Minnesota Legislature
SF 981
2nd Engrossment - 89th Legislature (2015 - 2016) Posted on 08/27/2015 03:32pm
Current Version - 2nd Engrossment
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A bill for an act
relating to health insurance; requiring coverage for telemedicine for health carriers
and medical assistance; amending Minnesota Statutes 2014, section 256B.0625,
subdivision 3b; proposing coding for new law in Minnesota Statutes, chapter 62A.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:
Section 1.
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[62A.67] SHORT TITLE.
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Sections 62A.67 to 62A.672 may be cited as the "Minnesota Telemedicine Act."
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Sec. 2.
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[62A.671] DEFINITIONS.
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new text begin Subdivision 1. new text end
new text begin Applicability. new text end
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For purposes of this section, the terms defined in this
section have the meanings given.
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new text begin Subd. 2. new text end
new text begin Distant site. new text end
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"Distant site" means a site at which a health care provider is
located while providing health care services or consultations by means of telemedicine.
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new text begin Subd. 3. new text end
new text begin Health care provider. new text end
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"Health care provider" has the meaning provided
in section 62A.63, subdivision 2.
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new text begin Subd. 4. new text end
new text begin Heath carrier. new text end
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"Health carrier" has the meaning provided in section
62A.011, subdivision 2.
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new text begin Subd. 5. new text end
new text begin Health plan. new text end
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"Health plan" means a health plan as defined in section
62A.011, subdivision 3, and includes dental plans as defined in section 62Q.76, subdivision
3, but does not include dental plans that provide indemnity-based benefits, regardless of
expenses incurred and are designed to pay benefits directly to the policyholder.
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new text begin Subd. 6. new text end
new text begin Originating site. new text end
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"Originating site" means a site including, but not limited
to, a health care facility at which a patient is located at the time health care services are
provided to the patient by means of telemedicine.
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new text begin Subd. 7. new text end
new text begin Store-and-forward technology. new text end
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"Store-and-forward technology" means
the transmission of a patient's medical information from an originating site to a health care
provider at a distant site without the patient being present, or the delivery of telemedicine
that does not occur in real time via synchronous transmissions.
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new text begin Subd. 8. new text end
new text begin Telemedicine. new text end
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"Telemedicine" means the delivery of health care services
or consultations while such patient is at an originating site and the health care provider is
at a distant site. A communication between health care providers that consists solely of a
telephone conversation or audio-only telephone, e-mail, or facsimile transmissions does
not constitute telemedicine consultations. Telemedicine may be provided by means of
real-time two-way, interactive audio and visual communications, including the application
of secure video conferencing or store-and-forward technology to provide or support
health care delivery, which facilitate the assessment, diagnosis, consultation, treatment,
education, and care management of a patient's health care.
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Sec. 3.
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[62A.672] COVERAGE OF TELEMEDICINE SERVICES.
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new text begin Subdivision 1. new text end
new text begin Coverage of telemedicine. new text end
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A health plan sold, issued, or renewed
by a health carrier for which coverage of benefits begins on or after January 1, 2017,
shall include coverage for telemedicine benefits in the same manner as any other benefits
covered under the policy, plan, or contract, and shall comply with the regulations of this
section. Nothing in this section shall be construed to require a health carrier to provide
coverage for services that are not medically necessary.
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new text begin Subd. 2. new text end
new text begin Parity between telemedicine and in-person services. new text end
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A health carrier
shall not exclude a service for coverage solely because the service is provided via
telemedicine and is not provided through in-person consultation or contact between a
health care provider and a patient.
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new text begin Subd. 3. new text end
new text begin Reimbursement for telemedicine services. new text end
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(a) A health carrier shall
reimburse the distant site health care provider for covered services delivered via
telemedicine on the same basis and at the same rate as the health carrier would apply to
those services if they had been delivered by the distant site provider in person.
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(b) It is not a violation of this subdivision for a health carrier to include a
deductible, co-payment, or coinsurance requirement for a health care service provided via
telemedicine, provided that the deductible, co-payment, or coinsurance is not in addition
to, and does not exceed, the deductible, co-payment, or coinsurance applicable if the same
services were provided through in-person contact.
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new text begin Subd. 4. new text end
new text begin Originating site facility fee payment. new text end
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If a health care provider provides
the facility used as the originating site for the delivery of telemedicine to a health carrier's
insured or enrollee, the health carrier shall make a facility fee payment to the originating
site health care provider. The facility fee payment to the originating site health care
provider shall be in addition to the reimbursement to the distant site provider specified in
subdivision 3. The facility fee payment shall not be subject to any patient coinsurance,
deductible, or co-payment obligation.
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Sec. 4.
Minnesota Statutes 2014, section 256B.0625, subdivision 3b, is amended to read:
Subd. 3b.
Telemedicine consultations.
new text begin (a) new text end Medical assistance coversnew text begin services
and consultations delivered vianew text end telemedicine deleted text begin consultations. Telemedicine consultations
must be made via two-way, interactive video or store-and-forward technology.
Store-and-forward technology includes telemedicine consultations that do not occur in real
time via synchronous transmissions, and that do not require a face-to-face encounter with
the patient for all or any part of any such telemedicine consultationdeleted text end new text begin , as defined in section
62A.671, subdivision 7, in the same manner as if the service or consultation was delivered
in personnew text end . The patient record must include a written opinion from the consulting deleted text begin physiciandeleted text end new text begin
health care providernew text end providing the telemedicine consultation. A communication between
deleted text begin two physiciansdeleted text end new text begin health care providersnew text end that consists solely of a telephone conversation is
not a telemedicine consultation. Coverage is limited to three telemedicine deleted text begin consultationsdeleted text end new text begin
servicesnew text end per recipient per calendar week. Telemedicine deleted text begin consultationsdeleted text end new text begin servicesnew text end shall be paid
at the full allowable rate.
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(b) If a health care provider provides the facility used as the originating site for the
delivery of telemedicine to a patient, medical assistance shall make a facility fee payment
to the originating site health care provider. The facility fee payment to the originating
site health care provider shall be in addition to the reimbursement for the telemedicine
service specified in paragraph (a).
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Sec. 5. new text begin EFFECTIVE DATE.
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Sections 1 and 2 are effective August 1, 2016.
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