House Bill No. 6001
July Special Session, Public Act No. 20-2
AN ACT CONCERNING TE LEHEALTH.
Be it enacted by the Senate and House of Representatives in General
Assembly convened:
Section 1. (Effective from passage) (a) As used in this section:
(1) "Asynchronous" has the same meaning as provided in section 19a-
906 of the general statutes.
(2) "Connecticut medical assistance program" means the state's
Medicaid program and the Children's Health Insurance program
administered by the Department of Social Services.
(3) "Facility fee" has the same meaning as provided in section 19a-
508c of the general statutes.
(4) "Health record" has the same meaning as provided in section 19a-
906 of the general statutes.
(5) "Medical history" has the same meaning as provided in section
19a-906 of the general statutes.
(6) "Medication-assisted treatment" has the same meaning as
provided in section 19a-906 of the general statutes.
(7) "Originating site" has the same meaning as provided in section House Bill No. 6001
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19a-906 of the general statutes.
(8) "Peripheral devices" has the same meaning as provided in section
19a-906 of the general statutes.
(9) "Remote patient monitoring" has the same meaning as provided
in section 19a-906 of the general statutes.
(10) "Store and forward transfer" has the same meaning as provided
in section 19a-906 of the general statutes.
(11) "Synchronous" has the same meaning as provided in section 19a-
906 of the general statutes.
(12) "Telehealth" means the mode of delivering health care or other
health services via information and communication technologies to
facilitate the diagnosis, consultation and treatment, education, care
management and self-management of a patient's physical, oral and
mental health, and includes interaction between the patient at the
originating site and the telehealth provider at a distant site, synchronous
interactions, asynchronous store and forward transfers or remote
patient monitoring, but does not include interaction through (A)
facsimile, texting or electronic mail, or (B) audio-only telephone unless
the telehealth provider is (i) in-network, or (ii) a provider enrolled in the
Connecticut medical assistance program providing such health care or
other health services to a Connecticut medical assistance program
recipient.
(13) "Telehealth provider" means any person who is (A) an in-
network provider or a provider enrolled in the Connecticut medical
assistance program providing health care or other health services to a
Connecticut medical assistance program recipient through the use of
telehealth within such person's scope of practice and in accordance with
the standard of care applicable to such person's profession, and (B) (i) a
physician or physician assistant licensed under chapter 370 of the House Bill No. 6001
July Sp. Sess., Public Act No. 20-2 3 of 24
general statutes, physical therapist or physical therapist assistant
licensed under chapter 376 of the general statutes, chiropractor licensed
under chapter 372 of the general statutes, naturopath licensed under
chapter 373 of the general statutes, podiatrist licensed under chapter 375
of the general statutes, occupational therapist or occupational therapy
assistant licensed under chapter 376a of the general statutes, optometrist
licensed under chapter 380 of the general statutes, registered nurse or
advanced practice registered nurse licensed under chapter 378 of the
general statutes, psychologist licensed under chapter 383 of the general
statutes, marital and family therapist licensed under chapter 383a of the
general statutes, clinical social worker or master social worker licensed
under chapter 383b of the general statutes, alcohol and drug counselor
licensed under chapter 376b of the general statutes, professional
counselor licensed under chapter 383c of the general statutes, dietitian-
nutritionist certified under chapter 384b of the general statutes, speech
and language pathologist licensed under chapter 399 of the general
statutes, respiratory care practitioner licensed under chapter 381a of the
general statutes, audiologist licensed under chapter 397a of the general
statutes, pharmacist licensed under chapter 400j of the general statutes,
paramedic licensed pursuant to chapter 384d of the general statutes,
nurse-midwife licensed under chapter 377 of the general statutes,
dentist licensed under chapter 379 of the general statutes, behavior
analyst licensed under chapter 382a of the general statutes, genetic
counselor licensed under chapter 383d of the general statutes, music
therapist certified in the manner described in chapter 383f of the general
statutes, art therapist certified in the manner described in chapter 383g
of the general statutes or athletic trainer licensed under chapter 375a of
the general statutes, or (ii) an appropriately licensed, certified or
registered physician, physician assistant, physical therapist, physical
therapist assistant, chiropractor, naturopath, podiatrist, occupational
therapist, occupational therapy assistant, optometrist, registered nurse,
advanced practice registered nurse, psychologist, marital and family
therapist, clinical social worker, master social worker, alcohol and drug House Bill No. 6001
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counselor, professional counselor, dietitian-nutritionist, speech and
language pathologist, respiratory care practitioner, audiologist,
pharmacist, paramedic, nurse-midwife, dentist, behavior analyst,
genetic counselor, music therapist, art therapist or athletic trainer, in
another state or territory of the United States or the District of Columbia,
that provides telehealth services pursuant to his or her authority under
any relevant order issued by the Commissioner of Public Health and
maintains professional liability insurance or other indemnity against
liability for professional malpractice in an amount that is equal to or
greater than that required for similarly licensed, certified or registered
Connecticut health care providers.
