Massachusetts 2023-2024 Regular Session

Massachusetts House Bill H986 Compare Versions

Only one version of the bill is available at this time.

Old	New	Differences
1	1	1 of 1
2	2	HOUSE DOCKET, NO. 3511 FILED ON: 1/20/2023
3	3	HOUSE . . . . . . . . . . . . . . . No. 986
4	4	The Commonwealth of Massachusetts
5	5	_________________
6	6	PRESENTED BY:
7	7	Marjorie C. Decker and Susannah M. Whipps
8	8	_________________
9	9	To the Honorable Senate and House of Representatives of the Commonwealth of Massachusetts in General
10	10	Court assembled:
11	11	The undersigned legislators and/or citizens respectfully petition for the adoption of the accompanying bill:
12	12	An Act relative to telehealth and digital equity for patients.
13	13	_______________
14	14	PETITION OF:
15	15	NAME:DISTRICT/ADDRESS :DATE ADDED:Marjorie C. Decker25th Middlesex1/20/2023Susannah M. Whipps2nd Franklin1/20/2023Lindsay N. Sabadosa1st Hampshire1/20/2023Rodney M. Elliott16th Middlesex1/20/2023Vanna Howard17th Middlesex1/26/2023David Paul Linsky5th Middlesex2/24/2023James C. Arena-DeRosa8th Middlesex2/24/2023Steven Ultrino33rd Middlesex2/24/2023Simon Cataldo14th Middlesex2/27/2023Dylan A. FernandesBarnstable, Dukes and Nantucket2/27/2023Natalie M. Higgins4th Worcester2/28/2023Daniel Cahill10th Essex3/4/2023Samantha Montaño15th Suffolk3/9/2023 1 of 25
16	16	HOUSE DOCKET, NO. 3511 FILED ON: 1/20/2023
17	17	HOUSE . . . . . . . . . . . . . . . No. 986
18	18	By Representatives Decker of Cambridge and Whipps of Athol, a petition (accompanied by bill,
19	19	House, No. 986) of Marjorie C. Decker, Susannah M. Whipps and others relative to telehealth
20	20	and digital equity for patients. Financial Services.
21	21	The Commonwealth of Massachusetts
22	22	_______________
23	23	In the One Hundred and Ninety-Third General Court
24	24	(2023-2024)
25	25	_______________
26	26	An Act relative to telehealth and digital equity for patients.
27	27	Be it enacted by the Senate and House of Representatives in General Court assembled, and by the authority
28	28	of the same, as follows:
29	29	1 SECTION 1. Section 18AA of Chapter 6A of the General Laws, as most recently inserted
30	30	2by Section 1 of Chapter 174 of the Acts of 2022, is hereby amended by inserting after the word
31	31	3“benefits” the last time it appears the following:
32	32	4 The executive office of health and human services and the executive office of housing
33	33	5and economic development shall determine a method for the common application portal to also
34	34	6allow individuals to simultaneously apply to the affordable connectivity program administered
35	35	7by the federal communications commission.
36	36	8 SECTION 2. Section 30 of Chapter 32A of the General Laws, as most recently inserted
37	37	9by section 3 of Chapter 260 of the Acts of 2020, is hereby amended by striking out subsection (c)
38	38	10and inserting in place thereof the following:
39	39	11 (c) Coverage for telehealth services may include utilization review; provided, however,
40	40	12that any utilization review shall be made in the same manner as if the service was delivered in 2 of 25
41	41	13person. Carriers shall not impose any prior authorization requirements to obtain medically
42	42	14necessary health services via telehealth that would not apply to the receipt of those same services
43	43	15on an in-person basis. A carrier shall not be required to reimburse a health care provider for a
44	44	16health care service that is not a covered benefit under the plan or reimburse a health care
45	45	17provider not contracted under the plan except as provided for under subclause (i) of clause (4) of
46	46	18the second sentence of subsection (a) of section 6 of chapter 176O.
47	47	19 SECTION 3. Section 30 of Chapter 32A of the General Laws, as most recently inserted
48	48	20by Section 3 of Chapter 260 of the Acts of 2020 is hereby amended by adding at the end thereof
49	49	21the following subsections:
50	50	22 (i) Coverage for telehealth services shall include reimbursement for interpreter services
51	51	23for patients with limited English proficiency or those who are deaf or hard of hearing.
52	52	24 (j) Carriers providing coverage to an active or retired employee of the commonwealth
53	53	25insured under the group insurance commission shall develop and maintain procedures to identify
54	54	26and offer digital health education to enrollees with low digital health literacy to assist them with
55	55	27accessing any medical necessary covered telehealth benefits. These procedures shall include a
56	56	28digital health literacy screening program or other similar procedure to identify current enrollees
57	57	29with low digital health literacy and a digital health education program to educate insured
58	58	30members regarding the effective use of telehealth technology including but not limited to
59	59	31distributing educational materials about how to access certain telehealth technologies in multiple
60	60	32languages, including sign language, and in alternative formats; holding digital health literacy
61	61	33workshops; integrating digital health coaching; offering enrollees in-person digital health 3 of 25
62	62	34navigators; and partnering with local libraries and/or community centers that offer digital health
63	63	35education services and supports.
