SENATE DOCKET, NO. 24        FILED ON: 1/7/2011

SENATE  .  .  .  .  .  .  .  .  .  .  .  .  .  .  No. 521

The Commonwealth of Massachusetts

_________________

PRESENTED BY:

Michael O. Moore

_________________

To the Honorable Senate and House of Representatives of the Commonwealth of Massachusetts in General
Court assembled:

The undersigned legislators and/or citizens respectfully petition for the adoption of the accompanying bill:

An Act relative to telemedicine.

_______________

PETITION OF:

SENATE DOCKET, NO. 24        FILED ON: 1/7/2011

SENATE  .  .  .  .  .  .  .  .  .  .  .  .  .  .  No. 521

The Commonwealth of Massachusetts

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In the Year Two Thousand Eleven

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An Act relative to telemedicine.

Be it enacted by the Senate and House of Representatives in General Court assembled, and by the authority of the same, as follows:
 

                SECTION 1. Chapter 32A of the General Laws is hereby amended by adding the following section:-

                Section 26. (a) As used in this section the following words shall, unless the context clearly requires otherwise, have the following meanings:-

“Health Benefit Policy”, Any individual or group plan, policy, or contract for healthcare services issued, delivered, issued for delivery, executed, or renewed in this state, including, but not limited to, those contracts executed by the Commonwealth on behalf of state employees.

“Insurer”, an accident and sickness insurer, fraternal benefit society, hospital service corporation, medical service corporation, health care corporation, managed care entity, or any similar entity authorized to issue contracts under this title or to provide health benefit policies.

“Telemedicine”, the use of audio, video or other electronic media for the purpose of diagnosis, consultation, or treatment as it pertains to the delivery of healthcare services. Telemedicine does not include the use of audio only telephone or facsimile.  

                 (b) The commission shall provide to an active or retired employee of the commonwealth who is insured under the group insurance commission benefits on a nondiscriminatory basis for the application of telemedicine for covered services provided within the scope of practice of a physician or health care provider as a method of delivery of medical care by which an individual shall receive medical services from a health care provider without in person contact with the provider.

                (c) The commission may not deny coverage of the sole basis that the coverage is provided through telemedicine if the health care service would be covered if it were provided through in-person consultation between the covered person and a health care provider.

                (d) Nothing in this section shall prohibit an insurer from providing coverage for only those services that are medically necessary and subject to the terms and conditions of the covered person’s policy.

                SECTION 2. Chapter 175 of the General Laws is hereby amended by inserting after section 47AA the following section:-

                SECTION 1. Chapter 32A of the General Laws is hereby amended by adding the following section:-

                Section 26. (a) As used in this section the following words shall, unless the context clearly requires otherwise, have the following meanings:-

“Health Benefit Policy”, Any individual or group plan, policy, or contract for healthcare services issued, delivered, issued for delivery, executed, or renewed in this state, including, but not limited to, those contracts executed by the Commonwealth on behalf of state employees.

“Insurer”, an accident and sickness insurer, fraternal benefit society, hospital service corporation, medical service corporation, health care corporation, managed care entity, or any similar entity authorized to issue contracts under this title or to provide health benefit policies.

“Telemedicine”, the use of audio, video or other electronic media for the purpose of diagnosis, consultation, or treatment as it pertains to the delivery of healthcare services. Telemedicine does not include the use of audio only telephone or facsimile.  

                 (b) The commission shall provide to an active or retired employee of the commonwealth who is insured under the group insurance commission benefits on a nondiscriminatory basis for the application of telemedicine for covered services provided within the scope of practice of a physician or health care provider as a method of delivery of medical care by which an individual shall receive medical services from a health care provider without in person contact with the provider.

                (c) The commission may not deny coverage of the sole basis that the coverage is provided through telemedicine if the health care service would be covered if it were provided through in-person consultation between the covered person and a health care provider.

                (d) Nothing in this section shall prohibit an insurer from providing coverage for only those services that are medically necessary and subject to the terms and conditions of the covered person’s policy.

                SECTION 2. Chapter 175 of the General Laws is hereby amended by inserting after section 47AA the following section:-

Section 47BB. (a) As used in this section the following words shall, unless the context clearly requires otherwise, have the following meanings:-

“Health Benefit Policy”, Any individual or group plan, policy, or contract for healthcare services issued, delivered, issued for delivery, executed, or renewed in this state, including, but not limited to, those contracts executed by the Commonwealth on behalf of state employees.

