HLS 22RS-696 REENGROSSED
2022 Regular Session
HOUSE BILL NO. 304
BY REPRESENTATIVE FRIEMAN
INSURANCE/HEALTH: Provides relative to health coverage plan benefits for physical
therapy services delivered via telehealth
1 AN ACT
2To enact Subpart B-2 of Part II of Chapter 6 of Title 22 of the Louisiana Revised Statutes
3 of 1950, to be comprised of R.S. 22:1845.1, relative to payment of claims for
4 physical therapy services provided through telehealth; to prohibit maximum amounts
5 of coverage and other conditions for coverage relative to telehealth services that are
6 inapplicable to in-person services; to authorize enforcement and rulemaking; to
7 provide for definitions; to provide for exceptions; to provide for effectiveness; and
8 to provide for related matters.
9Be it enacted by the Legislature of Louisiana:
10 Section 1. Subpart B-2 of Part II of Chapter 6 of Title 22 of the Louisiana Revised
11Statutes of 1950, comprised of R.S. 22:1845.1, is hereby enacted to read as follows:
12 SUBPART B-2. COVERAGE AND PAYMENT PARI TY
13 FOR PHYSICAL THERAPY DELIVERED VIA TELEHEALTH
14 ยง1845.1. Telehealth coverage and reimbursement; prohibitions and limitations;
15 exceptions; rulemaking
16 A. A health coverage plan shall pay for covered physical therapy services
17 provided via telehealth to an insured person. Telehealth coverage and payment shall
18 be equivalent to the coverage and payment for the same service provided in person
19 unless the telehealth provider and the health coverage plan contractually agree to an
20 alternative payment rate for telehealth services.
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1 B. Benefits for a service provided as telehealth may be subject to a
2 deductible, copayment, or coinsurance. A deductible, copayment, or coinsurance
3 applicable to a particular service provided through telecommunications technology
4 shall not exceed the deductible, copayment, or coinsurance required by the health
5 coverage plan for the same service when provided in person.
6 C. A health coverage plan shall not impose an annual dollar maximum on
7 coverage for healthcare services covered under the health coverage plan that are
8 provided as telehealth, other than an annual dollar maximum that applies to the same
9 services when provided in person by the same provider.
10 D. A health coverage plan shall require a healthcare professional to be
11 licensed or otherwise authorized to practice physical therapy in this state to be
12 eligible to receive payment for telehealth services.
13 E. Payment made pursuant to this Section shall be consistent with any
14 provider network arrangements that have been established for the health coverage
15 plan.
16 F. A health coverage plan shall not do any of the following:
17 (1) Require a previously established in-person relationship or the provider
18 to be physically present with a patient or client, unless the provider determines that
19 it is necessary to perform that service in person.
20 (2) Require prior authorization, medical review, or administrative clearance
21 for telehealth that would not be required if that service were provided in person.
22 (3) Require demonstration that it is necessary to provide services to a patient
23 or client as telehealth.
24 (4) Require a provider to be employed by another provider or agency in
25 order to provide telehealth services that would not be required if that service were
26 provided in person.
27 (5) Restrict or deny coverage based solely on the communication technology
28 or application used to provide the telehealth service; however, a health coverage plan
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HB NO. 304
1 may restrict physical therapy services via telehealth when the services are being
2 provided solely by telephone.
3 (6) Impose specific requirements or limitations on the technologies used to
4 provide telehealth services; however, a health coverage plan may require the
5 provider to demonstrate that the technology used to provide telehealth services is
6 both safe and secure.
7 (7) Impose additional certification, location, or training requirements as a
8 condition of payment for telehealth services; however, this Paragraph does not
9 prohibit a health coverage plan from providing additional reimbursement incentives
10 to providers with an enhanced certification, training, or accreditation.
11 (8) Require a provider to be part of a telehealth network.
12 G. Nothing in this Section shall be construed to require a health coverage
13 plan to do either of the following:
14 (1) Provide coverage for telehealth services that are not medically necessary.
15 (2) Reimburse any fees charged by a telehealth facility for transmission of
16 a telehealth encounter.
17 H. A health coverage plan is not required to provide coverage or
18 reimbursement for any of the following procedures or services provided via
19 telehealth:
20 (1) A modality that is a type of electrical, thermal, or mechanical energy.
21 (2) Manual therapy, massage, dry needling, or other invasive procedures.
22 I. The department may take any action authorized in this Title to enforce the
23 provisions of this Section and the commissioner may, in compliance with the
24 Administrative Procedure Act, R.S. 49:950 et seq., promulgate and adopt rules as are
25 necessary or advisable to effectuate the provisions of this Section.