64	64	36 (k) Carriers providing coverage to an active or retired employee of the commonwealth
65	65	37insured under the group insurance commission shall make information available to the
66	66	38commission regarding the procedures that they have implemented under subsection (j) including
67	67	39but not limited to statistics on the number of enrollees identified with low digital health literacy
68	68	40and receiving digital health education, manner(s) or method of digital health literacy screening
69	69	41and digital health education, financial impact of the programs, and evaluations of effectiveness
70	70	42of digital health literacy interventions.
71	71	43 (l) Carriers providing coverage to an active or retired employee of the commonwealth
72	72	44insured under the group insurance commission shall not prohibit a physician licensed pursuant to
73	73	45Chapter 112 or otherwise authorized to provide healthcare services who is providing healthcare
74	74	46services to a patient who is physically located in Massachusetts at the time the healthcare
75	75	47services are provided via telehealth from providing such services from any location within
76	76	48Massachusetts or outside Massachusetts; provided, that the location from which the physician
77	77	49provides services does not compromise patient confidentiality and privacy and the location from
78	78	50which the physician provides the services does not exceed restrictions placed on the physician’s
79	79	51specific license, including but not limited to, restrictions set by the hospital, institution, clinic or
80	80	52program in which a physician licensed pursuant to section 9 of Chapter 112 of the General Laws
81	81	53has been appointed. 4 of 25
82	82	54 SECTION 4. Subsection (a) of Section 79 of Chapter 118E of the General Laws, as most
83	83	55recently amended by Section 40 of Chapter 260 of the Acts of 20202, is hereby amended by
84	84	56inserting after the definition of “behavioral health services” the following:
85	85	57 “E-consults”, asynchronous, consultative, provider-to-provider communications within a
86	86	58shared electronic health record (EHR) or web-based platform that are intended to improve access
87	87	59to specialty expertise for patients and providers without the need for a face-to-face visit, focused
88	88	60on a specific question. E-consults are inclusive of the consult generated from one provider or
89	89	61other qualified health professional to another, and of communications before/after consultation
90	90	62back to the member and/or the member’s caregiver.
91	91	63 “Remote patient monitoring services”, personal health and medical data collection,
92	92	64transmission, retrieval, or messaging from a member in one location, which is then transmitted to
93	93	65a provider in a different location and is used primarily for the management, treatment, care and
94	94	66related support of ongoing health conditions via regular information inputs from members and
95	95	67member guidance outputs from healthcare providers, including the remote monitoring of a
96	96	68patient’s vital signs, biometric data, or other objective or subjective data by a device that
97	97	69transmits such data electronically to a healthcare practitioner.
98	98	70 SECTION 5. Subsection (b) of Section 79 of Chapter 118E of the General Laws, as most
99	99	71recently amended by Section 40 of Chapter 260 of the Acts of 2020, is hereby amended by
100	100	72inserting at the end thereof after the word “providers.” the following:
101	101	73 Coverage for telehealth services shall include coverage and reimbursement for e-consults
102	102	74and remote patient monitoring services and devices. 5 of 25
103	103	75 SECTION 6. Section 79 of Chapter 118E of the General Laws, as most recently amended
104	104	76by Section 40 of Chapter 260 of the Acts of 2020, is hereby amended by striking subsection (c)
105	105	77 and inserting in place thereof the following:
106	106	78 (c) The division, a contracted health insurer, health plan, health maintenance
107	107	79organization, behavioral health management firm or third-party administrators under contract to
108	108	80a Medicaid managed care organization or primary care clinician plan shall not impose any
109	109	81utilization management requirements, including but not limited to, prior authorization
110	110	82requirements to obtain medically necessary health services via telehealth that would not apply to
111	111	83the receipt of those same services on an in-person basis. The division, a contracted health insurer,
112	112	84health plan, health maintenance organization, behavioral health management firm or third-party
113	113	85administrator under contract to a Medicaid managed care organization or primary care clinician
114	114	86plan shall not be required to reimburse a health care provider for a health care service that is not
115	115	87a covered benefit under the plan or reimburse a health care provider not contracted under the
116	116	88plan except as provided for under subclause (i) of clause (4) of the second sentence of subsection
117	117	89(a) of section 6 of chapter 176O.”
118	118	90 SECTION 7. Section 79 of Chapter 118E of the General Laws, as most recently inserted
119	119	91by Section 40 of Chapter 260 of the Acts of 2020 is hereby amended by inserting at the end
120	120	92thereof the following subsections:
121	121	93 (i) The division and its contracted health insurers, health plans, health maintenance
122	122	94organizations, behavioral health management firms and third-party administrators under contract
123	123	95to a Medicaid managed care organization, accountable care organization or primary care
124	124	96clinician plan shall include in its coverage for reimbursement for interpreter services for patients 6 of 25
125	125	97with limited English proficiency or those who are deaf or hard of hearing in its coverage for
126	126	98telehealth services.
127	127	99 (j) The division and its contracted health insurers, health plans, health maintenance
128	128	100organizations, behavioral health management firms and third-party administrators under contract
129	129	101to a Medicaid managed care organization, accountable care organization or primary care
130	130	102clinician plan shall develop and maintain procedures to identify and offer digital health education
131	131	103to members with low digital health literacy to assist them with accessing any medical necessary
132	132	104covered telehealth benefits. These procedures shall include a digital health literacy screening
133	133	105program or other similar procedure to identify new and current members with low digital health
134	134	106literacy and a digital health education program to educate insured members regarding the
135	135	107effective use of telehealth technology including but not limited to distributing educational
136	136	108materials about how to access certain telehealth technologies in multiple languages, including
137	137	109sign language, and in alternative formats; holding digital health literacy workshops; integrating
138	138	110digital health coaching; offering enrollees in-person digital health navigators; and partnering
139	139	111with local libraries and/or community centers that offer digital health education services and
140	140	112supports.