(b) (1) Notwithstanding the provisions of section 19a-906 of the
general statutes, during the period beginning on the effective date of
this section and ending on March 15, 2021, a telehealth provider may
only provide a telehealth service to a patient when the telehealth
provider:
(A) Is communicating through real-time, interactive, two-way
communication technology or store and forward transfer technology;
(B) Has determined whether the patient has health coverage that is
fully insured, not fully insured or provided through Medicaid or the
Children's Health Insurance Program, and whether the patient's health
coverage, if any, provides coverage for the telehealth service;
(C) Has access to, or knowledge of, the patient's medical history, as
provided by the patient, and the patient's health record, including the
name and address of the patient's primary care provider, if any;
(D) Conforms to the standard of care applicable to the telehealth
provider's profession and expected for in-person care as appropriate to
the patient's age and presenting condition, except when the standard of
care requires the use of diagnostic testing and performance of a physical House Bill No. 6001
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examination, such testing or examination may be carried out through
the use of peripheral devices appropriate to the patient's condition; and
(E) Provides the patient with the telehealth provider's license
number, if any, and contact information.
(2) Notwithstanding the provisions of section 19a-906 of the general
statutes, if a telehealth provider provides a telehealth service to a patient
during the period beginning on the effective date of this section and
ending on March 15, 2021, the telehealth provider shall, at the time of
the telehealth provider's first telehealth interaction with a patient,
inform the patient concerning the treatment methods and limitations of
treatment using a telehealth platform, including, but not limited to, the
limited duration of the relevant provisions of this section and sections 2
to 5, inclusive, of this act, and, after providing the patient with such
information, obtain the patient's consent to provide telehealth services.
The telehealth provider shall document such notice and consent in the
patient's health record. If a patient later revokes such consent, the
telehealth provider shall document the revocation in the patient's health
record.
(c) Notwithstanding the provisions of this section or title 20 of the
general statutes, no telehealth provider shall, during the period
beginning on the effective date of this section and ending on March 15,
2021, prescribe any schedule I, II or III controlled substance through the
use of telehealth, except a schedule II or III controlled substance other
than an opioid drug, as defined in section 20-14o of the general statutes,
in a manner fully consistent with the Ryan Haight Online Pharmacy
Consumer Protection Act, 21 USC 829(e), as amended from time to time,
for the treatment of a person with a psychiatric disability or substance
use disorder, as defined in section 17a-458 of the general statutes,
including, but not limited to, medication-assisted treatment. A
telehealth provider using telehealth to prescribe a schedule II or III
controlled substance pursuant to this subsection shall electronically House Bill No. 6001
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submit the prescription pursuant to section 21a-249 of the general
statutes.
(d) During the period beginning on the effective date of this section
and ending on March 15, 2021, each telehealth provider shall, at the time
of the initial telehealth interaction, ask the patient whether the patient
consents to the telehealth provider's disclosure of records concerning
the telehealth interaction to the patient's primary care provider. If the
patient consents to such disclosure, the telehealth provider shall provide
records of all telehealth interactions during such period to the patient's
primary care provider, in a timely manner, in accordance with the
provisions of sections 20-7b to 20-7e, inclusive, of the general statutes.
(e) During the period beginning on the effective date of this section
and ending on March 15, 2021, any consent or revocation of consent
under this section shall be obtained from or communicated by the
patient, or the patient's legal guardian, conservator or other authorized
representative, as applicable.
(f) (1) The provision of telehealth services and health records
maintained and disclosed as part of a telehealth interaction shall comply
with all provisions of the Health Insurance Portability and
Accountability Act of 1996 P.L. 104-191, as amended from time to time,
and the rules and regulations adopted thereunder, that are applicable to
such provision, maintenance or disclosure.
(2) Notwithstanding the provisions of section 19a-906 of the general
statutes and subdivision (1) of this subsection, a telehealth provider that
is an in-network provider or a provider enrolled in the Connecticut
medical assistance program that provides telehealth services to a
Connecticut medical assistance program recipient, may, during the
period beginning on the effective date of this section and ending on
March 15, 2021, use any information or communication technology in
accordance with the directions, modifications or revisions, if any, made House Bill No. 6001
July Sp. Sess., Public Act No. 20-2 7 of 24
by the Office for Civil Rights of the United States Department of Health
and Human Services to the provisions of the Health Insurance
Portability and Accountability Act of 1996 P.L. 104-191, as amended
from time to time, or the rules and regulations adopted thereunder.
