Massachusetts 2023-2024 Regular Session

Massachusetts Senate Bill S655 Compare Versions

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

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1	1	1 of 1
2	2	SENATE DOCKET, NO. 1984 FILED ON: 1/20/2023
3	3	SENATE . . . . . . . . . . . . . . No. 655
4	4	The Commonwealth of Massachusetts
5	5	_________________
6	6	PRESENTED BY:
7	7	Adam Gomez
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 :Adam GomezHampdenVanna Howard17th Middlesex2/27/2023 1 of 24
16	16	SENATE DOCKET, NO. 1984 FILED ON: 1/20/2023
17	17	SENATE . . . . . . . . . . . . . . No. 655
18	18	By Mr. Gomez, a petition (accompanied by bill, Senate, No. 655) of Adam Gomez and Vanna
19	19	Howard for legislation relative to telehealth and digital equity for patients. Financial Services.
20	20	The Commonwealth of Massachusetts
21	21	_______________
22	22	In the One Hundred and Ninety-Third General Court
23	23	(2023-2024)
24	24	_______________
25	25	An Act relative to telehealth and digital equity for patients.
26	26	Be it enacted by the Senate and House of Representatives in General Court assembled, and by the authority
27	27	of the same, as follows:
28	28	1 SECTION 1. Section 18AA of Chapter 6A of the General Laws, as most recently inserted
29	29	2by Section 1 of Chapter 174 of the Acts of 2022, is hereby amended by inserting after the word
30	30	3“benefits” the last time it appears the following:-
31	31	4 The executive office of health and human services and the executive office of housing
32	32	5and economic development shall determine a method for the common application portal to also
33	33	6allow individuals to simultaneously apply to the affordable connectivity program administered
34	34	7by the federal communications commission.
35	35	8 SECTION 2. Section 30 of Chapter 32A of the General Laws, as most recently inserted
36	36	9by section 3 of Chapter 260 of the Acts of 2020, is hereby amended by striking out subsection (c)
37	37	10and inserting in place thereof the following:-
38	38	11 (c) Coverage for telehealth services may include utilization review; provided, however,
39	39	12that any utilization review shall be made in the same manner as if the service was delivered in 2 of 24
40	40	13person. Carriers shall not impose any prior authorization requirements to obtain medically
41	41	14necessary health services via telehealth that would not apply to the receipt of those same services
42	42	15on an in-person basis. A carrier shall not be required to reimburse a health care provider for a
43	43	16health care service that is not a covered benefit under the plan or reimburse a health care
44	44	17provider not contracted under the plan except as provided for under subclause (i) of clause (4) of
45	45	18the second sentence of subsection (a) of section 6 of chapter 176O.
46	46	19 SECTION 3. Section 30 of Chapter 32A of the General Laws, as most recently inserted
47	47	20by Section 3 of Chapter 260 of the Acts of 2020 is hereby amended by adding at the end thereof
48	48	21the following subsections:-
49	49	22 (i) Coverage for telehealth services shall include reimbursement for interpreter services
50	50	23for patients with limited English proficiency or those who are deaf or hard of hearing.
51	51	24 (j) Carriers providing coverage to an active or retired employee of the commonwealth
52	52	25insured under the group insurance commission shall develop and maintain procedures to identify
53	53	26and offer digital health education to enrollees with low digital health literacy to assist them with
54	54	27accessing any medical necessary covered telehealth benefits. These procedures shall include a
55	55	28digital health literacy screening program or other similar procedure to identify current enrollees
56	56	29with low digital health literacy and a digital health education program to educate insured
57	57	30members regarding the effective use of telehealth technology including but not limited to
58	58	31distributing educational materials about how to access certain telehealth technologies in multiple
59	59	32languages, including sign language, and in alternative formats; holding digital health literacy
60	60	33workshops; integrating digital health coaching; offering enrollees in-person digital health 3 of 24
61	61	34navigators; and partnering with local libraries and/or community centers that offer digital health
62	62	35education services and supports.
63	63	36 (k) Carriers providing coverage to an active or retired employee of the commonwealth
64	64	37insured under the group insurance commission shall make information available to the
65	65	38commission regarding the procedures that they have implemented under subsection (j) including
66	66	39but not limited to statistics on the number of enrollees identified with low digital health literacy
67	67	40and receiving digital health education, manner(s) or method of digital health literacy screening
68	68	41and digital health education, financial impact of the programs, and evaluations of effectiveness
69	69	42of digital health literacy interventions.
