A health plan offered by a health carrier, a health plan offered to school or state employees and their dependents, a Medicaid managed care plan, and a behavioral health administrative services organization—for covered persons under 18 years of age—must reimburse providers for health care services provided through telemedicine or store and forward technology if:

• the services are covered services;
• the services are medically necessary;
• the services are essential health benefits under the federal Patient Protection and Affordable Care Act;
• the services are determined to be safely and effectively provided through telemedicine or store and forward technology according to generally accepted health care practices and standards; and
• the technology meets state and federal standards governing the privacy and security of protected health information.

Behavioral health administrative services organizations and managed care organizations shall reimburse a provider for a behavioral health service provided to a covered person through telemedicine or store and forward technology if:

• the services are covered services;
• the services are medically necessary;
• the services are essential health benefits under the federal Patient Protection and Affordable Care Act;
• the services are determined to be safely and effectively provided through telemedicine or store and forward technology according to generally accepted health care practices and standards; and
• the technology meets state and federal standards governing the privacy and security of protected health information.

• Removes all audio-only telemedicine amendatory language.
• Removes the provider reimbursement limitation from behavioral health administrative services organizations for telemedicine services provided to persons 18 years old and under, and allows providers to be reimbursed for telemedicine services provided to any covered person.
• Changes to the title to "concerning telemedicine."

The committee recommended a different version of the bill than what was heard.  PRO:  This bill recognizes that the phone can be a viable modality of telemedicine.  Audio only is very important for chronic disease care and behavioral health.  Audio-only telemedicine increases access in rural areas where other forms of telemedicine are a barrier to care.  The bill addresses inequities in access to care.

OTHER:  A prior in person meeting requirement for audio-only telemedicine is a barrier to care.  Audio is equal to other modalities and the only lifeline for many people.  The bill should take an equity approach to reimbursement instead of parity.