(g) Notwithstanding any provision of the general statutes, nothing in
this section shall, during the period beginning on the effective date of
this section and ending on March 15, 2021, prohibit a health care
provider from: (1) Providing on-call coverage pursuant to an agreement
with another health care provider or such health care provider's
professional entity or employer; (2) consulting with another health care
provider concerning a patient's care; (3) ordering care for hospital
outpatients or inpatients; or (4) using telehealth for a hospital inpatient,
including for the purpose of ordering medication or treatment for such
patient in accordance with the Ryan Haight Online Pharmacy
Consumer Protection Act, 21 USC 829(e), as amended from time to time.
As used in this subsection, "health care provider" means a person or
entity licensed or certified pursuant to chapter 370, 372, 373, 375, 376 to
376b, inclusive, 378, 379, 380, 381a, 383 to 383c, inclusive, 384b, 397a, 399
or 400j of the general statutes or licensed or certified pursuant to chapter
368d or 384d of the general statutes.
(h) Notwithstanding any provision of the general statutes, no
telehealth provider shall charge a facility fee for a telehealth service
provided during the period beginning on the effective date of this
section and ending on March 15, 2021.
(i) (1) Notwithstanding any provision of the general statutes, a
telehealth provider who provides health care or health services to a
patient through telehealth during the period beginning on the effective
date of this section and ending on March 15, 2021, shall accept as full
payment for such health care or health services:
(A) An amount that is equal to the amount that Medicare reimburses House Bill No. 6001
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for such health care or health services if the telehealth provider
determines that the patient does not have health coverage for such
health care or health services; or
(B) The amount that the patient's health coverage reimburses, and
any coinsurance, copayment, deductible or other out-of-pocket expense
imposed by the patient's health coverage, for such health care or health
services if the telehealth provider determines that the patient has health
coverage for such health care or health services.
(2) If a telehealth provider determines that a patient is unable to pay
for any health care or health services described in subdivision (1) of this
subsection that the provider provided to the patient through telehealth
during the period described in said subdivision, the provider shall offer
to the patient financial assistance, if such provider is otherwise required
to offer to the patient such financial assistance, under any applicable
state or federal law.
(j) Notwithstanding any provision of the general statutes or any
regulation adopted thereunder, a telehealth provider may provide
telehealth services pursuant to the provisions of this section from any
location.
(k) Notwithstanding the provisions of section 19a-906 of the general
statutes, during the period beginning on the effective date of this section
and ending on March 15, 2021, any Connecticut entity, institution or
health care provider that engages or contracts with a telehealth provider
that is licensed, certified or registered in another state or territory of the
United States or the District of Columbia to provide health care or other
health services shall verify the credentials of such provider in the state
in which he or she is licensed, certified or registered, ensure that such a
provider is in good standing in such state, and confirm that such
provider maintains professional liability insurance or other indemnity
against liability for professional malpractice in an amount that is equal House Bill No. 6001
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to or greater than that required for similarly licensed, certified or
registered Connecticut health care providers.
(l) Notwithstanding sections 4-168 to 4-174, inclusive, of the general
statutes, from the period beginning on the effective date of this section
and ending on March 15, 2021, the Commissioner of Public Health may
temporarily waive, modify or suspend any regulatory requirements
adopted by the Commissioner of Public Health or any boards or
commissions under chapters 368a, 368d, 368v, 369 to 381a, inclusive,
382a, 383 to 388, inclusive, 397a, 398, 399, 400a, 400c, 400j and 474 of the
general statutes as the Commissioner of Public Health deems necessary
to reduce the spread of COVID-19 and to protect the public health.
Sec. 2. Section 21a-249 of the general statutes is repealed and the
following is substituted in lieu thereof (Effective from passage):
(a) All prescriptions for controlled drugs shall include (1) the name
and address of the patient, or the name and address of the owner of an
animal and the species of the animal, (2) whether the patient is an adult
or a child, or his specific age, (3) the compound or preparation
prescribed and the amount thereof, (4) directions for use of the
medication, (5) the name and address of the prescribing practitioner, (6)
the date of issuance, and (7) the Federal Registry number of the
practitioner. No prescription blank containing a prescription for a
schedule II substance shall contain more than one prescription. No
prescription or order for a controlled substance issued by a practitioner
to an inanimate object or thing shall be considered a valid prescription
within the meaning of this chapter.