70	70	43 (l) Carriers providing coverage to an active or retired employee of the commonwealth
71	71	44insured under the group insurance commission shall not prohibit a physician licensed pursuant to
72	72	45Chapter 112 or otherwise authorized to provide healthcare services who is providing healthcare
73	73	46services to a patient who is physically located in Massachusetts at the time the healthcare
74	74	47services are provided via telehealth from providing such services from any location within
75	75	48Massachusetts or outside Massachusetts; provided, that the location from which the physician
76	76	49provides services does not compromise patient confidentiality and privacy and the location from
77	77	50which the physician provides the services does not exceed restrictions placed on the physician’s
78	78	51specific license, including but not limited to, restrictions set by the hospital, institution, clinic or
79	79	52program in which a physician licensed pursuant to section 9 of Chapter 112 of the General Laws
80	80	53has been appointed. 4 of 24
81	81	54 SECTION 4. Subsection (a) of Section 79 of Chapter 118E of the General Laws, as most
82	82	55recently amended by Section 40 of Chapter 260 of the Acts of 2020, is hereby amended by
83	83	56inserting after the definition of “behavioral health services” the following:-
84	84	57 “E-consults”, asynchronous, consultative, provider-to-provider communications within a
85	85	58shared electronic health record (EHR) or web-based platform that are intended to improve access
86	86	59to specialty expertise for patients and providers without the need for a face-to-face visit, focused
87	87	60on a specific question. E-consults are inclusive of the consult generated from one provider or
88	88	61other qualified health professional to another, and of communications before/after consultation
89	89	62back to the member and/or the member’s caregiver.
90	90	63 “Remote patient monitoring services”, personal health and medical data collection,
91	91	64transmission, retrieval, or messaging from a member in one location, which is then transmitted to
92	92	65a provider in a different location and is used primarily for the management, treatment, care and
93	93	66related support of ongoing health conditions via regular information inputs from members and
94	94	67member guidance outputs from healthcare providers, including the remote monitoring of a
95	95	68patient’s vital signs, biometric data, or other objective or subjective data by a device that
96	96	69transmits such data electronically to a healthcare practitioner.
97	97	70 SECTION 5. Subsection (b) of Section 79 of Chapter 118E of the General Laws, as most
98	98	71recently amended by Section 40 of Chapter 260 of the Acts of 2020, is hereby amended by
99	99	72inserting at the end thereof after the word “providers.” the following:-
100	100	73 Coverage for telehealth services shall include coverage and reimbursement for e-consults
101	101	74and remote patient monitoring services and devices. 5 of 24
102	102	75 SECTION 6. Section 79 of Chapter 118E of the General Laws, as most recently amended
103	103	76by Section 40 of Chapter 260 of the Acts of 2020, is hereby amended by striking subsection (c)
104	104	77 and inserting in place thereof the following:-
105	105	78 (c) The division, a contracted health insurer, health plan, health maintenance
106	106	79organization, behavioral health management firm or third-party administrators under contract to
107	107	80a Medicaid managed care organization or primary care clinician plan shall not impose any
108	108	81utilization management requirements, including but not limited to, prior authorization
109	109	82requirements to obtain medically necessary health services via telehealth that would not apply to
110	110	83the receipt of those same services on an in-person basis. The division, a contracted health insurer,
111	111	84health plan, health maintenance organization, behavioral health management firm or third-party
112	112	85administrator under contract to a Medicaid managed care organization or primary care clinician
113	113	86plan shall not be required to reimburse a health care provider for a health care service that is not
114	114	87a covered benefit under the plan or reimburse a health care provider not contracted under the
115	115	88plan except as provided for under subclause (i) of clause (4) of the second sentence of subsection
116	116	89(a) of section 6 of chapter 176O.”
117	117	90 SECTION 7. Section 79 of Chapter 118E of the General Laws, as most recently inserted
118	118	91by Section 40 of Chapter 260 of the Acts of 2020 is hereby amended by inserting at the end
119	119	92thereof the following subsections:-
120	120	93 (i) The division and its contracted health insurers, health plans, health maintenance
121	121	94organizations, behavioral health management firms and third-party administrators under contract
122	122	95to a Medicaid managed care organization, accountable care organization or primary care
123	123	96clinician plan shall include in its coverage for reimbursement for interpreter services for patients 6 of 24
124	124	97with limited English proficiency or those who are deaf or hard of hearing in its coverage for
125	125	98telehealth services.
126	126	99 (j) The division and its contracted health insurers, health plans, health maintenance
127	127	100organizations, behavioral health management firms and third-party administrators under contract
128	128	101to a Medicaid managed care organization, accountable care organization or primary care
129	129	102clinician plan shall develop and maintain procedures to identify and offer digital health education
130	130	103to members with low digital health literacy to assist them with accessing any medical necessary
131	131	104covered telehealth benefits. These procedures shall include a digital health literacy screening
132	132	105program or other similar procedure to identify new and current members with low digital health
133	133	106literacy and a digital health education program to educate insured members regarding the
134	134	107effective use of telehealth technology including but not limited to distributing educational
135	135	108materials about how to access certain telehealth technologies in multiple languages, including
136	136	109sign language, and in alternative formats; holding digital health literacy workshops; integrating
137	137	110digital health coaching; offering enrollees in-person digital health navigators; and partnering
138	138	111with local libraries and/or community centers that offer digital health education services and
139	139	112supports.
140	140	113 (k) The division and its contracted health insurers, health plans, health maintenance
141	141	114organizations, behavioral health management firms and third-party administrators under contract
142	142	115to a Medicaid managed care organization, accountable care organization or primary care
143	143	116clinician plan shall publish information annually regarding the procedures that they have
144	144	117implemented under subsection (j) including but not limited to statistics on the number of
145	145	118members identified with low digital health literacy and receiving digital health education, 7 of 24
146	146	119manner(s) or method of digital health literacy screening and digital health education, financial
147	147	120impact of the programs, and evaluations of effectiveness of digital health literacy interventions.
