| 47 | | - | SECTION 1. The legislature finds that the psychiatric collaborative care model of integrated care is ideal for states with community populations that are remote from urban centers because the model does not require the physical presence of a psychiatrist when psychiatric services can be delivered remotely. The psychiatric collaborative care model supports mental and behavioral health through a team-based, coordinated approach involving a psychiatric consultant, a behavioral health care manager, and the primary care clinician extending beyond the scope of an office visit. The legislature further finds that the Centers for Medicare and Medicaid Services (CMS) has released a medicare physician fee schedule that includes Healthcare Common Procedure Coding System G codes and fees for psychiatric collaborative care management services, which allows primary care physicians to be reimbursed for services that psychiatrists provide in the collaborative care model. Other payers, including the State Medicaid authorities and managed care plans, may choose to copy the CMS guidelines. Accordingly, the purpose of this Act is to specify that coverage for telehealth under the State's medicaid managed care and fee-for-service programs includes psychiatric services delivered via telehealth through a behavioral health care manager who is present in a primary health care provider's office. SECTION 2. Section 346-59.1, Hawaii Revised Statutes, is amended to read as follows: "[[]§346-59.1[]] Coverage for telehealth. (a) The State's medicaid managed care and fee-for-service programs shall not deny coverage for any service provided through telehealth that would be covered if the service were provided through in-person consultation between a patient and a health care provider. (b) Required coverage for services under subsection (a) shall include psychiatric services provided to a patient by a collaborative care team consisting of a primary care provider and behavioral health care manager, who shall be present in the primary care provider's office, in conjunction with a psychiatric consultant whose services may be delivered remotely through telehealth; provided that the psychiatric consultant shall be a licensed psychiatrist in the State. [(b)] (c) Reimbursement for services provided through telehealth shall be equivalent to reimbursement for the same services provided via face-to-face contact between a health care provider and a patient. Nothing in this section shall require a health care provider to be physically present with the patient at an originating site unless a health care provider at the distant site deems it necessary. [(c)] (d) There shall be no geographic restrictions or requirements for telehealth coverage or reimbursement under this section. [(d)] (e) There shall be no restrictions on originating site requirements for telehealth coverage or reimbursement under this section. [(e)] (f) Services provided by telehealth pursuant to this section shall be consistent with all federal and state privacy, security, and confidentiality laws. [(f)] (g) Notwithstanding any other law to the contrary, the provisions of this section shall comply with the applicable federal requirements related to utilization, coverage, and reimbursement for telehealth services. [(g)] (h) For the purposes of this section: "Behavioral health care manager" means a nurse, social worker, licensed counselor, or psychologist, who coordinates the overall effort of the collaborative care team, ensures effective communication among team members, provides psychotherapy when part of the treatment plan, and is responsible for coordinating and supporting mental health care within the clinic and for coordinating referrals to clinically indicated services outside the clinic. "Distant site" means the location of the health care provider delivering services through telehealth at the time the services are provided. "Health care provider" means a provider of services, as defined in title 42 United States Code section 1395x(u), a provider of medical and other health services, as defined in title 42 United States Code section 1395x(s), other practitioners licensed by the State and working within their scope of practice, and any other person or organization who furnishes, bills, or is paid for health care in the normal course of business, including but not limited to primary care providers, mental health providers, oral health providers, physicians and osteopathic physicians licensed under chapter 453, advanced practice registered nurses licensed under chapter 457, psychologists licensed under chapter 465, and dentists licensed under chapter 448. "Originating site" means the location where the patient is located, whether accompanied or not by a health care provider, at the time services are provided by a health care provider through telehealth, including but not limited to a health care provider's office, hospital, critical access hospital, rural health clinic, federally qualified health center, a patient's home, and other non-medical environments such as school-based health centers, university-based health centers, or the work location of a patient. "Telehealth" means the use of telecommunications services, as defined in section 269‑1, to encompass four modalities: store and forward technologies, remote monitoring, live consultation, and mobile health; and which shall include but not be limited to real-time video conferencing-based communication, secure interactive and non‑interactive web-based communication, and secure asynchronous information exchange, to transmit patient medical information, including diagnostic-quality digital images and laboratory results for medical interpretation and diagnosis, for the purpose of delivering enhanced health care services and information while a patient is at an originating site and the health care provider is at a distant site. Standard telephone contacts, facsimile transmissions, or e-mail text, in combination or by itself, does not constitute a telehealth service for the purposes of this section." SECTION 3. Statutory material to be repealed is bracketed and stricken. New statutory material is underscored. SECTION 4. This Act shall take effect on July 1, 2060. |