26 J. For purposes of this Section, the following definitions apply:
27 (1) "Health coverage plan" has the same meaning as provided for in R.S.
28 22:1841.
29 (2) "Telehealth" has the same meaning as provided for in R.S. 40:1223.3.
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1 Section 2. This Act shall apply to any new health coverage plan issued on and after
2January 1, 2023. Any health coverage plan in effect prior to January 1, 2023, shall convert
3to conform to the provisions of this Act on or before the renewal date, but no later than
4January 1, 2024.
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 304 Reengrossed 2022 Regular Session Frieman
Abstract: Requires health benefits and payment parity equal to in-person services for
physical therapy delivered via telehealth.
Proposed law requires a health coverage plan (plan) to pay for covered physical therapy
services provided via telehealth to an insured person. Requires equivalency for telehealth
coverage and payment for the same service provided in person, unless the telehealth provider
and plan contractually agree to an alternative payment rate. Provides that services via
telehealth may be subject to a deductible, copayment, or coinsurance not in excess of the
deductible, copayment, or coinsurance required by the plan for in-person services.
Proposed law prohibits a plan from imposing an annual dollar maximum on coverage for
healthcare services provided as telehealth, other than an annual dollar maximum that applies
to the same services when provided in person by the same provider.
Proposed law requires a plan to provide payment for telehealth services to healthcare
professionals licensed or otherwise permitted to practice physical therapy in this state.
Further requires telehealth payments to be consistent with any provider network
arrangements that have been established for the plan.
Proposed law prohibits a plan from doing any of the following:
(1) Requiring a previously established in-person relationship or the provider to be
physically present with a patient or client, unless the provider determines that it is
necessary to perform that service in person.
(2) Requiring prior authorization, medical review, or administrative clearance for
telehealth that would not be required if that service were provided in person.
(3) Requiring demonstration that it is necessary to provide services to a patient or client
as telehealth.
(4) Requiring a provider to be employed by another provider or agency in order to
provide telehealth services that would not be required if that service were provided
in person.
(5) Restricting or denying coverage based solely on the communication technology or
application used to provide the telehealth service. However, proposed law authorizes
a health coverage plan to restrict physical therapy services via telehealth when the
services are being provided solely by telephone.
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(6) Imposing specific requirements or limitations on the technologies used to provide
telehealth services. However, proposed law authorizes a health coverage plan to
require a provider to demonstrate that the technology used to provide telehealth
services is both safe and secure.
(7) Imposing additional certification, location, or training requirements as a condition
of payment for telehealth services. However, proposed law does not prohibit a health
coverage plan from providing additional reimbursement incentives to providers with
an enhanced certification, training, or accreditation.
(8) Requiring a provider to be part of a telehealth network.
Nothing in proposed law requires a plan to provide coverage for telehealth services that are
not medically necessary or to reimburse any fees charged by a telehealth facility for
transmission of a telehealth encounter.
Proposed law does not require a health coverage plan to provide coverage or reimbursement
for any of the following procedures or services provided via telehealth:
(1) A modality that is a type of electrical, thermal, or mechanical energy.
(2) Manual therapy, massage, dry needling, or other invasive procedures.
Proposed law authorizes the Department of Insurance to take any action authorized in the
La. Insurance Code to enforce the provisions of proposed law and further authorizes the
commissioner, in accordance with the APA, to promulgate and adopt rules as necessary or
advisable to effectuate proposed law.
Proposed law defines "health coverage plan" and "telehealth".
Proposed law requires a current health coverage plan to conform to the provisions of
proposed law by Jan. 1, 2024.
Effective Jan. 1, 2023.
(Adds R.S. 22:1845.1)
Summary of Amendments Adopted by House
The Committee Amendments Proposed by House Committee on Insurance to the
original bill:
1. Authorize a health coverage plan to restrict physical therapy services via
telehealth when the services are being provided solely by telephone.
2. Authorize a health coverage plan to require a provider to demonstrate that the
technology used to provide telehealth services is both safe and secure.
3. Add that proposed law does not prohibit a health coverage plan from providing
additional reimbursement incentives to providers with an enhanced certification,
training, or accreditation.
4. Require any health coverage plan in effect prior to Jan. 1, 2023, to conform to the
provisions of proposed law on or before the renewal date, but no later than Jan.
1, 2024.
5. Make technical changes.
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The House Floor Amendments to the engrossed bill:
1. Add that proposed law does not require a health coverage plan to provide
coverage or reimbursement for procedures or services provided via telehealth by
modalities of electric, thermal, or mechanical energy or for manual therapy,
massage, dry needling, or other invasive procedures.
2. Make technical changes.
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