148	148	121 (l) The division and its contracted health insurers, health plans, health maintenance
149	149	122organizations, behavioral health management firms and third-party administrators under contract
150	150	123to a Medicaid managed care organization, accountable care organization or primary care
151	151	124clinician plan providing coverage to an active or retired employee of the commonwealth insured
152	152	125under the group insurance commission shall not prohibit a physician licensed pursuant to
153	153	126Chapter 112 or otherwise authorized to provide healthcare services who is providing healthcare
154	154	127services to a patient who is physically located in Massachusetts at the time the healthcare
155	155	128services are provided via telehealth from providing such services from any location within
156	156	129Massachusetts or outside Massachusetts; provided, that the location from which the physician
157	157	130provides services does not compromise patient confidentiality and privacy and the location from
158	158	131which the physician provides the services does not exceed restrictions placed on the physician’s
159	159	132specific license, including but not limited to, restrictions set by the hospital, institution, clinic, or
160	160	133program in which a physician licensed pursuant to section 9 of Chapter 112 of the General Laws
161	161	134has been appointed.
162	162	135 SECTION 8. Section 47MM of Chapter 175 of the General Laws, as most recently
163	163	136amended by Section 47 of Chapter 260 of the Acts of 2020, is hereby amended by striking out
164	164	137subsection (c) and inserting place thereof the following:-
165	165	138 (c) Coverage for telehealth services may include utilization review; provided, however,
166	166	139that any utilization review shall be made in the same manner as if the service was delivered in
167	167	140person. A policy, contract, agreement, plan or certificate of insurance issued, delivered or 8 of 24
168	168	141renewed within or without the commonwealth shall not impose any prior authorization
169	169	142requirements to obtain medically necessary health services via telehealth that would not apply to
170	170	143the receipt of those same services on an in-person basis. A policy, contract, agreement, plan or
171	171	144certificate of insurance issued, delivered or renewed within or without the commonwealth shall
172	172	145not be required to reimburse a health care provider for a health care service that is not a covered
173	173	146benefit under the plan or reimburse a health care provider not contracted under the plan except as
174	174	147provided for under subclause (i) of clause (4) of the second sentence of subsection (a) of section
175	175	1486 of chapter 176O.
176	176	149 SECTION 9. Section 47MM of Chapter 175 of the General Laws, as most recently
177	177	150inserted by Section 47 of Chapter 260 of the Acts of 2020 is hereby further amended by adding
178	178	151at the end thereof the following subsections:-
179	179	152 (i) A policy, contract, agreement, plan or certificate of insurance issued, delivered or
180	180	153renewed within the commonwealth that provides coverage for telehealth services shall include
181	181	154reimbursement for interpreter services for patients with limited English proficiency or those who
182	182	155are deaf or hard of hearing.
183	183	156 (j) A policy, contract, agreement, plan or certificate of insurance issued, delivered or
184	184	157renewed within the commonwealth shall develop and maintain procedures to identify and offer
185	185	158digital health education to subscribers with low digital health literacy to assist them with
186	186	159accessing any medical necessary covered telehealth benefits. These procedures shall include a
187	187	160digital health literacy screening program or other similar procedure to identify new and current
188	188	161subscribers with low digital health literacy and a digital health education program to educate
189	189	162insured subscribers regarding the effective use of telehealth technology including but not limited 9 of 24
190	190	163to distributing educational materials about how to access certain telehealth technologies in
191	191	164multiple languages, including sign language, and in alternative formats; holding digital health
192	192	165literacy workshops; integrating digital health coaching; offering subscribers in-person digital
193	193	166health navigators; and partnering with local libraries and/or community centers that offer digital
194	194	167health education services and supports.
195	195	168 (k) A policy, contract, agreement, plan or certificate of insurance issued, delivered or
196	196	169renewed within the commonwealth shall publish information annually regarding the procedures
197	197	170that they have implemented under subsection (j) including but not limited to statistics on the
198	198	171number of subscribers identified with low digital health literacy and receiving digital health
199	199	172education, manner(s) or method of digital health literacy screening and digital health education,
200	200	173financial impact of the programs, and evaluations of effectiveness of digital health literacy
201	201	174interventions.
202	202	175 (l) A policy, contract, agreement, plan or certificate of insurance issued, delivered or
203	203	176renewed within the commonwealth shall not prohibit a physician licensed pursuant to Chapter
204	204	177112 or otherwise authorized to provide healthcare services who is providing healthcare services
205	205	178to a patient who is physically located in Massachusetts at the time the healthcare services are
206	206	179provided via telehealth from providing such services from any location within Massachusetts or
207	207	180outside Massachusetts; provided, that the location from which the physician provides services
208	208	181does not compromise patient confidentiality and privacy and the location from which the
209	209	182physician provides the services does not exceed restrictions placed on the physician’s specific
210	210	183license, including but not limited to, restrictions set by the hospital, institution, clinic or program
211	211	184in which a physician licensed pursuant to section 9 of Chapter 112 of the General Laws has been
212	212	185appointed. 10 of 24
213	213	186 SECTION 10. Section 38 of Chapter 176A of the General Laws, as most recently
214	214	187amended by Section 49 of Chapter 260 of the Acts of 2020, is hereby further amended by
215	215	188striking subsection (c) and inserting in place thereof the following:-
216	216	189 (c) Coverage for telehealth services may include utilization review; provided, however,
217	217	190that any utilization review shall be made in the same manner as if the service was delivered in
218	218	191person. A carrier shall not impose any prior authorization requirements to obtain medically
219	219	192necessary health services via telehealth that would not apply to the receipt of those same services
220	220	193on an in-person basis. A carrier shall not be required to reimburse a health care provider for a
221	221	194health care service that is not a covered benefit under the plan or reimburse a health care
222	222	195provider not contracted under the plan except as provided for under subclause (i) of clause (4) of
223	223	196the second sentence of subsection (a) of section 6 of chapter 176O.
