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.
(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.
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.