Northeast Legislative/Regulatory March-April 2018 Update Please Note: CCHP has a pending legislation/regulation webpage located at the following link: http://cchpca.org/state-laws-and-reimbursement-policies LEGISLATION Pending Legislation State Bill # Status Summary Connecticut Connecticut Connecticut 5152 5299 302 2156 2174 3/28/18: Failed Joint Favorable deadline. 3/28/18: Failed Joint Favorable deadline. 3/26/18: Filed with Legislative Commissioner s Office 3/26/18: From Joint Committee on Financial Services: Amended by substitution of New Draft 3/26/18: From Joint Committee on Financial Services: Amended by substitution of New Draft. For Concerns the prescribing of controlled substances used in medication-assisted treatment of substance use disorders through the use of Telehealth. Concerns telehealth prescribing for treatment of psychiatric disorders; allows state licensed physicians to prescribe certain medications via telehealth for treatment of psychiatric disorders and change certain patient consent requirements; adds telehealth examinations; implements payment for parity for telehealth services. Concerns telehealth services; adds providers who can administer telehealth services and to modify and clarify patient consent procedures. Ensures telehealth is utilized to increase access to behavioral health services. Expands access to telemedicine services.
Page 2 further action see H 4332. 2179 3/26/18: From Joint Committee on Financial Services: Amended by substitution of New Draft. For further action see H 4332. Mandates coverage for telemedicine behavioral health services under certain circumstances. 2391 3/22/18: concurred. Relates to behavioral health services integration. 2434 2/6/18: In Joint Public : Extension Order Filed. Extended until 5/9/2018. Facilitates the provision of telehealth services 4332 3/26/18: To Joint Committee on Care Financing Advances and expands access to telemedicine services. 578 3/26/18: From Joint Committee on Financial Services: Amended by substitution of New Draft. For further action see H 4332. Advances and expands access to telemedicine services. 1095 2/6/18: In Joint Mental and Substance Abuse: Extension order filed. Extended until 3/20/18. Relates to behavioral health telemedicine. 620 Creates a rural home health flexibility program. The Commissioner can consider for approval proposals from providers operating
Page 3 under this article and serving rural counties to qualify for home telehealth reimbursement (among other items). New Hampshire 1471 3/29/18: Hearing for 4/3/18 This bill clarifies the law relating to telemedicine services. New Jersey 1583 1/9/18: To and Senior Services Enters New Jersey into the Multistate Nurse Licensure Compact. New Jersey 1699 2/5/18: Introduced and referred to, Human Services and Senior Citizens. Enters New Jersey into the Nurse Multistate Licensure Compact. New Jersey 954 1/16/18: To, Human Services and Senior Citizens Enters New Jersey into the Multistate Nurse Licensure Compact. 1026 Education. Relates to the power of certain school boards of education to provide or enter into contract for the provision of health care services for the school community; requires the school district to receive a subsidy or reimbursement in the same manner that a county would receive for providing those health care services. Allows telemedicine to be used as a method of delivery. 1410 Promotes the development, provision and accessibility of telehealth/telemedicine services in state; establishes a telehealth/telemedicine development and research grant fund. 1419 Insurance Requires comprehensive motor vehicle reparations and workers' compensation coverage of health care services delivered by means of telehealth. 1421 2/26/18: Amended in Relates to rates of reimbursement for telehealth services; requires insurers to reimburse telehealth providers at the same rate as they would if the services had been provided in person; reimburses
Page 4 Insurance. the telehealth provider for covered services delivered via telehealth on the same basis and at the same rate as established for the same service when not delivered via telehealth. 1535 Corporations, Authorities and Commissions Provides for the delivery and insurance coverage of telehealth services by means of home care services. 1958 Bill states in its Legislative Findings that the legislature finds that rural areas in NY lack the multiple telecommunications connections necessary to link outside resources during times of emergency, that broadband networks are necessary to facilitate telemedicine networks that connect rural and urban medical centers and that increased broadband networks and advanced communications services will enhance government operations through telemedicine for healthcare, distance learning for education, redundant and diversely pathed communications networks for public safety communications and to generally protect the health and welfare of the state and its citizens. 827 Provides that demonstration rates of payment for telehealth services by home health agencies, long term home health care and AIDS home care shall be paid to providers in an equitable and direct manner. 9507 3/30/18: Substituted by S 7507 Delivered to Governor Creates the healthcare facility transformation program which would foster participation in value based payment models intended to (among other components) improve health information technology infrastructure, including telehealth, to strengthen the acute, post-acute and long term care continuum. Also it amends the definition of an originating site to make it subject to regulation by the Commissioner of Mental, Office of Alcoholism and Substance Abuse Services and Office of People with Developmental Disabilities. 9521 2/6/18: Reported. Ways and Means. Provides for payment for telehealth services under the medical assistance program. 2880 Corporations, Bill states in its Legislative Findings that the legislature finds that rural areas in NY lack the multiple telecommunications connections necessary to link outside resources during times of emergency, that broadband networks are necessary to facilitate telemedicine networks that connect rural and urban medical