141	141	113 (k) The division and its contracted health insurers, health plans, health maintenance
142	142	114organizations, behavioral health management firms and third-party administrators under contract
143	143	115to a Medicaid managed care organization, accountable care organization or primary care
144	144	116clinician plan shall publish information annually regarding the procedures that they have
145	145	117implemented under subsection (j) including but not limited to statistics on the number of
146	146	118members identified with low digital health literacy and receiving digital health education, 7 of 25
147	147	119manner(s) or method of digital health literacy screening and digital health education, financial
148	148	120impact of the programs, and evaluations of effectiveness of digital health literacy interventions.
149	149	121 (l) The division and its contracted health insurers, health plans, health maintenance
150	150	122organizations, behavioral health management firms and third-party administrators under contract
151	151	123to a Medicaid managed care organization, accountable care organization or primary care
152	152	124clinician plan providing coverage to an active or retired employee of the commonwealth insured
153	153	125under the group insurance commission shall not prohibit a physician licensed pursuant to
154	154	126Chapter 112 or otherwise authorized to provide healthcare services who is providing healthcare
155	155	127services to a patient who is physically located in Massachusetts at the time the healthcare
156	156	128services are provided via telehealth from providing such services from any location within
157	157	129Massachusetts or outside Massachusetts; provided, that the location from which the physician
158	158	130provides services does not compromise patient confidentiality and privacy and the location from
159	159	131which the physician provides the services does not exceed restrictions placed on the physician’s
160	160	132specific license, including but not limited to, restrictions set by the hospital, institution, clinic, or
161	161	133program in which a physician licensed pursuant to section 9 of Chapter 112 of the General Laws
162	162	134has been appointed.
163	163	135 SECTION 8. Section 47MM of Chapter 175 of the General Laws, as most recently
164	164	136amended by Section 47 of Chapter 260 of the Acts of 2020, is hereby amended by striking out
165	165	137subsection (c) and inserting place thereof the following:
166	166	138 (c) Coverage for telehealth services may include utilization review; provided, however,
167	167	139that any utilization review shall be made in the same manner as if the service was delivered in
168	168	140person. A policy, contract, agreement, plan or certificate of insurance issued, delivered or 8 of 25
169	169	141renewed within or without the commonwealth shall not impose any prior authorization
170	170	142requirements to obtain medically necessary health services via telehealth that would not apply to
171	171	143the receipt of those same services on an in-person basis. A policy, contract, agreement, plan or
172	172	144certificate of insurance issued, delivered or renewed within or without the commonwealth shall
173	173	145not be required to reimburse a health care provider for a health care service that is not a covered
174	174	146benefit under the plan or reimburse a health care provider not contracted under the plan except as
175	175	147provided for under subclause (i) of clause (4) of the second sentence of subsection (a) of section
176	176	1486 of chapter 176O.
177	177	149 SECTION 9. Section 47MM of Chapter 175 of the General Laws, as most recently
178	178	150inserted by Section 47 of Chapter 260 of the Acts of 2020 is hereby further amended by adding
179	179	151at the end thereof the following subsections:
180	180	152 (i) A policy, contract, agreement, plan or certificate of insurance issued, delivered or
181	181	153renewed within the commonwealth that provides coverage for telehealth services shall include
182	182	154reimbursement for interpreter services for patients with limited English proficiency or those who
183	183	155are deaf or hard of hearing.
184	184	156 (j) A policy, contract, agreement, plan or certificate of insurance issued, delivered or
185	185	157renewed within the commonwealth shall develop and maintain procedures to identify and offer
186	186	158digital health education to subscribers with low digital health literacy to assist them with
187	187	159accessing any medical necessary covered telehealth benefits. These procedures shall include a
188	188	160digital health literacy screening program or other similar procedure to identify new and current
189	189	161subscribers with low digital health literacy and a digital health education program to educate
190	190	162insured subscribers regarding the effective use of telehealth technology including but not limited 9 of 25
191	191	163to distributing educational materials about how to access certain telehealth technologies in
192	192	164multiple languages, including sign language, and in alternative formats; holding digital health
193	193	165literacy workshops; integrating digital health coaching; offering subscribers in-person digital
194	194	166health navigators; and partnering with local libraries and/or community centers that offer digital
195	195	167health education services and supports.
196	196	168 (k) A policy, contract, agreement, plan or certificate of insurance issued, delivered or
197	197	169renewed within the commonwealth shall publish information annually regarding the procedures
198	198	170that they have implemented under subsection (j) including but not limited to statistics on the
199	199	171number of subscribers identified with low digital health literacy and receiving digital health
200	200	172education, manner(s) or method of digital health literacy screening and digital health education,
201	201	173financial impact of the programs, and evaluations of effectiveness of digital health literacy
202	202	174interventions.