224	224	197 SECTION 11. Section 38 of Chapter 176A of the General Laws, as most recently inserted
225	225	198by Section 49 of Chapter 260 of the Acts of 2020, is hereby amended by adding at the end
226	226	199thereof the following subsections:-
227	227	200 (i) Coverage for telehealth services shall include reimbursement for interpreter services
228	228	201for patients with limited English proficiency or those who are deaf or hard of hearing.
229	229	202 (j) Hospital service corporations shall develop and maintain procedures to identify and
230	230	203offer digital health education to subscribers with low digital health literacy to assist them with
231	231	204accessing any medical necessary covered telehealth benefits. These procedures shall include a
232	232	205digital health literacy screening program or other similar procedure to identify new and current
233	233	206subscribers with low digital health literacy and a digital health education program to educate
234	234	207insured subscribers regarding the effective use of telehealth technology including but not limited 11 of 24
235	235	208to distributing educational materials about how to access certain telehealth technologies in
236	236	209multiple languages, including sign language, and in alternative formats; holding digital health
237	237	210literacy workshops; integrating digital health coaching; offering subscribers in-person digital
238	238	211health navigators; and partnering with local libraries and/or community centers that offer digital
239	239	212health education services and supports.
240	240	213 (k) Hospital service corporations shall publish information annually regarding the
241	241	214procedures that they have implemented under subsection (j) including but not limited to statistics
242	242	215on the number of subscribers identified with low digital health literacy and receiving digital
243	243	216health education, manner(s) or method of digital health literacy screening and digital health
244	244	217education, financial impact of the programs, and evaluations of effectiveness of digital health
245	245	218literacy interventions.
246	246	219 (l) Hospital service corporations providing coverage under this section shall not prohibit a
247	247	220physician licensed pursuant to Chapter 112 or otherwise authorized to provide healthcare
248	248	221services who is providing healthcare services to a patient who is physically located in
249	249	222Massachusetts at the time the healthcare services are provided via telehealth from providing such
250	250	223services from any location within Massachusetts or outside Massachusetts; provided, that the
251	251	224location from which the physician provides services does not compromise patient confidentiality
252	252	225and privacy and the location from which the physician provides the services does not exceed
253	253	226restrictions placed on the physician’s specific license, including but not limited to, restrictions set
254	254	227by the hospital, institution, clinic or program in which a physician licensed pursuant to section 9
255	255	228of Chapter 112 of the General Laws has been appointed. 12 of 24
256	256	229 SECTION 12. Section 25 of Chapter 176B of the General Laws, as most recently
257	257	230amended by Section 51 of Chapter 260 of the Acts of 2020, is hereby further amended by
258	258	231striking subsection (c) and inserting in place thereof the following:-
259	259	232 (c) Coverage for telehealth services may include utilization review; provided, however,
260	260	233that any utilization review shall be made in the same manner as if the service was delivered in
261	261	234person. A carrier shall not impose any prior authorization requirements to obtain medically
262	262	235necessary health services via telehealth that would not apply to the receipt of those same services
263	263	236on an in-person basis. A carrier shall not be required to reimburse a health care provider for a
264	264	237health care service that is not a covered benefit under the plan or reimburse a health care
265	265	238provider not contracted under the plan except as provided for under subclause (i) of clause (4) of
266	266	239the second sentence of subsection (a) of section 6 of chapter 176O.
267	267	240 SECTION 13. Section 25 of Chapter 176B of the General Laws, as most recently
268	268	241inserted by Section 51 of Chapter 260 of the Acts of 2020, is hereby amended by adding at the
269	269	242end thereof the following subsections:-
270	270	243 (i) A contract that provides coverage for telehealth services shall include reimbursement
271	271	244for interpreter services for patients with limited English proficiency or those who are deaf or
272	272	245hard of hearing who require interpreter services.
273	273	246 (j) Medical service corporations shall develop and maintain procedures to identify and
274	274	247offer digital health education to subscribers with low digital health literacy to assist them with
275	275	248accessing any medical necessary covered telehealth benefits. These procedures shall include a
276	276	249digital health literacy screening program or other similar procedure to identify new and current
277	277	250subscribers with low digital health literacy and a digital health education program to educate 13 of 24
278	278	251insured subscribers regarding the effective use of telehealth technology including but not limited
279	279	252to distributing educational materials about how to access certain telehealth technologies in
280	280	253multiple languages, including sign language, and in alternative formats; holding digital health
281	281	254literacy workshops; integrating digital health coaching; offering subscribers in-person digital
282	282	255health navigators; and partnering with local libraries and/or community centers that offer digital
283	283	256health education services and supports.