“Insurer”, an accident and sickness insurer, fraternal benefit society, hospital service corporation, medical service corporation, health care corporation, managed care entity, or any similar entity authorized to issue contracts under this title or to provide health benefit policies.

“Telemedicine”, the use of audio, video or other electronic media for the purpose of diagnosis, consultation, or treatment as it pertains to the delivery of healthcare services. Telemedicine does not include the use of audio only telephone or facsimile.  

                 (b) An individual policy of accident and sickness insurance issued under section 108 that provides hospital expense and surgical expense insurance and any group blanket or general policy of accident and sickness insurance issued under section 110 that provides hospital expense and surgical expense insurance, which is issued or renewed within or without the commonwealth, shall provide benefits on a nondiscriminatory basis to residents of the commonwealth and to all policyholders having a principal place of employment in the commonwealth for the application of telemedicine for covered services provided within the scope of practice of a physician or health care provider as a method of delivery of medical care by which an individual shall receive medical services from a health care provider without in person contact with the provider.

                (c) The commission may not deny coverage of the sole basis that the coverage is provided through telemedicine if the health care service would be covered if it were provided through in-person consultation between the covered person and a health care provider.

                (d) Nothing in this section shall prohibit an insurer from providing coverage for only those services that are medically necessary and subject to the terms and conditions of the covered person’s policy.

                SECTION 3. Chapter 176A of the General Laws is hereby amended by inserting after section 8DD the following section:-

                Section 8EE. (a) As used in this section the following words shall, unless the context clearly requires otherwise, have the following meanings:-

“Health Benefit Policy”, Any individual or group plan, policy, or contract for healthcare services issued, delivered, issued for delivery, executed, or renewed in this state, including, but not limited to, those contracts executed by the Commonwealth on behalf of state employees.

“Insurer”, an accident and sickness insurer, fraternal benefit society, hospital service corporation, medical service corporation, health care corporation, managed care entity, or any similar entity authorized to issue contracts under this title or to provide health benefit policies.

“Telemedicine”, the use of audio, video or other electronic media for the purpose of diagnosis, consultation, or treatment as it pertains to the delivery of healthcare services. Telemedicine does not include the use of audio only telephone or facsimile.  

                 (b) A contract between a subscriber and the corporation under an individual or group hospital service plan which is issued or renewed within or without the commonwealth shall provide benefits on a nondiscriminatory basis to residents of the commonwealth and to all policyholders having a principal place of employment in the commonwealth for the application of telemedicine for covered services provided within the scope of practice of a physician or health care provider as a method of delivery of medical care by which an individual shall receive medical services from a health care provider without in person contact with the provider.

                 (c) The commission may not deny coverage of the sole basis that the coverage is provided through telemedicine if the health care service would be covered if it were provided through in-person consultation between the covered person and a health care provider.

                (d) Nothing in this section shall prohibit an insurer from providing coverage for only those services that are medically necessary and subject to the terms and conditions of the covered person’s policy.

                SECTION 4. Chapter 176B of the General Laws is hereby amended by inserting after section 4DD the following section:-

                Section 4EE. (a) As used in this section the following words shall, unless the context clearly requires otherwise, have the following meanings:-

“Health Benefit Policy”, Any individual or group plan, policy, or contract for healthcare services issued, delivered, issued for delivery, executed, or renewed in this state, including, but not limited to, those contracts executed by the Commonwealth on behalf of state employees.

“Insurer”, an accident and sickness insurer, fraternal benefit society, hospital service corporation, medical service corporation, health care corporation, managed care entity, or any similar entity authorized to issue contracts under this title or to provide health benefit policies.

“Telemedicine”, the use of audio, video or other electronic media for the purpose of diagnosis, consultation, or treatment as it pertains to the delivery of healthcare services. Telemedicine does not include the use of audio only telephone or facsimile.  

                 (b) A subscription certificate under an individual or group medical service agreement which is issued or renewed within or without the commonwealth shall provide benefits on a nondiscriminatory basis to residents of the commonwealth and to all policyholders having a principal place of employment in the commonwealth for the application of telemedicine for covered services provided within the scope of practice of a physician or health care provider as a method of delivery of medical care by which an individual shall receive medical services from a health care provider without in person contact with the provider.

                 (c) The commission may not deny coverage of the sole basis that the coverage is provided through telemedicine if the health care service would be covered if it were provided through in-person consultation between the covered person and a health care provider.

                (d) Nothing in this section shall prohibit an insurer from providing coverage for only those services that are medically necessary and subject to the terms and conditions of the covered person’s policy.

