Adds services delivered, to individuals with developmental disabilities and traumatic brain injury, through a facility licensed under article twenty-eight of the public health law, to the requirement that telehealth services be reimbursed at the applicable in person rates or fees regardless of the location of the patient or the clinician.
NEW YORK STATE ASSEMBLY MEMORANDUM IN SUPPORT OF LEGISLATION submitted in accordance with Assembly Rule III, Sec 1(f)
BILL NUMBER: A6509
SPONSOR: McDonald TITLE OF BILL:
An act to amend the public health law, in relation to reimbursement for
telehealth services
PURPOSE:
Currently, telehealth services licensed, certified, or otherwise author-
ized pursuant to article sixteen, article thirty-one or article thirty-
two of the mental hygiene law, are required to be reimbursed at the
applicable in person rates or fees regardless of the location of the
patient or the clinician. This bill would add services delivered, to
individuals with developmental disabilities and traumatic brain injury,
through a facility licensed under article twenty-eight of the public
health law, to the requirement that telehealth services be reimbursed at
the applicable in person rates or fees regardless of the location of the
patient or the clinician.
SUMMARY OF SPECIFIC PROVISIONS:
Section one amends public health law section 2999-dd. Section two sets
forth the effective date.
JUSTIFICATION:
The telehealth flexibilities allowed by Medicare and Medicaid during the
Public Health Emergency (PHE) enabled clinics to use telehealth technol-
ogy in the most efficient and effective manner for people with develop-
mental disabilities (IDD). Current law stipulates that when the PHE
ends, telehealth services where both the clinician and patient are via
telehealth and located outside the Article 28 clinic, the reimbursement
for the telehealth visit will be reduced to eliminate clinic operating
or facility costs. However, no costs are eliminated simply because a
service is provided via telehealth. In fact, telehealth creates addi-
tional expenses for software, hardware and internet services, etc. This
will effectively eliminate telehealth and access to physicians for indi-
viduals with disabilities.
Article 28. clinics' Medicaid reimbursement rates have only had one 1%
increase since 2008, while health care costs have increased 103% since
2008. As a result, Article 28 clinics serving individuals with develop-
mental disabilities are losing 30-35% of their operating costs.
There's also an access issue, particularly for people with IDD: it is
very difficult for our Article 28 clinics to hire clinicians - partic-
ularly specialists, and remote work has made it possible to recruit
specialists to meet these patients' needs. If specialists are required
to come to the clinic site, people with I/DD will have reduced access to
specialists. If patients with I/DD are required to come into the clinic
for a telehealth visit with a clinician, the benefit of telehealth would
be negated.
Telehealth provides better access and quality of care for people with
disabilities. Without this access to care, people with disabilities will
rely on emergency rooms and hospital inpatient stays for their health
care.
This bill allows for the full reimbursement of the telehealth service
provided through an Article 28 facility regardless of the location for
the provider or patient, Providing access to health care, better quality
of care and significant Medicaid savings.
LEGISLATIVE HISTORY:
New bill.
FISCAL IMPLICATIONS:
To be determined.
EFFECTIVE DATE:
This bill shall take effect immediately.
STATE OF NEW YORK
________________________________________________________________________
6509
2023-2024 Regular Sessions
IN ASSEMBLY
April 12, 2023
___________
Introduced by M. of A. McDONALD -- read once and referred to the Commit-
tee on Health
AN ACT to amend the public health law, in relation to reimbursement for
telehealth services
The People of the State of New York, represented in Senate and Assem-bly, do enact as follows:
1 Section 1. Subdivision 1 of section 2999-dd of the public health law,
2 as amended by section 2 of part V of chapter 57 of the laws of 2022, is
3 amended to read as follows:
4 1. Health care services delivered by means of telehealth shall be
5 entitled to reimbursement under section three hundred sixty-seven-u of
6 the social services law on the same basis, at the same rate, and to the
7 same extent the equivalent services, as may be defined in regulations
8 promulgated by the commissioner, are reimbursed when delivered in
9 person; provided, however, that health care services delivered by means
10 of telehealth shall not require reimbursement to a telehealth provider
11 for certain costs, including but not limited to facility fees or costs
12 reimbursed through ambulatory patient groups or other clinic reimburse-
13 ment methodologies set forth in section twenty-eight hundred seven of
14 this chapter, if such costs were not incurred in the provision of tele-
15 health services due to neither the originating site nor the distant site
16 occurring within a facility or other clinic setting; and further
17 provided, however, reimbursement for additional modalities, provider
18 categories and originating sites specified in accordance with section
19 twenty-nine hundred ninety-nine-ee of this article, and audio-only tele-
20 phone communication defined in regulations promulgated pursuant to
21 subdivision four of section twenty-nine hundred ninety-nine-cc of this
22 article, shall be contingent upon federal financial participation.
23 Notwithstanding the provisions of this subdivision, for services
24 licensed, certified or otherwise authorized pursuant to article sixteen,
25 article thirty-one or article thirty-two of the mental hygiene law, and
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[] is old law to be omitted.
LBD10741-01-3
A. 6509 2
1 for any services delivered through a facility licensed under article
2 twenty-eight of this chapter to eligible persons diagnosed with a devel-
3 opmental disability or a traumatic brain injury, such services provided
4 by telehealth[, as deemed appropriate by the relevant commissioner,]
5 shall be reimbursed at the applicable in person rates or fees estab-
6 lished by law, or otherwise established or certified by the office for
7 people with developmental disabilities, office of mental health, or the
8 office of addiction services and supports pursuant to article forty-
9 three of the mental hygiene law.
10 § 2. This act shall take effect immediately and shall be deemed to
11 have been in effect on and after April 1, 2023; provided, however, that
12 the amendments to subdivision 1 of section 2999-dd of the public health
13 law made by section one of this act shall be subject to the expiration
14 and reversion of such subdivision and shall expire and be deemed
15 repealed therewith.
