DIGEST
The digest printed below was prepared by House Legislative Services. It constitutes no part of the
legislative instrument. The keyword, one-liner, abstract, and digest do not constitute part of the law
or proof or indicia of legislative intent. [R.S. 1:13(B) and 24:177(E)]
HB 530 Reengrossed 2020 Regular Session Echols
Abstract: Requires health insurance coverage for telehealth or telemedicine services.
Proposed law defines "health coverage plan", "medication adherence management services",
"platform", "remote patient monitoring services", "store-and-forward telemedicine services",
"telehealth", and "telemedicine".
Proposed law requires any health coverage plan delivered or issued for delivery in this state to
provide coverage for a covered healthcare service or procedure delivered by a contracted healthcare
provider to a covered patient as a telemedicine medical service or a telehealth healthcare service,
including store-and-forward telemedicine services and remote patient monitoring services, as
described in proposed law.
Proposed law requires a health coverage plan to provide coverage for a telemedicine medical service
or telehealth healthcare service provided through an audio-only telephone consultation, when such
consultation meets the criteria set forth in present law (R.S. 32:1271(B)(4)(b) or R.S. 40:1223.3(5)).
Proposed law requires a provider's telehealth and telemedicine platform to comply with certain
federal civil rights and patient information privacy protection rights. Prohibits a healthcare coverage
plan's limitation, denial, or reduction of coverage for telehealth and telemedicine services or
procedures when the provider's platform complies with such federal civil rights and patient
information privacy protection rights.
Proposed law requires the issuer of a health coverage plan to display in a conspicuous manner on the
issuer's internet website patient information regarding how the patient may receive covered
telemedicine and telehealth services.
Proposed law provides that prior to the patient's receipt of store-and-forward telemedicine services,
a provider may notify the patient that he may be billed for a portion of those services in accordance
with coverage under his health coverage plan.
Proposed law provides that any patient receiving medical care by store-and-forward telemedicine
services may request interactive communication with the distant specialist healthcare professional
and prohibits any telemedicine network unable to offer the interactive consultation from being
reimbursed for store-and-forward telemedicine services.
Proposed law requires remote patient monitoring services through telehealth to consist of an assessment, problem identification, and evaluation and the implementation of a management plan.
Further requires the entity providing remote patient monitoring services to have certain enumerated
protocols in place.
Proposed law provides that a health coverage plan may require an authorization request for remote
patient monitoring prior to the health coverage plan's approval of coverage for a specified healthcare
service.
Proposed law does not apply to any plan providing coverage for excepted benefits, limited benefit
health insurance plans, and short-term policies with a term of less than 12 months.
Effective Jan. 1, 2021.
(Adds R.S. 22:1841-1846)
Summary of Amendments Adopted by House
The Committee Amendments Proposed by House Committee on Insurance to the original bill:
1. Remove the definition of "healthcare professional".
2. Modify the definitions of "qualifying patient" and "qualified telemedicine equipment and
network".
3. Require telehealth and telemedicine platforms to comply with certain federal civil rights
and patient information privacy protection rights. Prohibit a healthcare coverage plan's
limitation, denial, or reduction of coverage for telehealth and telemedicine services or
procedures when the provider's platform is compliant.
4. Remove provisions for telehealth and telemedicine services, including asynchronous and
store-and-forward telemedicine services, requiring healthcare plan coverage to the same
extent services would be covered if the they were provided during in-person visits.
Provide for coverage to be determined by the provisions of store-and-forward services
and remote patient monitoring services prescribed in proposed law.
5. Modify proposed law to require the issuer of a health coverage plan to display in a
conspicuous manner on the issuer's website patient information regarding how the patient
may receive covered telemedicine and telehealth services.
6. Require a patient's consent to store-and-forward telemedicine services, including
notification to the patient that he may be billed for a portion of those services, prior to
the patient's receipt of such services.
7. Authorize an out-of-state healthcare provider to seek reimbursement for store-and-
forward telemedicine services if the provider holds a telemedicine license in this state, and has appropriate arrangements with licensed La. providers for urgent or emergent
care.
8. Remove the requirement for an entity providing remote patient monitoring services to
be Louisiana based.
9. Remove specified reimbursement rates for remote patient monitoring services.
10.Retain present law (R.S. 22:1821(F)) which requires the reimbursement to a healthcare
provider at an originating facility or terminus to be not less than 75% of the reasonable
and customary amount of reimbursement the provider would receive for an intermediate
office visit.
11.Make technical changes.
The House Floor Amendments to the engrossed bill:
1. Remove the definitions of "qualifying patient" and "qualified telemedicine equipment
and network". Modify certain definitions.
2. Remove provisions requiring medical necessity, appropriateness, and the use of certain
procedures for a health coverage plan's reimbursement to healthcare providers for
telemedicine or telehealth services.
3. Remove certain provisions relative to patient deductibles, copayments, or coinsurance
required by health coverage plans.
4 Make modifications to require a health coverage plan to cover a telemedicine or
telehealth service provided through an audio-only telephone consultation, when the
consultation meets the criteria set forth in present law (R.S. 32:1271(B)(4)(b) or R.S.
40:1223.3(5)).
5. Remove provisions prohibiting a health coverage plan's discrimination against telehealth,
telemedicine, or certain methods of transmitted electronic imaging.
6. Specify that a trained and licensed specialty healthcare provider means a non-primary
healthcare provider.
7. Remove the required consent of a patient relative to the use of store-and-forward
telemedicine services. Provide that a healthcare provider may notify the patient that he
may be billed for a portion of those services.
8. Remove provisions relative to requiring healthcare providers to have certain licensure in
the state of La. to seek reimbursement for store-and-forward telemedicine services. 9. Modify relative to remote patient monitoring to provide that a health coverage plan may
require an authorization request prior to the plan's approval of coverage for a specified
healthcare service.
10.Provide an effective date of Jan. 1, 2021.
11.Provide for a policy, contract, or health coverage plan to comply with proposed law by
Jan. 1, 2022.
12.Make technical changes.