                SECTION 5. Chapter 176G of the General Laws is hereby amended by inserting after section 4V the following section:-

                Section 4W. (a) As used in this section the following words shall, unless the context clearly requires otherwise, have the following meanings:-

“Health Benefit Policy”, Any individual or group plan, policy, or contract for healthcare services issued, delivered, issued for delivery, executed, or renewed in this state, including, but not limited to, those contracts executed by the Commonwealth on behalf of state employees.

“Insurer”, an accident and sickness insurer, fraternal benefit society, hospital service corporation, medical service corporation, health care corporation, managed care entity, or any similar entity authorized to issue contracts under this title or to provide health benefit policies.

“Telemedicine”, the use of audio, video or other electronic media for the purpose of diagnosis, consultation, or treatment as it pertains to the delivery of healthcare services. Telemedicine does not include the use of audio only telephone or facsimile.  

                 (b) A health maintenance contract issued or renewed within or without the commonwealth shall provide benefits on a nondiscriminatory basis to residents of the commonwealth and to all policyholders having a principal place of employment in the commonwealth for the application of telemedicine for covered services provided within the scope of practice of a physician or health care provider as a method of delivery of medical care by which an individual shall receive medical services from a health care provider without in person contact with the provider.

                 (c) The commission may not deny coverage of the sole basis that the coverage is provided through telemedicine if the health care service would be covered if it were provided through in-person consultation between the covered person and a health care provider.

                (d) Nothing in this section shall prohibit an insurer from providing coverage for only those services that are medically necessary and subject to the terms and conditions of the covered person’s policy.

                SECTION 6. All policies, contracts and certificates of health insurance subject to section 25 of chapter 32A, section 47AA of chapter 175, section 8DD of chapter 176A, section 4CC of chapter 176B, and section 4V of chapter 176G of the General Laws which are delivered, issued or renewed on or after January 1, 2011 shall conform with the provisions of this act. Form filings implementing this act shall be subject to the approval of the commissioner of insurance.

                SECTION 7. This act shall take effect on January 1, 2012.

                Section 47BB. (a) As used in this section the following words shall, unless the context clearly requires otherwise, have the following meanings:-

“Health Benefit Policy”, Any individual or group plan, policy, or contract for healthcare services issued, delivered, issued for delivery, executed, or renewed in this state, including, but not limited to, those contracts executed by the Commonwealth on behalf of state employees.

“Insurer”, an accident and sickness insurer, fraternal benefit society, hospital service corporation, medical service corporation, health care corporation, managed care entity, or any similar entity authorized to issue contracts under this title or to provide health benefit policies.

“Telemedicine”, the use of audio, video or other electronic media for the purpose of diagnosis, consultation, or treatment as it pertains to the delivery of healthcare services. Telemedicine does not include the use of audio only telephone or facsimile.  

                 (b) An individual policy of accident and sickness insurance issued under section 108 that provides hospital expense and surgical expense insurance and any group blanket or general policy of accident and sickness insurance issued under section 110 that provides hospital expense and surgical expense insurance, which is issued or renewed within or without the commonwealth, shall provide benefits on a nondiscriminatory basis to residents of the commonwealth and to all policyholders having a principal place of employment in the commonwealth for the application of telemedicine for covered services provided within the scope of practice of a physician or health care provider as a method of delivery of medical care by which an individual shall receive medical services from a health care provider without in person contact with the provider.

                (c) The commission may not deny coverage of the sole basis that the coverage is provided through telemedicine if the health care service would be covered if it were provided through in-person consultation between the covered person and a health care provider.

                (d) Nothing in this section shall prohibit an insurer from providing coverage for only those services that are medically necessary and subject to the terms and conditions of the covered person’s policy.

                SECTION 3. Chapter 176A of the General Laws is hereby amended by inserting after section 8DD the following section:-

                Section 8EE. (a) As used in this section the following words shall, unless the context clearly requires otherwise, have the following meanings:-

“Health Benefit Policy”, Any individual or group plan, policy, or contract for healthcare services issued, delivered, issued for delivery, executed, or renewed in this state, including, but not limited to, those contracts executed by the Commonwealth on behalf of state employees.

“Insurer”, an accident and sickness insurer, fraternal benefit society, hospital service corporation, medical service corporation, health care corporation, managed care entity, or any similar entity authorized to issue contracts under this title or to provide health benefit policies.

“Telemedicine”, the use of audio, video or other electronic media for the purpose of diagnosis, consultation, or treatment as it pertains to the delivery of healthcare services. Telemedicine does not include the use of audio only telephone or facsimile.  

