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