203	203	175 (l) A policy, contract, agreement, plan or certificate of insurance issued, delivered or
204	204	176renewed within the commonwealth shall not prohibit a physician licensed pursuant to Chapter
205	205	177112 or otherwise authorized to provide healthcare services who is providing healthcare services
206	206	178to a patient who is physically located in Massachusetts at the time the healthcare services are
207	207	179provided via telehealth from providing such services from any location within Massachusetts or
208	208	180outside Massachusetts; provided, that the location from which the physician provides services
209	209	181does not compromise patient confidentiality and privacy and the location from which the
210	210	182physician provides the services does not exceed restrictions placed on the physician’s specific
211	211	183license, including but not limited to, restrictions set by the hospital, institution, clinic or program
212	212	184in which a physician licensed pursuant to section 9 of Chapter 112 of the General Laws has been
213	213	185appointed. 10 of 25
214	214	186 SECTION 10. Section 38 of Chapter 176A of the General Laws, as most recently
215	215	187amended by Section 49 of Chapter 260 of the Acts of 2020, is hereby further amended by
216	216	188striking subsection (c) and inserting in place thereof the following:
217	217	189 (c) Coverage for telehealth services may include utilization review; provided, however,
218	218	190that any utilization review shall be made in the same manner as if the service was delivered in
219	219	191person. A carrier shall not impose any prior authorization requirements to obtain medically
220	220	192necessary health services via telehealth that would not apply to the receipt of those same services
221	221	193on an in-person basis. A carrier shall not be required to reimburse a health care provider for a
222	222	194health care service that is not a covered benefit under the plan or reimburse a health care
223	223	195provider not contracted under the plan except as provided for under subclause (i) of clause (4) of
224	224	196the second sentence of subsection (a) of section 6 of chapter 176O.
225	225	197 SECTION 11. Section 38 of Chapter 176A of the General Laws, as most recently inserted
226	226	198by Section 49 of Chapter 260 of the Acts of 2020, is hereby amended by adding at the end
227	227	199thereof the following subsections:
228	228	200 (i) Coverage for telehealth services shall include reimbursement for interpreter services
229	229	201for patients with limited English proficiency or those who are deaf or hard of hearing.
230	230	202 (j) Hospital service corporations shall develop and maintain procedures to identify and
231	231	203offer digital health education to subscribers with low digital health literacy to assist them with
232	232	204accessing any medical necessary covered telehealth benefits. These procedures shall include a
233	233	205digital health literacy screening program or other similar procedure to identify new and current
234	234	206subscribers with low digital health literacy and a digital health education program to educate
235	235	207insured subscribers regarding the effective use of telehealth technology including but not limited 11 of 25
236	236	208to distributing educational materials about how to access certain telehealth technologies in
237	237	209multiple languages, including sign language, and in alternative formats; holding digital health
238	238	210literacy workshops; integrating digital health coaching; offering subscribers in-person digital
239	239	211health navigators; and partnering with local libraries and/or community centers that offer digital
240	240	212health education services and supports.
241	241	213 (k) Hospital service corporations shall publish information annually regarding the
242	242	214procedures that they have implemented under subsection (j) including but not limited to statistics
243	243	215on the number of subscribers identified with low digital health literacy and receiving digital
244	244	216health education, manner(s) or method of digital health literacy screening and digital health
245	245	217education, financial impact of the programs, and evaluations of effectiveness of digital health
246	246	218literacy interventions.
247	247	219 (l) Hospital service corporations providing coverage under this section shall not prohibit a
248	248	220physician licensed pursuant to Chapter 112 or otherwise authorized to provide healthcare
249	249	221services who is providing healthcare services to a patient who is physically located in
250	250	222Massachusetts at the time the healthcare services are provided via telehealth from providing such
251	251	223services from any location within Massachusetts or outside Massachusetts; provided, that the
252	252	224location from which the physician provides services does not compromise patient confidentiality
253	253	225and privacy and the location from which the physician provides the services does not exceed
254	254	226restrictions placed on the physician’s specific license, including but not limited to, restrictions set
255	255	227by the hospital, institution, clinic or program in which a physician licensed pursuant to section 9
256	256	228of Chapter 112 of the General Laws has been appointed. 12 of 25
257	257	229 SECTION 12. Section 25 of Chapter 176B of the General Laws, as most recently
258	258	230amended by Section 51 of Chapter 260 of the Acts of 2020, is hereby further amended by
259	259	231striking subsection (c) and inserting in place thereof the following:
260	260	232 (c) Coverage for telehealth services may include utilization review; provided, however,
261	261	233that any utilization review shall be made in the same manner as if the service was delivered in
262	262	234person. A carrier shall not impose any prior authorization requirements to obtain medically
263	263	235necessary health services via telehealth that would not apply to the receipt of those same services
264	264	236on an in-person basis. A carrier shall not be required to reimburse a health care provider for a
265	265	237health care service that is not a covered benefit under the plan or reimburse a health care
266	266	238provider not contracted under the plan except as provided for under subclause (i) of clause (4) of
267	267	239the second sentence of subsection (a) of section 6 of chapter 176O.
268	268	240 SECTION 13. Section 25 of Chapter 176B of the General Laws, as most recently
269	269	241inserted by Section 51 of Chapter 260 of the Acts of 2020, is hereby amended by adding at the
270	270	242end thereof the following subsections:
271	271	243 (i) A contract that provides coverage for telehealth services shall include reimbursement
272	272	244for interpreter services for patients with limited English proficiency or those who are deaf or
273	273	245hard of hearing who require interpreter services.