Page 5 Authorities and Commissions centers and that increased broadband networks and advanced communications services will enhance government operations through telemedicine for healthcare, distance learning for education, redundant and diversely pathed communications networks for public safety communications and to generally protect the health and welfare of the state and its citizens. 3937 Provides for the delivery and insurance coverage of telehealth services by means of home care services. 3951 Insurance Requires comprehensive motor vehicle reparations and workers' compensation coverage of health care services delivered by means of telehealth. 6947 1/16/18: Amended in Finance Establishes the sexual assault forensic examination telemedicine pilot program. 7507 4/2/18: Delivered to Governor Creates the healthcare facility transformation program which would foster participation in value based payment models intended to (among other components) improve health information technology infrastructure, including telehealth, to strengthen the acute, post-acute and long term care continuum. Also it amends the definition of an originating site to make it subject to regulation by the Commissioner of Mental, Office of Alcoholism and Substance Abuse Services and Office of People with Developmental Disabilities. 7579 1/26/18: Introduced and referred to Higher Education Enacts the Interstate Medical Licensure Compact. 833 1/25/18: Amended in Labor Establishes a task force to conduct a study on the ability to utilize telehealth within the workers' compensation system.
Page 6 834 1/26/18: Amended in Relates to rates of reimbursement for telehealth services; requires insurers to reimburse telehealth providers at the same rate as they would if the services had been provided in person. Rhode Island 2549 3/15/18: Adopted by. 3/27/18: To House Care Extends the reporting and expiration dates of the special commission to examine the advisability of joining the Interstate Medical Licensure Compact. Adopts the Interstate Medical Licensure Compact. Vermont 253 2017 Carry Over Legislation State Bill # Status Summary Maine 701 6/6/17: Placed on Special Appropriation s Table pending final passage Maine LR 2196 10/27/17: Accepted by Legislative Committee Maine LR 2219 10/27/17: Accepted by Legislative Committee 2443 10/30/17: Hearing scheduled for 11/7 1244 (Formerl y SD 897) 10/24/17: In Joint Public : Heard. Eligible for Executive Session The Department of and Human Services is directed to explore opportunities to provide additional telehealth services, including care coordination services, provided by both licensed medical personnel and non-licensed personnel. This bill requires that services under MaineCare that are provided through telehealth be reimbursed at the same rates as those services that are not provided through telehealth. The bill also requires the Department of and Human Services to amend its rule relating to MaineCare coverage for services delivered through telehealth. Relates to commercial insurers; relates to telehealth. Allows for credentialing and privileging by proxy for telemedicine services under certain circumstances. Facilitates the provision of telehealth services.
Page 7 2202 11/9/17: Amended on Floor. Further action see 2211. 2211 11/9/17: In. Read third time. Passed. House. 501 7/18/17: Eligible for Executive session. 527 7/18/17: Eligible for Executive session. 532 7/18/17: Eligible for Executive session. 549 7/18/17: Eligible for Executive session. Rhode Island 6299 6/25/17: Meeting postponed Rhode Island 269 3/30/17: Committee recommended measure be held for further study Rhode Island 330 4/28/17: To House Corporations Vermont 118 1/24/17: Furthers health empowerment and affordability by leveraging transformative health care. Furthers health empowerment and affordability while leveraging transformative health care. Expands access to telemedicine services. Relates to telemedicine. Relates to full application of telemedicine coverage. Advances and expands access to telemedicine services. Requires the Commissioner to make recommendations regarding adequate telemedicine reimbursement rates that will ensure quality access to mental health and behavioral health services. Enacts the interstate medical licensure compact. Requires the Commissioner, before Jan. 1, 2018 to make recommendations regarding the adequate telemedicine reimbursement rates that will ensure quality access to mental health and behavioral health providers, among other components. Relates to insurance coverage for telemedicine services delivered in or outside a health care facility.