                 (b) A contract between a subscriber and the corporation under an individual or group hospital service plan which is issued or renewed within or without the commonwealth shall provide benefits on a nondiscriminatory basis to residents of the commonwealth and to all policyholders having a principal place of employment in the commonwealth for the application of telemedicine for covered services provided within the scope of practice of a physician or health care provider as a method of delivery of medical care by which an individual shall receive medical services from a health care provider without in person contact with the provider.

                 (c) The commission may not deny coverage of the sole basis that the coverage is provided through telemedicine if the health care service would be covered if it were provided through in-person consultation between the covered person and a health care provider.

                (d) Nothing in this section shall prohibit an insurer from providing coverage for only those services that are medically necessary and subject to the terms and conditions of the covered person’s policy.

                SECTION 4. Chapter 176B of the General Laws is hereby amended by inserting after section 4DD the following section:-

                Section 4EE. (a) As used in this section the following words shall, unless the context clearly requires otherwise, have the following meanings:-

“Health Benefit Policy”, Any individual or group plan, policy, or contract for healthcare services issued, delivered, issued for delivery, executed, or renewed in this state, including, but not limited to, those contracts executed by the Commonwealth on behalf of state employees.

“Insurer”, an accident and sickness insurer, fraternal benefit society, hospital service corporation, medical service corporation, health care corporation, managed care entity, or any similar entity authorized to issue contracts under this title or to provide health benefit policies.

“Telemedicine”, the use of audio, video or other electronic media for the purpose of diagnosis, consultation, or treatment as it pertains to the delivery of healthcare services. Telemedicine does not include the use of audio only telephone or facsimile.  

                 (b) A subscription certificate under an individual or group medical service agreement which is issued or renewed within or without the commonwealth shall provide benefits on a nondiscriminatory basis to residents of the commonwealth and to all policyholders having a principal place of employment in the commonwealth for the application of telemedicine for covered services provided within the scope of practice of a physician or health care provider as a method of delivery of medical care by which an individual shall receive medical services from a health care provider without in person contact with the provider.

                 (c) The commission may not deny coverage of the sole basis that the coverage is provided through telemedicine if the health care service would be covered if it were provided through in-person consultation between the covered person and a health care provider.

                (d) Nothing in this section shall prohibit an insurer from providing coverage for only those services that are medically necessary and subject to the terms and conditions of the covered person’s policy.

                SECTION 5. Chapter 176G of the General Laws is hereby amended by inserting after section 4V the following section:-

                Section 4W. (a) As used in this section the following words shall, unless the context clearly requires otherwise, have the following meanings:-

“Health Benefit Policy”, Any individual or group plan, policy, or contract for healthcare services issued, delivered, issued for delivery, executed, or renewed in this state, including, but not limited to, those contracts executed by the Commonwealth on behalf of state employees.

“Insurer”, an accident and sickness insurer, fraternal benefit society, hospital service corporation, medical service corporation, health care corporation, managed care entity, or any similar entity authorized to issue contracts under this title or to provide health benefit policies.

“Telemedicine”, the use of audio, video or other electronic media for the purpose of diagnosis, consultation, or treatment as it pertains to the delivery of healthcare services. Telemedicine does not include the use of audio only telephone or facsimile.  

                 (b) A health maintenance contract issued or renewed within or without the commonwealth shall provide benefits on a nondiscriminatory basis to residents of the commonwealth and to all policyholders having a principal place of employment in the commonwealth for the application of telemedicine for covered services provided within the scope of practice of a physician or health care provider as a method of delivery of medical care by which an individual shall receive medical services from a health care provider without in person contact with the provider.

                 (c) The commission may not deny coverage of the sole basis that the coverage is provided through telemedicine if the health care service would be covered if it were provided through in-person consultation between the covered person and a health care provider.

                (d) Nothing in this section shall prohibit an insurer from providing coverage for only those services that are medically necessary and subject to the terms and conditions of the covered person’s policy.

                SECTION 6. All policies, contracts and certificates of health insurance subject to section 25 of chapter 32A, section 47AA of chapter 175, section 8DD of chapter 176A, section 4CC of chapter 176B, and section 4V of chapter 176G of the General Laws which are delivered, issued or renewed on or after January 1, 2011 shall conform with the provisions of this act. Form filings implementing this act shall be subject to the approval of the commissioner of insurance.

                SECTION 7. This act shall take effect on January 1, 2012.