(b) Each prescribing practitioner, as defined in section 20-14c, who
the Department of Consumer Protection authorizes to prescribe
controlled substances, within the scope of practice of his or her license,
shall electronically transmit the controlled substance prescription to a
pharmacy. Electronically transmitted prescriptions shall be promptly House Bill No. 6001
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printed out in hardcopy or created as an electronic record and filed by
the prescriber. Electronically transmitted prescriptions shall be
consistent with the requirements of the federal Controlled Substances
Act, 21 USC 801, as amended from time to time. All records shall be kept
on file for three years at the premises of the licensed practitioner and
maintained in such form as to be readily available for inspection by the
commissioner, his or her authorized agent or other persons, as
authorized in section 21a-265, at reasonable times. For purposes of this
subsection and subsections (c), (d) and (e) of this section, the term
"electronically transmit" means to transmit by computer modem or
other similar electronic device.
(c) A licensed practitioner shall not be required to electronically
transmit a prescription when:
(1) Electronic transmission is not available due to a temporary
technological or electrical failure. In the event of a temporary
technological or electrical failure, the practitioner shall, without undue
delay, reasonably attempt to correct any cause for the failure that is
within his or her control. A practitioner who issues a prescription, but
fails to electronically transmit the prescription, as permitted by this
subsection, shall document the reason for the practitioner's failure to
electronically transmit the prescription in the patient's medical record
as soon as practicable, but in no instance more than seventy-two hours
following the end of the temporary technological or electrical failure
that prevented the electronic transmittal of the prescription. For
purposes of this subdivision, "temporary technological or electrical
failure" means failure of a computer system, application or device or the
loss of electrical power to such system, application or device, or any
other service interruption to such system, application or device that
reasonably prevents the practitioner from utilizing his or her certified
application to electronically transmit the prescription in accordance
with subsection (b) of this section; House Bill No. 6001
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(2) The practitioner reasonably determines that it would be
impractical for the patient to obtain substances prescribed by an
electronically transmitted prescription in a timely manner and that such
delay would adversely impact the patient's medical condition, provided
if such prescription is for a controlled substance, the quantity of such
controlled substance does not exceed a five-day supply for the patient,
if the controlled substance was used in accordance with the directions
for use. A practitioner who issues a prescription, but fails to
electronically transmit the prescription, as permitted by this subsection,
shall document the reason for the practitioner's failure to electronically
transmit the prescription in the patient's medical record;
(3) The prescription is to be dispensed by a pharmacy located outside
this state. A practitioner who issues a prescription, but fails to
electronically transmit the prescription, as permitted by this subsection,
shall document the reason for the practitioner's failure to electronically
transmit the prescription in the patient's medical record;
(4) Use of an electronically transmitted prescription may negatively
impact patient care, such as a prescription containing two or more
products to be compounded by a pharmacist, a prescription for direct
administration to a patient by parenteral, intravenous, intramuscular,
subcutaneous or intraspinal infusion, a prescription that contains long
or complicated directions, a prescription that requires certain elements
to be included by the federal Food and Drug and Administration, or an
oral prescription communicated to a pharmacist by a health care
practitioner for a patient in a chronic and convalescent nursing home,
licensed pursuant to chapter 368v; or
(5) The practitioner demonstrates, in a form and manner prescribed
by the commissioner, that such practitioner does not have the
technological capacity to issue electronically transmitted prescriptions.
For the purposes of this subsection, "technological capacity" means
possession of a computer system, hardware or device that can be used House Bill No. 6001
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to electronically transmit controlled substance prescriptions consistent
with the requirements of the federal Controlled Substances Act, 21 USC
801, as amended from time to time. The provisions of this subdivision
shall not apply to a practitioner when such practitioner is prescribing as
a telehealth provider, as defined in section 19a-906 or section 1 of this
act, as applicable, pursuant to [subdivision (2) of] subsection (c) of [said]
section 19a-906 or subsection (c) of section 1 of this act, as applicable.
(d) Any prescription issued in a form other than an electronically
transmitted prescription pursuant to subsection (c) of this section may
be issued as a written order or, to the extent permitted by the federal
Controlled Substance Act, 21 USC 801, as from time to time amended,
as an oral order or transmitted by facsimile machine. Such oral order or
order transmitted by facsimile machine shall be promptly reduced to
writing on a prescription blank or a hardcopy printout or created as an
electronic record and filed by the pharmacist filling it. No duplicate,
carbon or photographic copies and no printed or rubber-stamped orders
shall be considered valid prescriptions within the meaning of this
chapter.