274	274	246 (j) Medical service corporations shall develop and maintain procedures to identify and
275	275	247offer digital health education to subscribers with low digital health literacy to assist them with
276	276	248accessing any medical necessary covered telehealth benefits. These procedures shall include a
277	277	249digital health literacy screening program or other similar procedure to identify new and current
278	278	250subscribers with low digital health literacy and a digital health education program to educate 13 of 25
279	279	251insured subscribers regarding the effective use of telehealth technology including but not limited
280	280	252to distributing educational materials about how to access certain telehealth technologies in
281	281	253multiple languages, including sign language, and in alternative formats; holding digital health
282	282	254literacy workshops; integrating digital health coaching; offering subscribers in-person digital
283	283	255health navigators; and partnering with local libraries and/or community centers that offer digital
284	284	256health education services and supports.
285	285	257 (k) Medical service corporations shall publish information annually regarding the
286	286	258procedures that they have implemented under subsection (j) including but not limited to statistics
287	287	259on the number of subscribers identified with low digital health literacy and receiving digital
288	288	260health education, manner(s) or method of digital health literacy screening and digital health
289	289	261education, financial impact of the programs, and evaluations of effectiveness of digital health
290	290	262literacy interventions.
291	291	263 (l) Medical service corporations providing coverage under this section shall not prohibit a
292	292	264physician licensed pursuant to Chapter 112 or otherwise authorized to provide healthcare
293	293	265services who is providing healthcare services to a patient who is physically located in
294	294	266Massachusetts at the time the healthcare services are provided via telehealth from providing such
295	295	267services from any location within Massachusetts or outside Massachusetts; provided, that the
296	296	268location from which the physician provides services does not compromise patient confidentiality
297	297	269and privacy and the location from which the physician provides the services does not exceed
298	298	270restrictions placed on the physician’s specific license, including but not limited to, restrictions set
299	299	271by the hospital, institution, clinic or program in which a physician licensed pursuant to section 9
300	300	272of Chapter 112 of the General Laws has been appointed. 14 of 25
301	301	273 SECTION 14. Section 33 of Chapter 176G of the General Laws, as most recently
302	302	274amended by Section 53 of Chapter 260 of the Acts of 2020, is hereby further amended by
303	303	275striking subsection (c) and inserting in place thereof the following:
304	304	276 (c) Coverage for telehealth services may include utilization review; provided, however,
305	305	277that any utilization review shall be made in the same manner as if the service was delivered in
306	306	278person. A health maintenance organization shall not impose any prior authorization requirements
307	307	279to obtain medically necessary health services via telehealth that would not apply to the receipt of
308	308	280those same services on an in-person basis. A health maintenance organization shall not be
309	309	281required to reimburse a health care provider for a health care service that is not a covered benefit
310	310	282under the plan or reimburse a health care provider not contracted under the plan except as
311	311	283provided for under subclause (i) of clause (4) of the second sentence of subsection (a) of section
312	312	2846 of chapter 176O.
313	313	285 SECTION 15. Section 33 of Chapter 176G of the General Laws, as most recently inserted
314	314	286by Section 53 of Chapter 260 of the Acts of 2020, is hereby amended by adding at the end
315	315	287thereof the following subsection:
316	316	288 (i) A contract that provides coverage for telehealth services shall include reimbursement
317	317	289for interpreter services for patients with limited English proficiency or those who are deaf or
318	318	290hard of hearing.
319	319	291 (j) Health maintenance organizations shall develop and maintain procedures to identify
320	320	292and offer digital health education to members with low digital health literacy to assist them with
321	321	293accessing any medical necessary covered telehealth benefits. These procedures shall include a
322	322	294digital health literacy screening program or other similar procedure to identify new and current 15 of 25
323	323	295members with low digital health literacy and a digital health education program to educate
324	324	296insured subscribers regarding the effective use of telehealth technology including but not limited
325	325	297to distributing educational materials about how to access certain telehealth technologies in
326	326	298multiple languages, including sign language, and in alternative formats; holding digital health
327	327	299literacy workshops; integrating digital health coaching; offering subscribers in-person digital
328	328	300health navigators; and partnering with local libraries and/or community centers that offer digital
329	329	301health education services and supports.
330	330	302 (k) Health maintenance organizations shall publish information annually regarding the
331	331	303procedures that they have implemented under subsection (j) including but not limited to statistics
332	332	304on the number of subscribers identified with low digital health literacy and receiving digital
333	333	305health education, manner(s) or method of digital health literacy screening and digital health
334	334	306education, financial impact of the programs, and evaluations of effectiveness of digital health
335	335	307literacy interventions.
336	336	308 (l) Health maintenance organizations providing coverage under this section shall not
337	337	309prohibit a physician licensed pursuant to Chapter 112 or otherwise authorized to provide
338	338	310healthcare services who is providing healthcare services to a patient who is physically located in
339	339	311Massachusetts at the time the healthcare services are provided via telehealth from providing such
340	340	312services from any location within Massachusetts or outside Massachusetts; provided, that the
341	341	313location from which the physician provides services does not compromise patient confidentiality
342	342	314and privacy and the location from which the physician provides the services does not exceed
343	343	315restrictions placed on the physician’s specific license, including but not limited to, restrictions set
344	344	316by the hospital, institution, clinic or program in which a physician licensed pursuant to section 9
345	345	317of Chapter 112 of the General Laws has been appointed. 16 of 25
346	346	318 SECTION 16. Section 13 of Chapter 176I of the General Laws, as most recently
347	347	319amended by section 54 of Chapter 260 of the Acts of 2020, is hereby further amended by striking
348	348	320subsection (c) and inserting in place thereof the following:
349	349	321 (c) Coverage for telehealth services may include utilization review; provided, however,
350	350	322that any utilization review shall be made in the same manner as if the service was delivered in
351	351	323person. An organization shall not impose any prior authorization requirements to obtain
352	352	324medically necessary health services via telehealth that would not apply to the receipt of those
353	353	325same services on an in-person basis. An organization shall not be required to reimburse a health
354	354	326care provider for a health care service that is not a covered benefit under the plan or reimburse a
355	355	327health care provider not contracted under the plan except as provided for under subclause (i) of
356	356	328clause (4) of the second sentence of subsection (a) of section 6 of chapter 176O.
