Amendment ID: S2769-69

Amendment 69

Ensuring Equitable Use of Prior Authorization Services for Telehealth on Par with In-Person Visits

Mr. Barrett, Ms. DiZoglio, Mr. Finegold, Ms. Gobi, Messrs. Welch, Velis, Timilty and O'Connor move that the proposed new draft be amended in section 3, in line 88, by striking the words “, including preauthorization,” and inserting in line 91 after the words “person.” the following:-

“Carriers shall not impose any prior authorization requirements to obtain medically necessary health services via telehealth that would not apply to receipt of those same services on an in-person basis.”;

and in section 49, in line 703, by striking the words “, including preauthorization,”; and inserting in line 706 after the words “person.” the following:-

“The division, a contracted health insurer, health plan, health maintenance organization, behavioral health management firm or third-party administrators under contract to a Medicaid managed care organization or primary care clinician plan shall not impose any prior authorization requirements to obtain medically necessary health services via telehealth that would not apply to receipt of those same services on an in-person basis.”;

and in section 52, in line 921, by striking the words “, including preauthorization,” and inserting in line 924 after the words “person.” the following:-

“A policy, contract, agreement, plan or certificate of insurance issued, delivered or renewed within the commonwealth shall not impose any prior authorization requirements to obtain medically necessary health services via telehealth that would not apply to receipt of those same services on an in-person basis.”;

and in section 53, in line 959, by striking the words “, including preauthorization,”; and inserting in line 961 after the words “person.” the following:-

“Carriers shall not impose any prior authorization requirements to obtain medically necessary health services via telehealth that would not apply to receipt of those same services on an in-person basis.”;

and in section 54, in line 993, by striking the words “, including preauthorization,”; and inserting in line 995 after the words “person.” the following:-

“Carriers shall not impose any prior authorization requirements to obtain medically necessary health services via telehealth that would not apply to receipt of those same services on an in-person basis.”;

and in section 55, in line 1028, by striking the words “, including preauthorization,”; and inserting in line 1030 after the words “person.” the following:-

“Carriers shall not impose any prior authorization requirements to obtain medically necessary health services via telehealth that would not apply to receipt of those same services on an in-person basis.”;

and in section 56, in line 1064, by striking the words “, including preauthorization,”; and inserting in line 1066 after the words “person.” the following:-

“An organization shall not impose any prior authorization requirements to obtain medically necessary health services via telehealth that would not apply to receipt of those same services on an in-person basis.”