(e) Prescriptions for schedule II substances shall be electronically
transmitted by the prescribing practitioner at the time of issuance and
previously signed orders for such schedule II substances shall not be
considered valid prescriptions within the meaning of this chapter. No
practitioner shall prescribe, dispense or administer schedule II
sympathomimetic amines as anorectics, except as may be authorized by
regulations adopted by the Departments of Public Health and
Consumer Protection acting jointly. To the extent permitted by the
federal Controlled Substances Act, 21 USC 801, as from time to time
amended, in an emergency, the dispensing of schedule II substances
may be made upon the oral order of a prescribing registrant known to
or confirmed by the filling pharmacist. The filling pharmacist shall
promptly reduce such oral order to writing on a prescription blank, House Bill No. 6001
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provided such oral order shall be confirmed by the proper completion
and mailing or delivery of a prescription prepared by the prescribing
registrant to the pharmacist filling such oral order within seventy-two
hours after the oral order has been given. Such prescription of the
registrant shall be affixed to the temporary prescription prepared by the
pharmacist and both prescriptions shall be maintained on file as
required in this chapter. The Department of Public Health and the
Department of Consumer Protection, acting jointly, may adopt
regulations, in accordance with chapter 54, allowing practitioners to
prescribe, dispense or administer schedule II sympathomimetic amines
as anorectics under certain specific circumstances. Nothing in this
subsection shall be construed to require a licensed pharmacist to
determine the diagnosis of a patient prior to dispensing a prescription
for such substances to a patient.
(f) All prescriptions for controlled substances shall comply fully with
any additional requirements of the federal food and drug laws, the
federal Controlled Substances Act, and state laws and regulations
adopted under this chapter.
(g) Repealed by P.A. 82-419, S. 46, 47.
(h) Except when dispensed directly by a practitioner, other than a
pharmacy, to an ultimate user, a controlled substance included in
schedule III or IV, which is a prescription drug as determined under
federal food and drug laws, shall not be dispensed without a written,
electronically transmitted or oral prescription of a practitioner. The
prescription shall not be filled or refilled more than six months after the
date thereof or be refilled more than five times, unless renewed by the
practitioner.
(i) A controlled substance included in schedule V shall not be
distributed or dispensed other than for a medical purpose. House Bill No. 6001
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(j) A pharmacy may sell and dispense controlled substances upon the
prescription of a prescribing practitioner, as defined in subdivision (22)
of section 20-571.
(k) Pharmacies shall file filled prescriptions for controlled substances
separately from other prescriptions. All schedule II prescriptions shall
be filed in a separate file or in an electronic file. All schedule III, IV and
V prescriptions shall be filed in another separate file or in an electronic
file, except as otherwise provided for in regulations adopted pursuant
to section 21a-243, 21a-244 or 21a-244a. All written controlled substance
prescriptions shall, immediately upon filling, be filed chronologically
and consecutively.
(l) (1) Any pharmacy may transfer: [prescriptions]
(A) A prescription for a controlled [substances] substance included in
[schedules] schedule III, IV [and] or V to any other pharmacy in
accordance with the requirements set forth in the federal Controlled
Substances Act 21 USC 801 et seq. and the regulations promulgated
thereunder, as from time to time amended; [.] and
(B) An unfilled prescription for a controlled substance included in
schedule II, III, IV or V that was electronically transmitted in accordance
with the requirements set forth in the federal Controlled Substances Act
21 USC 801 et seq. and the regulations promulgated thereunder, as from
time to time amended. The pharmacy may transfer the unfilled
electronic prescription by telephone or other electronic transmission if:
(i) Such transfer is consistent with the federal Controlled Substances
Act 21 USC 801 et seq. and the regulations promulgated thereunder, as
from time to time amended, and policies established by the federal Drug
Enforcement Administration;
(ii) The pharmacy that first receives such prescription: House Bill No. 6001
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(I) Takes measures to prevent such prescription from being filled at
any pharmacy other than the pharmacy to which the such pharmacy is
transferring such prescription; and
(II) Records the name, telephone number and address of the
pharmacy to which such pharmacy is transferring such prescription,
and the name and license number of the pharmacist who receives such
transferred prescription; and
(iii) The pharmacy that receives such transferred prescription
records:
(I) All of the information required under subsection (a) of this section;
(II) That such prescription has been transferred;
(III) The name of the pharmacy that first received such prescription;
(IV) The date on which such prescription was issued;
(V) The date on which such prescription was transferred; and
(VI) Any refills issued for such prescription if such prescription is for
a controlled substance included in schedule III, IV or V of the federal
Controlled Substances Act 21 USC 801 et seq.
(2) The pharmacy that first receives an electronically transmitted
prescription described in subparagraph (B) of subdivision (1) of this
subsection may send a facsimile containing the prescription information
for such prescription if such pharmacy is transferring such prescription
pursuant to said subparagraph by telephone.