284	284	257 (k) Medical service corporations shall publish information annually regarding the
285	285	258procedures that they have implemented under subsection (j) including but not limited to statistics
286	286	259on the number of subscribers identified with low digital health literacy and receiving digital
287	287	260health education, manner(s) or method of digital health literacy screening and digital health
288	288	261education, financial impact of the programs, and evaluations of effectiveness of digital health
289	289	262literacy interventions.
290	290	263 (l) Medical service corporations providing coverage under this section shall not prohibit a
291	291	264physician licensed pursuant to Chapter 112 or otherwise authorized to provide healthcare
292	292	265services who is providing healthcare services to a patient who is physically located in
293	293	266Massachusetts at the time the healthcare services are provided via telehealth from providing such
294	294	267services from any location within Massachusetts or outside Massachusetts; provided, that the
295	295	268location from which the physician provides services does not compromise patient confidentiality
296	296	269and privacy and the location from which the physician provides the services does not exceed
297	297	270restrictions placed on the physician’s specific license, including but not limited to, restrictions set
298	298	271by the hospital, institution, clinic or program in which a physician licensed pursuant to section 9
299	299	272of Chapter 112 of the General Laws has been appointed. 14 of 24
300	300	273 SECTION 14. Section 33 of Chapter 176G of the General Laws, as most recently
301	301	274amended by Section 53 of Chapter 260 of the Acts of 2020, is hereby further amended by
302	302	275striking subsection (c) and inserting in place thereof the following:-
303	303	276 (c) Coverage for telehealth services may include utilization review; provided, however,
304	304	277that any utilization review shall be made in the same manner as if the service was delivered in
305	305	278person. A health maintenance organization shall not impose any prior authorization requirements
306	306	279to obtain medically necessary health services via telehealth that would not apply to the receipt of
307	307	280those same services on an in-person basis. A health maintenance organization shall not be
308	308	281required to reimburse a health care provider for a health care service that is not a covered benefit
309	309	282under the plan or reimburse a health care provider not contracted under the plan except as
310	310	283provided for under subclause (i) of clause (4) of the second sentence of subsection (a) of section
311	311	2846 of chapter 176O.
312	312	285 SECTION 15. Section 33 of Chapter 176G of the General Laws, as most recently inserted
313	313	286by Section 53 of Chapter 260 of the Acts of 2020, is hereby amended by adding at the end
314	314	287thereof the following subsection:-
315	315	288 (i) A contract that provides coverage for telehealth services shall include reimbursement
316	316	289for interpreter services for patients with limited English proficiency or those who are deaf or
317	317	290hard of hearing.
318	318	291 (j) Health maintenance organizations shall develop and maintain procedures to identify
319	319	292and offer digital health education to members with low digital health literacy to assist them with
320	320	293accessing any medical necessary covered telehealth benefits. These procedures shall include a
321	321	294digital health literacy screening program or other similar procedure to identify new and current 15 of 24
322	322	295members with low digital health literacy and a digital health education program to educate
323	323	296insured subscribers regarding the effective use of telehealth technology including but not limited
324	324	297to distributing educational materials about how to access certain telehealth technologies in
325	325	298multiple languages, including sign language, and in alternative formats; holding digital health
326	326	299literacy workshops; integrating digital health coaching; offering subscribers in-person digital
327	327	300health navigators; and partnering with local libraries and/or community centers that offer digital
328	328	301health education services and supports.
329	329	302 (k) Health maintenance organizations shall publish information annually regarding the
330	330	303procedures that they have implemented under subsection (j) including but not limited to statistics
331	331	304on the number of subscribers identified with low digital health literacy and receiving digital
332	332	305health education, manner(s) or method of digital health literacy screening and digital health
333	333	306education, financial impact of the programs, and evaluations of effectiveness of digital health
334	334	307literacy interventions.
335	335	308 (l) Health maintenance organizations providing coverage under this section shall not
336	336	309prohibit a physician licensed pursuant to Chapter 112 or otherwise authorized to provide
337	337	310healthcare services who is providing healthcare services to a patient who is physically located in
338	338	311Massachusetts at the time the healthcare services are provided via telehealth from providing such
339	339	312services from any location within Massachusetts or outside Massachusetts; provided, that the
340	340	313location from which the physician provides services does not compromise patient confidentiality
341	341	314and privacy and the location from which the physician provides the services does not exceed
342	342	315restrictions placed on the physician’s specific license, including but not limited to, restrictions set
343	343	316by the hospital, institution, clinic or program in which a physician licensed pursuant to section 9
344	344	317of Chapter 112 of the General Laws has been appointed. 16 of 24
345	345	318 SECTION 16. Section 13 of Chapter 176I of the General Laws, as most recently
346	346	319amended by section 54 of Chapter 260 of the Acts of 2020, is hereby further amended by striking
347	347	320subsection (c) and inserting in place thereof the following:-
348	348	321 (c) Coverage for telehealth services may include utilization review; provided, however,
349	349	322that any utilization review shall be made in the same manner as if the service was delivered in
350	350	323person. An organization shall not impose any prior authorization requirements to obtain
351	351	324medically necessary health services via telehealth that would not apply to the receipt of those
352	352	325same services on an in-person basis. An organization shall not be required to reimburse a health
353	353	326care provider for a health care service that is not a covered benefit under the plan or reimburse a
354	354	327health care provider not contracted under the plan except as provided for under subclause (i) of
355	355	328clause (4) of the second sentence of subsection (a) of section 6 of chapter 176O.