357	357	329 SECTION 17. Section 13 of Chapter 176I of the General Laws, as most recently inserted
358	358	330by Section 54 of Chapter 260 of the Acts of 2020, is hereby amended by adding at the end
359	359	331thereof the following subsection:
360	360	332 (i) A preferred provider contract that provides coverage for telehealth services shall
361	361	333include reimbursement for interpreter services for patients with limited English proficiency or
362	362	334those who are deaf or hard of hearing.
363	363	335 (j) Organizations shall develop and maintain procedures to identify and offer digital
364	364	336health education to covered persons with low digital health literacy to assist them with accessing
365	365	337any medical necessary covered telehealth benefits. These procedures shall include a digital
366	366	338health literacy screening program or other similar procedure to identify new and current covered
367	367	339persons with low digital health literacy and a digital health education program to educate covered 17 of 25
368	368	340persons regarding the effective use of telehealth technology including but not limited to
369	369	341distributing educational materials about how to access certain telehealth technologies in multiple
370	370	342languages, including sign language, and in alternative formats; holding digital health literacy
371	371	343workshops; integrating digital health coaching; offering covered persons in-person digital health
372	372	344navigators; and partnering with local libraries and/or community centers that offer digital health
373	373	345education services and supports.
374	374	346 (k) Organizations shall publish information annually regarding the procedures that they
375	375	347have implemented under subsection (j) including but not limited to statistics on the number of
376	376	348covered persons identified with low digital health literacy and receiving digital health education,
377	377	349manner(s) or method of digital health literacy screening and digital health education, financial
378	378	350impact of the programs, and evaluations of effectiveness of digital health literacy interventions.
379	379	351 (l) Organizations providing coverage under this section shall not prohibit a physician
380	380	352licensed pursuant to Chapter 112 or otherwise authorized to provide healthcare services who is
381	381	353providing healthcare services to a patient who is physically located in Massachusetts at the time
382	382	354the healthcare services are provided via telehealth from providing such services from any
383	383	355location within Massachusetts or outside Massachusetts; provided, that the location from which
384	384	356the physician provides services does not compromise patient confidentiality and privacy and the
385	385	357location from which the physician provides the services does not exceed restrictions placed on
386	386	358the physician’s specific license, including but not limited to, restrictions set by the hospital,
387	387	359institution, clinic or program in which a physician licensed pursuant to section 9 of Chapter 112
388	388	360of the General Laws has been appointed. 18 of 25
389	389	361 SECTION 18. Section 1 of Chapter 176O of the General Laws, as most recently amended
390	390	362by Section 56 of Chapter 260 of the Acts of 2020, is hereby amended in the definition of
391	391	363“Chronic disease management”, by inserting after the word “cancer” the following words:
392	392	364“COVID-19 and its long-term symptoms, serious, long-term physical diseases including, but not
393	393	365limited to, cerebral palsy, cystic fibrosis, HIV/AIDS, blood diseases, such as anemia or sickle
394	394	366cell disease, muscular dystrophy, spina bifida, epilepsy, ”.
395	395	367 SECTION 19. Section 26 of Chapter 176O of the General Laws is hereby amended by
396	396	368striking the current section and inserting in place thereof the following:
397	397	369 Section 26. The commissioner shall establish standardized processes and procedures
398	398	370applicable to all health care providers and payers for the determination of a patient's health
399	399	371benefit plan eligibility at or prior to the time of service, including telehealth services. As part of
400	400	372such processes and procedures, the commissioner shall (i) require payers to implement
401	401	373automated approval systems such as decision support software in place of telephone approvals
402	402	374for specific types of services specified by the commissioner and (ii) require establishment of an
403	403	375electronic data exchange to allow providers to determine eligibility at or prior to the point of care
404	404	376and determine the insured’s cost share for a proposed telehealth service, including any
405	405	377copayment, deductible, coinsurance or other out of pocket amount for any covered telehealth
406	406	378services.