(m) A practitioner authorized to prescribe controlled substances shall
not prescribe anabolic steroids for the sole purpose of enhancing a
patient's athletic ability or performance. House Bill No. 6001
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(n) Each pharmacy, as defined in section 20-571, shall accept an
electronically transmitted prescription for a controlled substance from a
practitioner, as defined in section 21a-316. All records shall be kept on
file for three years at the premises of the pharmacy and maintained
current and separate from other business records in such form as to be
readily available at the pharmacy for inspection by the Commissioner
of Consumer Protection, his or her authorized agent or other persons, as
authorized in section 21a-265, at reasonable times. Prescription records
received from the practitioner electronically may be stored
electronically, provided the files are maintained in the pharmacy
computer system for not less than three years. If the electronically
transmitted prescription is printed, it shall be filed as required in
subsection (k) of this section.
Sec. 3. (Effective from passage) (a) For the purposes of this section:
(1) "Asynchronous" has the same meaning as provided in section 19a-
906 of the general statutes;
(2) "Originating site" has the same meaning as provided in section
19a-906 of the general statutes;
(3) "Remote patient monitoring" has the same meaning as provided
in section 19a-906 of the general statutes;
(4) "Store and forward transfer" has the same meaning as provided in
section 19a-906 of the general statutes;
(5) "Synchronous" has the same meaning as provided in section 19a-
906 of the general statutes;
(6) "Telehealth" means the mode of delivering health care or other
health services via information and communication technologies to
facilitate the diagnosis, consultation and treatment, education, care
management and self-management of an insured's physical, oral and House Bill No. 6001
July Sp. Sess., Public Act No. 20-2 17 of 24
mental health, and includes interaction between the insured at the
originating site and the telehealth provider at a distant site, synchronous
interactions, asynchronous store and forward transfers or remote
patient monitoring, but does not include interaction through (A)
facsimile, texting or electronic mail, or (B) audio-only telephone if the
telehealth provider is out-of-network; and
(7) "Telehealth provider" means any person who (A) provides health
care or other health services through the use of telehealth within such
person's scope of practice and in accordance with the standard of care
applicable to such person's profession, and (B) is (i) a physician or
physician assistant licensed under chapter 370 of the general statutes,
physical therapist or physical therapist assistant licensed under chapter
376 of the general statutes, chiropractor licensed under chapter 372 of
the general statutes, naturopath licensed under chapter 373 of the
general statutes, podiatrist licensed under chapter 375 of the general
statutes, occupational therapist or occupational therapy assistant
licensed under chapter 376a of the general statutes, optometrist licensed
under chapter 380 of the general statutes, registered nurse or advanced
practice registered nurse licensed under chapter 378 of the general
statutes, psychologist licensed under chapter 383 of the general statutes,
marital and family therapist licensed under chapter 383a of the general
statutes, clinical social worker or master social worker licensed under
chapter 383b of the general statutes, alcohol and drug counselor licensed
under chapter 376b of the general statutes, professional counselor
licensed under chapter 383c of the general statutes, dietitian-nutritionist
certified under chapter 384b of the general statutes, speech and
language pathologist licensed under chapter 399 of the general statutes,
respiratory care practitioner licensed under chapter 381a of the general
statutes, audiologist licensed under chapter 397a of the general statutes,
pharmacist licensed under chapter 400j of the general statutes,
paramedic licensed pursuant to chapter 384d of the general statutes,
nurse-midwife licensed under chapter 377 of the general statutes, House Bill No. 6001
July Sp. Sess., Public Act No. 20-2 18 of 24
dentist licensed under chapter 379 of the general statutes, behavior
analyst licensed under chapter 382a of the general statutes, genetic
counselor licensed under chapter 383d of the general statutes, music
therapist certified in the manner described in chapter 383f of the general
statutes, art therapist certified in the manner described in chapter 383g
of the general statutes or athletic trainer licensed under chapter 375a of
the general statutes, or (ii) an in-network and appropriately licensed,
certified or registered physician, physician assistant, physical therapist,
physical therapist assistant, chiropractor, naturopath, podiatrist,
occupational therapist, occupational therapy assistant, optometrist,
registered nurse, advanced practice registered nurse, psychologist,
marital and family therapist, clinical social worker, master social
worker, alcohol and drug counselor, professional counselor, dietitian-
nutritionist, speech and language pathologist, respiratory care
practitioner, audiologist, pharmacist, paramedic, nurse-midwife,
dentist, behavior analyst, genetic counselor, music therapist, art
therapist or athletic trainer, in another state or territory of the United
States or the District of Columbia, that provides telehealth services
pursuant to his or her authority under any relevant order issued by the
Commissioner of Public Health and maintains professional liability
insurance or other indemnity against liability for professional
malpractice in an amount that is equal to or greater than that required
for similarly licensed, certified or registered Connecticut health care
providers.