356	356	329 SECTION 17. Section 13 of Chapter 176I of the General Laws, as most recently inserted
357	357	330by Section 54 of Chapter 260 of the Acts of 2020, is hereby amended by adding at the end
358	358	331thereof the following subsection:-
359	359	332 (i) A preferred provider contract that provides coverage for telehealth services shall
360	360	333include reimbursement for interpreter services for patients with limited English proficiency or
361	361	334those who are deaf or hard of hearing.
362	362	335 (j) Organizations shall develop and maintain procedures to identify and offer digital
363	363	336health education to covered persons with low digital health literacy to assist them with accessing
364	364	337any medical necessary covered telehealth benefits. These procedures shall include a digital
365	365	338health literacy screening program or other similar procedure to identify new and current covered
366	366	339persons with low digital health literacy and a digital health education program to educate covered 17 of 24
367	367	340persons regarding the effective use of telehealth technology including but not limited to
368	368	341distributing educational materials about how to access certain telehealth technologies in multiple
369	369	342languages, including sign language, and in alternative formats; holding digital health literacy
370	370	343workshops; integrating digital health coaching; offering covered persons in-person digital health
371	371	344navigators; and partnering with local libraries and/or community centers that offer digital health
372	372	345education services and supports.
373	373	346 (k) Organizations shall publish information annually regarding the procedures that they
374	374	347have implemented under subsection (j) including but not limited to statistics on the number of
375	375	348covered persons identified with low digital health literacy and receiving digital health education,
376	376	349manner(s) or method of digital health literacy screening and digital health education, financial
377	377	350impact of the programs, and evaluations of effectiveness of digital health literacy interventions.
378	378	351 (l) Organizations providing coverage under this section shall not prohibit a physician
379	379	352licensed pursuant to Chapter 112 or otherwise authorized to provide healthcare services who is
380	380	353providing healthcare services to a patient who is physically located in Massachusetts at the time
381	381	354the healthcare services are provided via telehealth from providing such services from any
382	382	355location within Massachusetts or outside Massachusetts; provided, that the location from which
383	383	356the physician provides services does not compromise patient confidentiality and privacy and the
384	384	357location from which the physician provides the services does not exceed restrictions placed on
385	385	358the physician’s specific license, including but not limited to, restrictions set by the hospital,
386	386	359institution, clinic or program in which a physician licensed pursuant to section 9 of Chapter 112
387	387	360of the General Laws has been appointed. 18 of 24
388	388	361 SECTION 18. Section 1 of Chapter 176O of the General Laws, as most recently amended
389	389	362by Section 56 of Chapter 260 of the Acts of 2020, is hereby amended in the definition of
390	390	363“Chronic disease management”, by inserting after the word “cancer” the following words:
391	391	364“COVID-19 and its long-term symptoms, serious, long-term physical diseases including, but not
392	392	365limited to, cerebral palsy, cystic fibrosis, HIV/AIDS, blood diseases, such as anemia or sickle
393	393	366cell disease, muscular dystrophy, spina bifida, epilepsy, ”.
394	394	367 SECTION 19. Section 26 of Chapter 176O of the General Laws is hereby amended by
395	395	368striking the current section and inserting in place thereof the following:-
396	396	369 Section 26. The commissioner shall establish standardized processes and procedures
397	397	370applicable to all health care providers and payers for the determination of a patient's health
398	398	371benefit plan eligibility at or prior to the time of service, including telehealth services. As part of
399	399	372such processes and procedures, the commissioner shall (i) require payers to implement
400	400	373automated approval systems such as decision support software in place of telephone approvals
401	401	374for specific types of services specified by the commissioner and (ii) require the establishment of
402	402	375an electronic data exchange to allow providers to determine eligibility at or prior to the point of
403	403	376care and determine the insured’s cost share for a proposed telehealth service, including any
404	404	377copayment, deductible, coinsurance or other out of pocket amount for any covered telehealth
405	405	378services.