407	407	379 SECTION 20. Notwithstanding any general or special law to the contrary, the health
408	408	380policy commission, in consultation with the center for health information and analysis, the
409	409	381executive office of health and human services and the division of insurance shall issue a report
410	410	382on the use of telehealth services in the commonwealth and the effect of telehealth on health care 19 of 25
411	411	383access and system cost. The report, along with a suggested plan to implement its
412	412	384recommendations in order to maximize access, quality of care and cost savings, shall be
413	413	385submitted to the joint committee on health care financing and the house and senate committees
414	414	386on ways and means not later than 2 years from the effective date of this act; provided, however,
415	415	387that not later than 1 year from the effective date of this act, the commission shall present a report
416	416	388on: i) the estimated impacts on costs and time spent by patients accessing healthcare services due
417	417	389to the use of telehealth; ii) the estimated impacts to access to healthcare services due to the use of
418	418	390telehealth including employment productivity, transportation costs and school attendance; iii) the
419	419	391estimated impacts on healthcare costs due to the impacts of telehealth on COVID-19
420	420	392transmission and treatment; iv) the estimated impact on the costs of personal protective
421	421	393equipment for providers and healthcare facilities due to the use of telehealth; v) an estimate of
422	422	394the impact of health outcomes to those communities that have not been able to access telehealth
423	423	395services due to language or accessibility issues; and vi) an interim estimate of the fiscal impact of
424	424	396telehealth use in the commonwealth that shall include public health outcomes, increased access
425	425	397to services, reduction in transportation services and vehicle miles traveled, and reduction in
426	426	398hospitalizations. The report shall additionally include data regarding the number of telehealth
427	427	399visits utilizing an interpreter for those who are deaf and hard of hearing and for languages other
428	428	400than English and shall quantify the number of telehealth visits in each language.
429	429	401 SECTION 21. Notwithstanding any general or special law to the contrary, the health
430	430	402policy commission shall establish a Digital Bridge Pilot Program to support telehealth services
431	431	403and devices and to provide funding for healthcare and human service providers and their patients
432	432	404and clients to support the purchase of telecommunications, information services and connected
433	433	405devices necessary to provide telehealth services to patients and clients. Communities that have 20 of 25
434	434	406had the highest prevalence of and been disproportionately affected by COVID-19 shall be
435	435	407prioritized for funding under this program in addition to communities that experience barriers in
436	436	408accessing telehealth services due to language constraints, socioeconomic constraints or other
437	437	409accessibility issues. Eligible programs may include but not be limited to public private
438	438	410partnerships with telecommunication providers, municipalities, healthcare providers and other
439	439	411organizations.
440	440	412 Eligible services may include, but not be limited to: telecommunications services;
441	441	413broadband and internet connectivity services including the purchase of broadband subscriptions
442	442	414and the establishment of wireless hotspots, so-called; voice services; remote patient monitoring
443	443	415platforms and services; patient reported outcome platforms; store and forward services, including
444	444	416the asynchronous transfer of patient images and data for interpretation by a physician; platforms
445	445	417and services to provide synchronous video consultation; tablets, smartphones, or connected
446	446	418devices to receive connected care services at home for patient or provider use; and telemedicine
447	447	419kiosks / carts for provider sites. Funding shall not be used for unconnected devices that patients
448	448	420utilize in the home and then manually report their results to providers.
449	449	421 SECTION 22. (a) Notwithstanding any general or special law to the contrary, the health
450	450	422policy commission shall establish a Digital Health Navigator Tech Literacy Pilot Program,
451	451	423herein referred to as the program, to complement and work in conjunction with the Digital
452	452	424Bridge Pilot Program. The program shall establish telehealth digital health navigators including
453	453	425community health workers, medical assistants, and other healthcare professionals to assist
454	454	426patients with accessing telehealth services. The program and its funding shall prioritize
455	455	427populations who experience increased barriers in accessing healthcare and telehealth services,
456	456	428including those disproportionately affected by COVID-19, the elderly and those who may need 21 of 25
457	457	429assistance with telehealth services due to limited English proficiency or limited literacy with
458	458	430digital health tools. Entities receiving funding through this program will provide culturally and
459	459	431linguistically competent hands-on support to educate patients on how to access broadband and
460	460	432wireless services and subsequently utilize devices and online platforms to access telehealth
461	461	433services.
462	462	434 (b) The health policy commission shall publish a report, one year following the
463	463	435implementation of said Digital Bridge Health Navigator Tech Literacy Pilot Program, which
464	464	436shall include but not be limited to the following: (i) an identification of the program’s telehealth
465	465	437navigators disaggregated by healthcare profession; (ii) the resources required to provide literacy
466	466	438with digital health tools, including, but not limited to, the cost of operating said pilot program
467	467	439and additional workforce training for the program’s telehealth navigators; (iii) an identification
468	468	440of the populations served by the program disaggregated by demographics including, but not
469	469	441limited to, race, ethnicity, age, gender identity and primary language spoken; (iv) an
470	470	442identification of the regions served by the program across the commonwealth; and (v) an
471	471	443evaluation of the efficacy of the program in increasing the utilization of telehealth services
472	472	444disaggregated by patient demographics and including, but not limited to, the rate of attendance at
473	473	445telehealth visits.
474	474	446 SECTION 23. a) Notwithstanding any general or special law to the contrary, the
475	475	447executive office of health and human services shall establish a task force to address barriers and
476	476	448impediments to the practice of telehealth across state lines. The task force shall consist of: the
477	477	449secretary of the executive office of health and human services or a designee who shall serve as
478	478	450chair; the commissioner of the department of public health or a designee; the commissioner of
479	479	451the department of mental health or a designee; the executive director of the board of registration 22 of 25
480	480	452in medicine or a designee; the Undersecretary of the office of consumer affairs and business
481	481	453regulation or a designee; a representative from the health policy commission; a representative
482	482	454from the Massachusetts Medical Society; a representative from the Massachusetts Health and
483	483	455Hospital Association; and a representative from the Massachusetts League of Community Health
484	484	456Centers.