Page 8 House Care Vermont 281 2/16/17: Introduced and referred to House Human Services Requires the trauma informed service director to conduct an inventory of available resources, program capabilities and coordination capacity in each county, including the availability of referral treatment programs for families and individuals who have experienced trauma or are experiencing trauma and whether telemedicine may be used to address shortages in services (among other items). REGULATION Pending Regulation State Rule Citation Status Summary Maine 10-144-101, Ch. I, Sec. 4 New Hampshire Mhp 501.02(a)(3) New Jersey NJAC 10:60-1.1, 1.2, 1.3, 1.6, 1.7, 1.8, 1.9, 2.2, 2.3, 2.5, 3.1 through 3.9, 5.1 through 5.11, 11.2, 11/17/17: Proposed Rule Comment Deadline: 12/15/17 2/1/18: Expedited Rule Notice Comment Deadline: 2/15/18 3/8/18: Expedited rule up for joint legislative committee on administrative rules review 8/21/17: Proposed Rule Comment Deadline: 10/20/17 Title: Mainecare Benefits Manual Agency: Office of MaineCare Services Allows telehealth services to include a FQHC, RHC or IHC scope of practice, as approved by HRSA and the State. These facilities may serve as the provider site and bill under the encounter rate. Title: Code of Ethics Agency: Board of Mental Practitioners Amends rules relating to the counselor client relationship, telehealth, distance counseling, and social media, nondiscrimination, forensic activity, and the commitment to students, supervisees, and employees. Title: Home Care Services Agency: Division of Medical Assistance and Services Concerns rules and regulations regarding several waiver programs providing home and community-based services into the New Jersey 1115 Comprehensive Medicaid Waiver (the Comprehensive Waiver) and the implementation of sections of the Affordable Care Act. Contains section on telehealth.
Page 9 10:60 Appendix A, 10:60-6, 10:60-3.10, 10:60-4, 7, 8, 9, 10 Adopted Regulation State Rule Citation Status Summary Maine 2-373-1 1/5/18: Adopted Rule Partial: 2-373-1 Effective: 12/23/17 New Hampshire 104 CMR 27.00, 28.00 Spe 301.04,.05, 406.02, 607 New Jersey NJAC 11:20-1.2, 12.4, 24.2A, 24.4, 11:20 Appendix Exhibits A and B New Jersey NJAC 10:31, 10:31 2/23/18: Rule Adopted Effective; 2/23/18 3/8/18: Rule Adopted Effective: 3/1/18 11/6/17: Rule Adoption 12/20/17: Readopted Title: Rule Regarding Physicians Agency: Board of Licensure Medicine Repeals and replaces rule that establishes medical licensure requirements. Establishes the Interstate Telemedicine Consultation Registration, and places limits on physicians under this registration. It also provides a definition for telemedicine. Title: Licensing and Operational Standards for Mental Agency: Department of Mental Simplifies privacy rules by applying federal HIPAA standards for disclosures for purposes of "treatment, payment and operations"; new language allows for alternative technology, such as telemedicine; clarifies current licensing practice regarding DMH action in response to licensing application, plans of correction, staff training, notices to DMH from licensed facilities; adopts language similar to DPH licensing regulations concerning required notifications to DMH; repeals outdated section on behavior management; updates language regarding authority of guardians to conform with current Uniform Probate Code in effect; reorganization of sections for clarity. Title: Speech Language Pathology Agency: Governing Board of Speech-Language Pathologists Allows real time telecommunication technology to be used for purposes of direct supervision. Title: Individual Benefits Plans Agency: Individual Coverage Program Board Concerns rules and regulations regarding standard health benefits plans offered in the individual market. Specifically related to telehealth, the proposal would replace the definition for telehealth and telemedicine and create a new variable provision to address telemedicine and/or telehealth coverage. Title: Screening and Screening Outreach Program Agency: Division of Mental and Addiction Services
Page 10 Appendix A, 10:31-12 Title 14 NYCRR Part 830 rule with amendments Effective: 1/16/18 1/8/18: Rule adopted Effective: 1/24/18 Concerns rules and regulations regarding screening and screening outreach programs. Contains section on telepsychiatry. Title: Acupuncture and Telepractice Agency: Office of Alcoholism and Substance Abuse Services The proposal (among other components) adds a new optional service of Telepractice which certified providers with adequate technology may choose to implement.