406	406	379 SECTION 20. Notwithstanding any general or special law to the contrary, the health
407	407	380policy commission, in consultation with the center for health information and analysis, the
408	408	381executive office of health and human services, and the division of insurance shall issue a report
409	409	382on the use of telehealth services in the commonwealth and the effect of telehealth on health care 19 of 24
410	410	383access and system cost. The report, along with a suggested plan to implement its
411	411	384recommendations in order to maximize access, quality of care and cost savings, shall be
412	412	385submitted to the joint committee on health care financing and the house and senate committees
413	413	386on ways and means not later than 2 years from the effective date of this act; provided, however,
414	414	387that not later than 1 year from the effective date of this act, the commission shall present a report
415	415	388on: i) the estimated impacts on costs and time spent by patients accessing healthcare services due
416	416	389to the use of telehealth; ii) the estimated impacts to access to healthcare services due to the use of
417	417	390telehealth including employment productivity, transportation costs and school attendance; iii) the
418	418	391estimated impacts on healthcare costs due to the impacts of telehealth on COVID-19
419	419	392transmission and treatment; iv) the estimated impact on the costs of personal protective
420	420	393equipment for providers and healthcare facilities due to the use of telehealth; v) an estimate of
421	421	394the impact of health outcomes to those communities that have not been able to access telehealth
422	422	395services due to language or accessibility issues; and vi) an interim estimate of the fiscal impact of
423	423	396telehealth use in the commonwealth that shall include public health outcomes, increased access
424	424	397to services, reduction in transportation services and vehicle miles traveled, and reduction in
425	425	398hospitalizations. The report shall additionally include data regarding the number of telehealth
426	426	399visits utilizing an interpreter for those who are deaf and hard of hearing and for languages other
427	427	400than English and shall quantify the number of telehealth visits in each language.
428	428	401 SECTION 21. Notwithstanding any general or special law to the contrary, the health
429	429	402policy commission shall establish a Digital Bridge Pilot Program to support telehealth services
430	430	403and devices and to provide funding for healthcare and human service providers and their patients
431	431	404and clients to support the purchase of telecommunications, information services and connected
432	432	405devices necessary to provide telehealth services to patients and clients. Communities that have 20 of 24
433	433	406had the highest prevalence of and been disproportionately affected by COVID-19 shall be
434	434	407prioritized for funding under this program in addition to communities that experience barriers in
435	435	408accessing telehealth services due to language constraints, socioeconomic constraints, or other
436	436	409accessibility issues. Eligible programs may include but not be limited to public-private
437	437	410partnerships with telecommunication providers, municipalities, healthcare providers, and other
438	438	411organizations.
439	439	412 Eligible services may include, but not be limited to: telecommunications services;
440	440	413broadband and internet connectivity services including the purchase of broadband subscriptions
441	441	414and the establishment of wireless hotspots, so-called; voice services; remote patient monitoring
442	442	415platforms and services; patient reported outcome platforms; store and forward services, including
443	443	416the asynchronous transfer of patient images and data for interpretation by a physician; platforms
444	444	417and services to provide synchronous video consultation; tablets, smartphones, or connected
445	445	418devices to receive connected care services at home for patient or provider use; and telemedicine
446	446	419kiosks/carts for provider sites. Funding shall not be used for unconnected devices that patients
447	447	420utilize in the home and then manually report their results to providers.
448	448	421 SECTION 22. (a) Notwithstanding any general or special law to the contrary, the health
449	449	422policy commission shall establish a Digital Health Navigator Tech Literacy Pilot Program,
450	450	423herein referred to as the program, to complement and work in conjunction with the Digital
451	451	424Bridge Pilot Program. The program shall establish telehealth digital health navigators including
452	452	425community health workers, medical assistants, and other healthcare professionals to assist
453	453	426patients with accessing telehealth services. The program and its funding shall prioritize
454	454	427populations who experience increased barriers in accessing healthcare and telehealth services,
455	455	428including those disproportionately affected by COVID-19, the elderly, and those who may need 21 of 24
456	456	429assistance with telehealth services due to limited English proficiency or limited literacy with
457	457	430digital health tools. Entities receiving funding through this program will provide culturally and
458	458	431linguistically competent hands-on support to educate patients on how to access broadband and
459	459	432wireless services and subsequently utilize devices and online platforms to access telehealth
460	460	433services.
461	461	434 (b) The health policy commission shall publish a report, one year following the
462	462	435implementation of said Digital Bridge Health Navigator Tech Literacy Pilot Program, which
463	463	436shall include but not be limited to the following: (i) an identification of the program’s telehealth
464	464	437navigators disaggregated by healthcare profession; (ii) the resources required to provide literacy
465	465	438with digital health tools, including, but not limited to, the cost of operating said pilot program
466	466	439and additional workforce training for the program’s telehealth navigators; (iii) an identification
467	467	440of the populations served by the program disaggregated by demographics including, but not
468	468	441limited to, race, ethnicity, age, gender identity and primary language spoken; (iv) an
469	469	442identification of the regions served by the program across the commonwealth; and (v) an
470	470	443evaluation of the efficacy of the program in increasing the utilization of telehealth services
471	471	444disaggregated by patient demographics and including, but not limited to, the rate of attendance at
472	472	445telehealth visits.
473	473	446 SECTION 23. a) Notwithstanding any general or special law to the contrary, the
474	474	447executive office of health and human services shall establish a task force to address barriers and
475	475	448impediments to the practice of telehealth across state lines. The task force shall consist of: the
476	476	449secretary of the executive office of health and human services or a designee who shall serve as
477	477	450chair; the commissioner of the department of public health or a designee; the commissioner of
478	478	451the department of mental health or a designee; the executive director of the board of registration 22 of 24
479	479	452in medicine or a designee; the Undersecretary of the office of consumer affairs and business
480	480	453regulation or a designee; a representative from the health policy commission; a representative
481	481	454from the Massachusetts Medical Society; a representative from the Massachusetts Health and
482	482	455Hospital Association; and a representative from the Massachusetts League of Community Health
483	483	456Centers.