(b) Notwithstanding any provision of the general statutes, each
individual health insurance policy that provides coverage of the type
specified in subdivisions (1), (2), (4), (11) and (12) of section 38a-469 of
the general statutes that is effective at any time during the period
beginning on the effective date of this section and ending on March 15,
2021, shall, at all times that the policy remains in effect during such
period, provide coverage for medical advice, diagnosis, care or
treatment provided through telehealth, to the same extent coverage is House Bill No. 6001
July Sp. Sess., Public Act No. 20-2 19 of 24
provided for such advice, diagnosis, care or treatment when provided
to the insured in person. The policy shall not, at any time during such
period, exclude coverage for a service that is appropriately provided
through telehealth because such service is provided through telehealth
or a telehealth platform selected by an in-network telehealth provider.
(c) Notwithstanding any provision of the general statutes, no
telehealth provider who receives a reimbursement for a covered service
provided through telehealth in accordance with subsection (b) of this
section shall seek any payment for such service from the insured who
received such service, except for any coinsurance, copayment,
deductible or other out-of-pocket expense set forth in the insured's
policy. Such amount shall be deemed by the telehealth provider to be
payment in full.
(d) Nothing in this section shall prohibit or limit a health insurer,
health care center, hospital service corporation, medical service
corporation or other entity from conducting utilization review for
telehealth services, provided such utilization review is conducted in the
same manner and uses the same clinical review criteria as a utilization
review for an in-person consultation for the same service. Except as
provided in subsection (b) or (c) of this section, the coverage required
under subsection (b) of this section shall be subject to the same terms
and conditions applicable to all other benefits under the policy
providing such coverage.
Sec. 4. (Effective from passage) (a) For the purposes of this section:
(1) "Asynchronous" has the same meaning as provided in section 19a-
906 of the general statutes;
(2) "Originating site" has the same meaning as provided in section
19a-906 of the general statutes;
(3) "Remote patient monitoring" has the same meaning as provided House Bill No. 6001
July Sp. Sess., Public Act No. 20-2 20 of 24
in section 19a-906 of the general statutes;
(4) "Store and forward transfer" has the same meaning as provided in
section 19a-906 of the general statutes;
(5) "Synchronous" has the same meaning as provided in section 19a-
906 of the general statutes;
(6) "Telehealth" means the mode of delivering health care or other
health services via information and communication technologies to
facilitate the diagnosis, consultation and treatment, education, care
management and self-management of an insured's physical, oral and
mental health, and includes interaction between the insured at the
originating site and the telehealth provider at a distant site, synchronous
interactions, asynchronous store and forward transfers or remote
patient monitoring, but does not include interaction through (A)
facsimile, texting or electronic mail, or (B) audio-only telephone if the
telehealth provider is out-of-network; and
(7) "Telehealth provider" means any person who (A) provides health
care or other health services through the use of telehealth within such
person's scope of practice and in accordance with the standard of care
applicable to such person's profession, and (B) is (i) a physician or
physician assistant licensed under chapter 370 of the general statutes,
physical therapist or physical therapist assistant licensed under chapter
376 of the general statutes, chiropractor licensed under chapter 372 of
the general statutes, naturopath licensed under chapter 373 of the
general statutes, podiatrist licensed under chapter 375 of the general
statutes, occupational therapist or occupational therapy assistant
licensed under chapter 376a of the general statutes, optometrist licensed
under chapter 380 of the general statutes, registered nurse or advanced
practice registered nurse licensed under chapter 378 of the general
statutes, psychologist licensed under chapter 383 of the general statutes,
marital and family therapist licensed under chapter 383a of the general House Bill No. 6001
July Sp. Sess., Public Act No. 20-2 21 of 24
statutes, clinical social worker or master social worker licensed under
chapter 383b of the general statutes, alcohol and drug counselor licensed
under chapter 376b of the general statutes, professional counselor
licensed under chapter 383c of the general statutes, dietitian-nutritionist
certified under chapter 384b of the general statutes, speech and
language pathologist licensed under chapter 399 of the general statutes,
respiratory care practitioner licensed under chapter 381a of the general
statutes, audiologist licensed under chapter 397a of the general statutes,
pharmacist licensed under chapter 400j of the general statutes,
paramedic licensed pursuant to chapter 384d of the general statutes,
nurse-midwife licensed under chapter 377 of the general statutes,
dentist licensed under chapter 379 of the general statutes, behavior
analyst licensed under chapter 382a of the general statutes, genetic
counselor licensed under chapter 383d of the general statutes, music
therapist certified in the manner described in chapter 383f of the general
statutes, art therapist certified in the manner described in chapter 383g
of the general statutes or athletic trainer licensed under chapter 375a of
the general statutes, or (ii) an in-network and appropriately licensed,
certified or registered physician, physician assistant, physical therapist,
physical therapist assistant, chiropractor, naturopath, podiatrist,
occupational therapist, occupational therapy assistant, optometrist,
registered nurse, advanced practice registered nurse, psychologist,
marital and family therapist, clinical social worker, master social
worker, alcohol and drug counselor, professional counselor, dietitian-
nutritionist, speech and language pathologist, respiratory care
practitioner, audiologist, pharmacist, paramedic, nurse-midwife,
dentist, behavior analyst, genetic counselor, music therapist, art
therapist or athletic trainer, in another state or territory of the United
States or the District of Columbia, that provides telehealth services
pursuant to his or her authority under any relevant order issued by the
Commissioner of Public Health and maintains professional liability
insurance or other indemnity against liability for professional
malpractice in an amount that is equal to or greater than that required House Bill No. 6001
July Sp. Sess., Public Act No. 20-2 22 of 24
for similarly licensed, certified or registered Connecticut health care
providers.