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| 47 | + | SECTION 1. The legislature finds that the psychiatric collaborative care model of integrated care is ideal for states with community populations that are remote from urban centers because the model does not require the physical presence of a psychiatrist when psychiatric services can be delivered remotely. The psychiatric collaborative care model supports mental and behavioral health through a team-based, coordinated approach involving a psychiatric consultant, a behavioral health care manager, and the primary care clinician extending beyond the scope of an office visit. The legislature further finds that the Centers for Medicare and Medicaid Services has released a medicare fee schedule that includes healthcare common procedure coding system G codes and fees for psychiatric collaborative care management services, which allows primary care physicians to be reimbursed for services that psychiatrists provide in the collaborative care model. Accordingly, the purpose of this Act is to specify that coverage for telehealth under the State's medicaid managed care and fee-for-service programs includes psychiatric services delivered via telehealth through a behavioral health care manager who is present in a primary health care provider's office. SECTION 2. Section 346-59.1, Hawaii Revised Statutes, is amended to read as follows: "[[]§346-59.1[]] Coverage for telehealth. (a) The State's medicaid managed care and fee-for-service programs shall not deny coverage for any service provided through telehealth that would be covered if the service were provided through in-person consultation between a patient and a health care provider. (b) Required coverage for services under subsection (a) includes psychiatric services provided to a patient by a collaborative care team consisting of a primary care provider and behavioral health care manager, who shall be present in the primary care provider's office, in conjunction with a psychiatric consultant whose services may be delivered remotely through telehealth; provided that the psychiatric consultant shall be a licensed psychiatrist in the State. [(b)] (c) Reimbursement for services provided through telehealth shall be equivalent to reimbursement for the same services provided via face-to-face contact between a health care provider and a patient. Nothing in this section shall require a health care provider to be physically present with the patient at an originating site unless a health care provider at the distant site deems it necessary. [(c)] (d) There shall be no geographic restrictions or requirements for telehealth coverage or reimbursement under this section. [(d)] (e) There shall be no restrictions on originating site requirements for telehealth coverage or reimbursement under this section. [(e)] (f) Services provided by telehealth pursuant to this section shall be consistent with all federal and state privacy, security, and confidentiality laws. [(f)] (g) Notwithstanding any other law to the contrary, the provisions of this section shall comply with the applicable federal requirements related to utilization, coverage, and reimbursement for telehealth services. [(g)] (h) For the purposes of this section: "Behavioral health care manager" means a nurse, social worker, licensed counselor, or psychologist, who coordinates the overall effort of the collaborative care team, ensures effective communication among team members, provides psychotherapy when that is part of the treatment plan, and is responsible for coordinating and supporting mental health care within the clinic and for coordinating referrals to clinically indicated services outside the clinic. "Distant site" means the location of the health care provider delivering services through telehealth at the time the services are provided. "Health care provider" means a provider of services, as defined in title 42 United States Code section 1395x(u), a provider of medical and other health services, as defined in title 42 United States Code section 1395x(s), other practitioners licensed by the State and working within their scope of practice, and any other person or organization who furnishes, bills, or is paid for health care in the normal course of business, including but not limited to primary care providers, mental health providers, oral health providers, physicians and osteopathic physicians licensed under chapter 453, advanced practice registered nurses licensed under chapter 457, psychologists licensed under chapter 465, and dentists licensed under chapter 448. "Originating site" means the location where the patient is located, whether accompanied or not by a health care provider, at the time services are provided by a health care provider through telehealth, including but not limited to a health care provider's office, hospital, critical access hospital, rural health clinic, federally qualified health center, a patient's home, and other non-medical environments such as school-based health centers, university-based health centers, or the work location of a patient. "Telehealth" means the use of telecommunications services, as defined in section 269‑1, to encompass four modalities: store and forward technologies, remote monitoring, live consultation, and mobile health; and which shall include but not be limited to real-time video conferencing-based communication, secure interactive and non‑interactive web-based communication, and secure asynchronous information exchange, to transmit patient medical information, including diagnostic-quality digital images and laboratory results for medical interpretation and diagnosis, for the purpose of delivering enhanced health care services and information while a patient is at an originating site and the health care provider is at a distant site. Standard telephone contacts, facsimile transmissions, or e-mail text, in combination or by itself, does not constitute a telehealth service for the purposes of this section." SECTION 3. This Act does not affect rights and duties that matured, penalties that were incurred, and proceedings that were begun before its effective date. SECTION 4. Statutory material to be repealed is bracketed and stricken. New statutory material is underscored. SECTION 5. This Act shall take effect on July 1, 2022. INTRODUCED BY: _____________________________ |
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