484	484	457 b) The task force shall conduct an analysis and issue a report evaluating the
485	485	458commonwealth’s options to facilitate appropriate interstate medical practice and the practice of
486	486	459telemedicine including consideration of the recommendations from the Federation of State
487	487	460Medical Boards Workgroup on telemedicine, the Telehealth Act developed by the Uniform Law
488	488	461Commission, model legislation developed by the American Medical Association, the interstate
489	489	462medical licensure compact, and/or other licensure reciprocity agreements. The analysis and
490	490	463report shall include but not be limited to: (i) an analysis of physician job vacancies in the
491	491	464commonwealth broken down by practice specialization and projected vacancies based on the
492	492	465demographics of the commonwealth’s physician workforce and medical school graduate
493	493	466retention rates; (ii) an analysis of other states’ entry into the interstate medical licensure compact
494	494	467and any impact on quality of care resulting from entry; (iii) an analysis of the ability of
495	495	468physicians to provide follow-up care across state lines, including via telehealth; (iv) an analysis
496	496	469of registration models for providers who may provide care for patients via telehealth with the
497	497	470provider located in one state and the patient located in another state, provided that said analysis
498	498	471would include delineation of provider responsibilities for registration and reporting to state
499	499	472professional licensure boards; (v) an analysis of impacts to health care quality, cost and access
500	500	473resulting from other states’ entry into a medical licensure compact, as well as anticipated impacts
501	501	474to health care quality, cost and access associated with entry into an interstate medical licensure 23 of 24
502	502	475compact; (vi) evaluations of barriers and solutions regarding prescribing across state lines; (vii)
503	503	476evaluations of the feasibility of a regional reciprocity agreement allowing telemedicine across
504	504	477state lines both for existing patient provider relationships and/or the establishment of new
505	505	478relationships; (viii) evaluations of the feasibility of the establishment of interstate proxy
506	506	479credentialing; and (ix) consideration of the recommendations from the Federation of State
507	507	480Medical Boards Workgroup on telemedicine, the Telehealth Act developed by the Uniform Law
508	508	481Commission, model legislation developed by the American Medical Association, the interstate
509	509	482medical licensure compact, and/or other reciprocity agreements.
510	510	483 (c) The task force shall submit its recommendations to the governor and the clerks of the
511	511	484house of representatives and the senate not later than October 1, 2023.
512	512	485 SECTION 24. (a) Notwithstanding any general or special law to the contrary, the
513	513	486executive office of health and human services shall establish a task force to address barriers and
514	514	487impediments to the practice of telehealth by health professionals across state lines. including
515	515	488advanced practice registered nurses, physician assistants, behavioral and allied health
516	516	489professions, and other health professions licensed or certified by the Department of Public
517	517	490Health. The task force shall consist of: the secretary of the executive office of health and human
518	518	491services or a designee who shall serve as chair; the commissioner of the department of public
519	519	492health or a designee; the commissioner of the department of mental health or a designee; the
520	520	493executive director of the board of registration in nursing or a designee; the Undersecretary of the
521	521	494office of consumer affairs and business regulation or a designee; and 12 persons to be appointed
522	522	495by the secretary of the executive office of health and human services representing organizations
523	523	496that represent advanced practice registered nurses, physician assistants, hospitals, patients, social 24 of 24
524	524	497workers, behavioral health professions, allied health professions, telehealth and other healthcare
525	525	498professionals licensed or certified by the Department of Public Health.
526	526	499 (b) The task force shall: i) investigate interstate license reciprocity models with other
527	527	500nearby states for advanced practice registered nurses, physician assistants, behavioral health,
528	528	501social workers, allied health, and other health professionals licensed or certified by the
529	529	502Department of Public Health to ensure that there is sufficient access for professionals throughout
530	530	503the region and ensure that continuity of care for patients is achieved for patients that access
531	531	504services in states throughout the region; and ii) examine registration models for providers who
532	532	505may provide care for patients via telehealth with the provider located in one state and the patient
533	533	506located in another state. Such examination would include the delineation of provider
534	534	507responsibilities for registration and reporting to state professional licensure boards.
535	535	508 (c) The task force shall submit its recommendations to the governor and the clerks of the
536	536	509house of representatives and the senate not later than February 1, 2024.
537	537	510 SECTION 25. Notwithstanding any general or special law to the contrary, the
538	538	511MassHealth program shall make permanent the rules for reimbursement for services rendered via
539	539	512telehealth consistent with MassHealth All Provider Bulletin 355 published in October 2022.
540	540	513 SECTION 26. Section 76 of Chapter 260 of the of the Acts of 2020 is hereby amended by
541	541	514striking the section in its entirety and inserting in place thereof the following:-
542	542	515 Section 76. Section 63 is hereby repealed.
543	543	516 SECTION 27. Sections 77 and 79 of Chapter 260 of the Acts of 2020 are hereby
544	544	517repealed.