Health coverage offered by a health carrier, the Public Employees Benefits Board, the School Employees Benefits Board, a Medicaid managed care plan, or a behavioral health administrative services organization must reimburse providers for health care services provided through telemedicine or store-and-forward technology if:
Additional requirements apply for audio-only telemedicine, including, beginning January 1, 2023, that the provider have an established relationship with the patient. An established relationship exists if the person has had at least one in-person appointment within the past year with the audio-only telemedicine provider or a provider in the same clinic, or the covered person was referred by another provider who has had at least one in-person appointment with the person within the past year and has given relevant medical information to the audio-only telemedicine provider.
In 2021, the Collaborative for the Advancement of Telemedicine (Collaborative) was directed to study the need for an established relationship for audio-only telemedicine. The Collaborative's recommendations included:
The definition of established relationship for purposes of audio-only telemedicine is changed by:
For purposes of the provisions in the definition relating to behavioral health, behavioral health services are services included in the essential health benefits category of Mental Health and Substance Use Disorder Services, Including Behavioral Health Treatment.
Modifies the definition of "established relationship" to allow a relationship to be established for physical health services through a telemedicine visit that includes both audio and video technology.
The committee recommended a different version of the bill than what was heard. PRO: Many do not have a provider they see every year, and three years is more reasonable time frame for the definition of established relationship.
OTHER: This will limit telemedicine because it requires in person visits within the past two years. A relationship can be established via telemedicine and can be maintained when the provider has access to medical records.