485	485	457 b) The task force shall conduct an analysis and issue a report evaluating the
486	486	458commonwealth’s options to facilitate appropriate interstate medical practice and the practice of
487	487	459telemedicine including consideration of the recommendations from the Federation of State
488	488	460Medical Boards Workgroup on telemedicine, the Telehealth Act developed by the Uniform Law
489	489	461Commission, model legislation developed by the American Medical Association, the interstate
490	490	462medical licensure compact, and/or other licensure reciprocity agreements . The analysis and
491	491	463report shall include but not be limited to: (i) an analysis of physician job vacancies in the
492	492	464commonwealth broken down by practice specialization and projected vacancies based on the
493	493	465demographics of the commonwealth’s physician workforce and medical school graduate
494	494	466retention rates; (ii) an analysis of other states’ entry into the interstate medical licensure compact
495	495	467and any impact on quality of care resulting from entry; (iii) an analysis of the ability of
496	496	468physicians to provide follow-up care across state lines, including via telehealth; (iv) an analysis
497	497	469of registration models for providers who may provide care for patients via telehealth with the
498	498	470provider located in one state and the patient located in another state, provided that said analysis
499	499	471would include delineation of provider responsibilities for registration and reporting to state
500	500	472professional licensure boards; (v) an analysis of impacts to health care quality, cost and access
501	501	473resulting from other states’ entry into a medical licensure compact, as well as anticipated impacts
502	502	474to health care quality, cost and access associated with entry into an interstate medical licensure 23 of 25
503	503	475compact; (vi) evaluations of barriers and solutions regarding prescribing across state lines; (vii)
504	504	476evaluations of the feasibility of a regional reciprocity agreement allowing telemedicine across
505	505	477state lines both for existing patient provider relationships and/or the establishment of new
506	506	478relationships; (viii) evaluations of the feasibility of the establishment of interstate proxy
507	507	479credentialing; (ix) recommendations to support the continuity of care for patients utilizing
508	508	480telehealth across state lines including but not limited to recommendations to support the
509	509	481continuity of care for people aged 25 and under when providing telehealth across state lines; (x)
510	510	482consideration of the recommendations from the Federation of State Medical Boards Workgroup
511	511	483on telemedicine, the Telehealth Act developed by the Uniform Law Commission, model
512	512	484legislation developed by the American Medical Association, the interstate medical licensure
513	513	485compact, and/or other reciprocity agreements.
514	514	486 (c) The task force shall submit its recommendations to the governor and the clerks of the
515	515	487house of representatives and the senate not later than October 1, 2023.
516	516	488 SECTION 24. (a) Notwithstanding any general or special law to the contrary, the
517	517	489executive office of health and human services shall establish a task force to address barriers and
518	518	490impediments to the practice of telehealth by health professionals across state lines. including
519	519	491advanced practice registered nurses, physician assistants, behavioral and allied health
520	520	492professions, and other health professions licensed or certified by the Department of Public
521	521	493Health. The task force shall consist of: the secretary of the executive office of health and human
522	522	494services or a designee who shall serve as chair; the commissioner of the department of public
523	523	495health or a designee; the commissioner of the department of mental health or a designee; the
524	524	496executive director of the board of registration in nursing or a designee; the Undersecretary of the
525	525	497office of consumer affairs and business regulation or a designee; and 12 persons to be appointed 24 of 25
526	526	498by the secretary of the executive office of health and human services representing organizations
527	527	499that represent advanced practice registered nurses, physician assistants, hospitals, patients, social
528	528	500workers, behavioral health professions, allied health professions, telehealth and other healthcare
529	529	501professionals licensed or certified by the Department of Public Health.
530	530	502 (b) The task force shall: i) investigate interstate license reciprocity models with other
531	531	503nearby states for advanced practice registered nurses, physician assistants, behavioral health,
532	532	504social workers, allied health and other health professionals licensed or certified by the
533	533	505Department of Public Health to ensure that there is sufficient access for professionals throughout
534	534	506the region and ensure that continuity of care for patients is achieved for patients that access
535	535	507services in state’s throughout the region; ii) consider recommendations to support the continuity
536	536	508of care for patients utilizing telehealth across state lines including but not limited to
537	537	509recommendations to support the continuity of care for children and adolescents when providing
538	538	510telehealth across state lines; and iii) examine registration models for providers who may provide
539	539	511care for patients via telehealth with the provider located in one state and the patient located in
540	540	512another state. Such examination would include delineation of provider responsibilities for
541	541	513registration and reporting to state professional licensure boards.
542	542	514 (c) The task force shall submit its recommendations to the governor and the clerks of the
543	543	515house of representatives and the senate not later than February 1, 2024.
544	544	516 SECTION 25. Notwithstanding any general or special law to the contrary, the
545	545	517MassHealth program shall make permanent the rules for reimbursement for services rendered via
546	546	518telehealth consistent with MassHealth All Provider Bulletin 355 published in October 2022. 25 of 25
547	547	519 SECTION 26. Section 76 of Chapter 260 of the of the Acts of 2020 is hereby amended by
548	548	520striking the section in its entirety and inserting in place thereof the following:
549	549	521 Section 76. Section 63 is hereby repealed.
550	550	522 SECTION 27. Sections 77 and 79 of Chapter 260 of the Acts of 2020 are hereby
551	551	523repealed.