to work from home where possible, students to transition to
online learning, and we have encouraged the use of telehealth for the
delivery of healthcare services.
Additionally, accessing healthcare services via telehealth has proven to
be critical in ensuring the safety of residents for whom being in a
healthcare setting may expose them to disease such as seniors, immuno-
compromised individuals, and people with chronic conditions. However,
as we push New Yorkers to use telehealth services, we have not ensured
that these services are re-imbursed at the same rate as a typical
doctor's visit, financially disadvantaging physicians who would like to
offer delivery of services through this mode.
This bill will require that a telehealth visit be re-imbursed at the
same rate as a traditional in-person visit and provides for patient
protections. Such protections include requiring consent for the use of
telehealth as a delivery modality for health services in place of an
None to the state.
This act shall take January 1, 2022 and shall apply to all policies and
contracts issued, renewed, modified, altered or amended on or after such
date. Effective immediately, the commissioner of health, the superinten-
dent of the department of financial services, the commissioner of the
office of mental health, the commissioner of the office of alcoholism
and substance abuse services, and the commissioner of the office for
people with developmental disabilities shall make regulations and take
other actions reasonably necessary to implement this act on that date.
STATE OF NEW YORK
2021-2022 Regular Sessions
March 11, 2021
Introduced by M. of A. WOERNER, GOTTFRIED -- read once and referred to
the Committee on Insurance
AN ACT to amend the public health law in relation to the delivery of
health care services via telehealth
The People of the State of New York, represented in Senate and Assem-bly, do enact as follows:
1 Section 1. Section 2999-cc of the public health law is amended by
2 adding a new subdivision 8 to read as follows:
3 8. "Health care plan" means an entity (other than a health care
4 provider) that approves, provides, arranges for, or pays for health care
5 services, including but not limited to:
6 (a) a health maintenance organization licensed under article forty-
7 three of the insurance law;
8 (b) a health maintenance organization or other organization certified
9 under article forty-four of this chapter;
10 (c) an insurer or corporation subject to the insurance law; and
11 (d) the medical assistance program under title eleven of article five
12 of the social services law ("medicaid"); the child health plus program
13 under title one-A of article twenty-five of this chapter, and the basic
14 health program under section three hundred sixty-nine-gg of the social
15 services law.
16 § 2. Section 2999-dd of the public health law, as amended by section 4
17 of subpart C of Part S of chapter 57 of the laws of 2018, subdivision 1
18 as amended by chapter 124 of the laws of 2020, subdivisions 3 and 4 as
19 added by chapter 328 of the laws of 2020, is amended to read as follows:
20 § 2999-dd. Telehealth delivery of services. 1. [Health care services
21 delivered by means of telehealth shall be entitled to reimbursement
22 under section three hundred sixty-seven-u of the social services law;
23 provided however, reimbursement for additional modalities, provider
24 categories and originating sites specified in accordance with section
25 twenty-nine hundred ninety-nine-ee of this article, and audio-only tele-
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
 is old law to be omitted.
A. 6256 2
1 phone communication defined in regulations promulgated pursuant to
2 subdivision four of section twenty-nine hundred ninety-nine-cc of this
3 article, shall be contingent upon federal financial participation.] (a)
4 A health care service may be delivered by means of telehealth by a tele-
5 health provider otherwise authorized to perform that service. A health
6 care service delivered by telehealth shall be with the consent of the
7 patient or a person authorized to consent for the patient. The consent
8 shall be documented in the patient's medical record.
9 (b) In-person contact between a telehealth provider and a patient
10 prior to the delivery of health care services via telehealth shall not
11 be required, unless the provider determines it to be clinically neces-
13 2. (a) A health care plan shall cover a service, regardless of whether
14 it is provided by telehealth, if the service would otherwise be covered
15 by the health care plan and the provider is otherwise covered by the
16 health care plan.
17 (b) A health care plan shall reimburse a treating or consulting health
18 care provider for health care services appropriately delivered by tele-
19 health on the same basis, at the same rate, and to the same extent that
20 the health care plan reimburses for the service when provided through
21 in-person diagnosis, consultation, or treatment.
22 (c) A health care plan may subject the coverage of a telehealth
23 service to copayments, coinsurance or deductibles if they are at least
24 as favorable to the enrollee as would apply if the service is not
25 provided by telehealth.
26 (d) This article does not alter any obligation a health care plan may
27 have to ensure that enrollees have access to all covered services
28 through an adequate network of contracted providers.
29 (e) With respect to health care plans under paragraph (d) of subdivi-
30 sion eight of section 2999-cc of this article (medicaid, child health
31 plus, and the basic health plan), this article shall only apply where
32 there is federal financial participation. The commissioner shall make
33 state plan amendments and seek federal waivers as necessary to obtain
34 that federal financial participation.
35 3. The department of health, the office of mental health, the office
36 of [alcoholism and substance abuse services] addiction services and
37 supports, and the office for people with developmental disabilities
38 shall coordinate on the issuance of a single guidance document, to be
39 updated as appropriate, that shall: (a) identify any differences in
40 regulations or policies issued by the agencies, including with respect
41 to reimbursement [pursuant to section three hundred sixty-seven-u of the
42 social services law]; and (b) be designed to assist consumers, provid-
43 ers, and health care plans in understanding and facilitating the appro-
44 priate use of telehealth in addressing barriers to care.
45 [3.] 4. The authority of the department of financial services to
46 establish and enforce minimum standards for accident and health insur-
47 ance under articles thirty-two and forty-three of the insurance law
48 shall include enforcement of telehealth standards set forth in this
50 5. (a) Dental telehealth services shall adhere to the standards of
51 appropriate patient care required in other dental health care settings,
52 including but not limited to appropriate patient examination, taking of
53 x-rays, and review of a patient's medical and dental history. All dental
54 telehealth providers shall identify themselves to patients, including
55 providing the professional's New York state license number. No dental
56 telehealth provider shall attempt to waive liability for its telehealth
A. 6256 3
1 services in advance of delivering such telehealth services and no dental
2 telehealth provider shall attempt to prevent a patient from filing any
3 complaint with any governmental agency or authority.
4 (b) This subdivision shall not be construed to diminish requirements
5 for other telehealth services.
6 [4.] 6. Nothing in this article shall be deemed to allow any person to
7 provide any service for which a license, registration, certification or
8 other authorization under title eight of the education law is required
9 and which the person does not possess.
10 § 3. If any provision of this act, or any application of any provision
11 of this act, is held to be invalid, or to violate or be inconsistent
12 with any federal law or regulation, that shall not affect the validity
13 or effectiveness of any other provision of this act, or of any other
14 application of any provision of this act, which can be given effect
15 without that provision or application; and to that end, the provisions
16 and applications of this act are severable.
17 § 4. This act shall take effect January 1, 2022 and shall apply to all
18 policies and contracts issued, renewed, modified, altered or amended on
19 or after such date. Effective immediately, the commissioner of health,
20 the superintendent of the department of financial services, the commis-
21 sioner of the office of mental health, the commissioner of the office of
22 addiction services and supports, and the commissioner of the office for
23 people with developmental disabilities shall make regulations and take
24 other actions reasonably necessary to implement this act on that date.