(b) Notwithstanding any provision of the general statutes, each
group health insurance policy that provides coverage of the type
specified in subdivisions (1), (2), (4), (11) and (12) of section 38a-469 of
the general statutes that is effective at any time during the period
beginning on the effective date of this section and ending on March 15,
2021, shall, at all times that the policy remains in effect during such
period, provide coverage for medical advice, diagnosis, care or
treatment provided through telehealth, to the same extent coverage is
provided for such advice, diagnosis, care or treatment when provided
to the insured in person. The policy shall not, at any time during such
period, exclude coverage for a service that is appropriately provided
through telehealth because such service is provided through telehealth
or a telehealth platform selected by an in-network telehealth provider.
(c) Notwithstanding any provision of the general statutes, no
telehealth provider who receives a reimbursement for a covered service
provided through telehealth in accordance with subsection (b) of this
section shall seek any payment for such service from the insured who
received such service, except for any coinsurance, copayment,
deductible or other out-of-pocket expense set forth in the insured's
policy. Such amount shall be deemed by the telehealth provider to be
payment in full.
(d) Nothing in this section shall prohibit or limit a health insurer,
health care center, hospital service corporation, medical service
corporation or other entity from conducting utilization review for
telehealth services, provided such utilization review is conducted in the
same manner and uses the same clinical review criteria as a utilization
review for an in-person consultation for the same service. Except as
provided in subsection (b) or (c) of this section, the coverage required
under subsection (b) of this section shall be subject to the same terms House Bill No. 6001
July Sp. Sess., Public Act No. 20-2 23 of 24
and conditions applicable to all other benefits under the policy
providing such coverage.
Sec. 5. (Effective from passage) (a) As used in this section:
(1) "Health carrier" has the same meaning as provided in section 38a-
1080 of the general statutes;
(2) "Insured" has the same meaning as provided in section 38a-1 of
the general statutes;
(3) "Telehealth" has the same meaning as provided in sections 3 and
4 of this act; and
(4) "Telehealth provider" has the same meaning as provided in
sections 3 and 4 of this act.
(b) Notwithstanding any provision of the general statutes, no health
carrier shall reduce the amount of a reimbursement paid to a telehealth
provider for covered health care or health services that the telehealth
provider appropriately provided to an insured through telehealth
during the period beginning on the effective date of this section and
ending on March 15, 2021, because the telehealth provider provided
such health care or health services to the patient through telehealth and
not in person.
Sec. 6. (Effective from passage) (a) As used in this section:
(1) "Telehealth" means the mode of delivering health care or other
health services via information and communication technologies to
facilitate the diagnosis, consultation and treatment, education, care
management and self-management of a patient's physical, oral and
mental health, and includes (A) interaction between the patient at the
originating site and the telehealth provider at a distant site, and (B)
synchronous interactions, asynchronous store and forward transfers or House Bill No. 6001
July Sp. Sess., Public Act No. 20-2 24 of 24
remote patient monitoring. "Telehealth" does not include the use of
facsimile, texting or electronic mail.
(2) "Connecticut medical assistance program" means the state's
Medicaid program and the Children's Health Insurance Program under
Title XXI of the Social Security Act, as amended from time to time.
(b) Notwithstanding the provisions of section 17b-245c, 17b-245e or
19a-906 of the general statutes, or any other section, regulation, rule,
policy or procedure governing the Connecticut medical assistance
program, the Commissioner of Social Services may, in the
commissioner's discretion and to the extent permissible under federal
law, provide coverage under the Connecticut medical assistance
program for audio-only telehealth services for the period beginning on
the effective date of this section and ending on March 15, 2021.
Approved July 31, 2020