AN ACT TO REQUIRE HEALTH BENEFIT PLAN COVERAGE FOR THE DELIVERY OF HEALTH CARE SERVICES THROUGH TELEHEALTH.
Enacts GS 58-50-305, establishing guidelines and requirements regarding the coverage of health care services delivered through telehealth for health benefit plans (plans) offered in the State. Defines telehealth to mean the delivery of health care services by a licensed health care provider through (1) an encounter conducted through real-time interactive audio and video technology, (2) store and forward real-time interactive audio and video technologies as the standard practice of care where medical information is sent to a provider for evaluation, or (3) a communication in which the provider has access to the patient's medical history prior to the telehealth encounter. Excludes the delivery of services solely though email, text chat, or audio communication unless additional medical history and clinical information is communicated electronically between the provider and patient. Deems any in-person requirement satisfied with the use of asynchronous telecommunications technologies in which the health care provider has access to the patient's medical history prior to the telehealth encounter.
Prohibits plans from excluding from coverage services or procedures delivered by a health care professional to an insured through telehealth solely because the service or procedure is not provided in-person, including reimbursement for patient monitoring using telehealth. Requires plans to reimburse for provider-for-provider consultations that are conducted using telehealth the same as face-to-face reimbursement. Allows for plans to require a deductible, copayment, or coinsurance for covered services or procedures delivered through telehealth by a preferred or contracted provider, but bars setting amounts that exceed the amounts set for face-to-face services. Bars plans from requiring prior authorization for the delivery of health care services through telehealth if not required for face-to-face services. Bars plans from putting limits on the originating site or the distant site for the delivery of health care services through telehealth. Bars the use of telehealth for any health care services related to an abortion except for emergency therapeutic abortions.
Applies to health benefit plan contracts issued, renewed, or amended on or after October 1, 2021.
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