EXPLANATION: CAPITALS INDICATE MAT TER ADDED TO EXISTIN G LAW.
[Brackets] indicate matter deleted from existing law.
*sb0534*
SENATE BILL 534
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By: Senators Gile, Beidle, Ellis, Griffith, Hershey, Klausmeier, and Mautz
Introduced and read first time: February 3, 2023
Assigned to: Finance
A BILL ENTITLED
AN ACT concerning 1
Preserve Telehealth Access Act of 2023 2
FOR the purpose of extending to a certain date the inclusion of certain audio–only 3
telephone conversations under the definition of “telehealth” for the purpose of certain 4
provisions of law relating to reimbursement and coverage of telehealth by the 5
Maryland Medical Assistance Program and certain insurers, nonprofit health service 6
plans, and health maintenance organizations; extending to a certain date a 7
requirement on the Program and certain insurers, nonprofit health service plans, 8
and health maintenance organizations to provide reimbursement for certain health 9
care services provided through telehealth on a certain basis and at a certain rate; 10
and generally relating to the coverage and reimbursement of health care services 11
delivered through telehealth. 12
BY repealing and reenacting, with amendments, 13
Article – Health – General 14
Section 15–141.2(a)(7) and (g) 15
Annotated Code of Maryland 16
(2019 Replacement Volume and 2022 Supplement) 17
BY repealing and reenacting, with amendments, 18
Article – Insurance 19
Section 15–139(a) and (d) 20
Annotated Code of Maryland 21
(2017 Replacement Volume and 2022 Supplement) 22
BY repealing and reenacting, without amendments, 23
Article – Insurance 24
Section 15–139(b) and (c) 25
Annotated Code of Maryland 26
(2017 Replacement Volume and 2022 Supplement) 27
2 SENATE BILL 534
SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND, 1
That the Laws of Maryland read as follows: 2
Article – Health – General 3
15–141.2. 4
(a) (7) (i) “Telehealth” means the delivery of medically necessary somatic, 5
dental, or behavioral health services to a patient at an originating site by a distant site 6
provider through the use of technology–assisted communication. 7
(ii) “Telehealth” includes: 8
1. Synchronous and asynchronous interactions; 9
2. From July 1, 2021, to June 30, [2023] 2025, both 10
inclusive, an audio–only telephone conversation between a health care provider and a 11
patient that results in the delivery of a billable, covered health care service; and 12
3. Remote patient monitoring services. 13
(iii) “Telehealth” does not include the provision of health care 14
services solely through: 15
1. Except as provided in subparagraph (ii)2 of this 16
paragraph, an audio–only telephone conversation; 17
2. An e–mail message; or 18
3. A facsimile transmission. 19
(g) (1) Subject to paragraph (3) of this subsection, the Program shall 20
reimburse a health care provider for the diagnosis, consultation, and treatment of a 21
Program recipient for a health care service covered by the Program that can be 22
appropriately provided through telehealth. 23
(2) This subsection does not require the Program to reimburse a health 24
care provider for a health care service delivered in person or through telehealth that is: 25
(i) Not a covered health care service under the Program; or 26
(ii) Delivered by an out–of–network provider unless the health care 27
service is a self–referred service authorized under the Program. 28
(3) (i) From July 1, 2021, to June 30, [2023] 2025, both inclusive, when 29
appropriately provided through telehealth, the Program shall provide reimbursement in 30 SENATE BILL 534 3
accordance with paragraph (1) of this subsection on the same basis and the same rate as if 1
the health care service were delivered by the health care provider in person. 2
(ii) The reimbursement required under subparagraph (i) of this 3
paragraph does not include: 4
1. Clinic facility fees unless the health care service is 5
provided by a health care provider not authorized to bill a professional fee separately for 6
the health care service; or 7
2. Any room and board fees. 8
Article – Insurance 9
15–139. 10
(a) (1) In this section, “telehealth” means, as it relates to the delivery of health 11
care services, the use of interactive audio, video, or other telecommunications or electronic 12
technology by a licensed health care provider to deliver a health care service within the 13
scope of practice of the health care provider at a location other than the location of the 14
patient. 15
(2) “Telehealth” includes from July 1, 2021, to June 30, [2023] 2025, both 16
inclusive, an audio–only telephone conversation between a health care provider and a 17
patient that results in the delivery of a billable, covered health care service. 18
(3) “Telehealth” does not include: 19
(i) except as provided in paragraph (2) of this subsection, an 20
audio–only telephone conversation between a health care provider and a patient; 21
(ii) an electronic mail message between a health care provider and a 22
patient; or 23
(iii) a facsimile transmission between a health care provider and a 24
patient. 25
(b) This section applies to: 26
(1) insurers and nonprofit health service plans that provide hospital, 27
medical, or surgical benefits to individuals or groups on an expense–incurred basis under 28
health insurance policies or contracts that are issued or delivered in the State; and 29
(2) health maintenance organizations that provide hospital, medical, or 30
surgical benefits to individuals or groups under contracts that are issued or delivered in 31
the State. 32
4 SENATE BILL 534
(c) (1) An entity subject to this section: 1
(i) shall provide coverage under a health insurance policy or 2
contract for health care services appropriately delivered through telehealth regardless of 3
the location of the patient at the time the telehealth services are provided; 4
(ii) may not exclude from coverage a health care service solely 5
because it is provided through telehealth and is not provided through an in–person 6
consultation or contact between a health care provider and a patient; and 7
(iii) may not exclude from coverage or deny coverage for a behavioral 8
health care service that is a covered benefit under a health insurance policy or contract 9
when provided in person solely because the behavioral health care service may also be 10
provided through a covered telehealth benefit. 11
(2) The health care services appropriately delivered through telehealth 12
shall include counseling and treatment for substance use disorders and mental health 13
conditions. 14
(d) (1) Subject to paragraph (2) of this subsection, an entity subject to this 15
section: 16
(i) shall reimburse a health care provider for the diagnosis, 17
consultation, and treatment of an insured patient for a health care service covered under a 18
health insurance policy or contract that can be appropriately provided through telehealth; 19
(ii) is not required to: 20
1. reimburse a health care provider for a health care service 21
delivered in person or through telehealth that is not a covered benefit under the health 22
insurance policy or contract; or 23
2. reimburse a health care provider who is not a covered 24
provider under the health insurance policy or contract; and 25
(iii) 1. may impose a deductible, copayment, or coinsurance 26
amount on benefits for health care services that are delivered either through an in–person 27
consultation or through telehealth; 28
2. may impose an annual dollar maximum as permitted by 29
federal law; and 30
3. may not impose a lifetime dollar maximum. 31
(2) (i) From July 1, 2021, to June 30, [2023] 2025, both inclusive, when 32
a health care service is appropriately provided through telehealth, an entity subject to this 33
section shall provide reimbursement in accordance with paragraph (1)(i) of this subsection 34 SENATE BILL 534 5
on the same basis and at the same rate as if the health care service were delivered by the 1
health care provider in person. 2
(ii) The reimbursement required under subparagraph (i) of this 3
paragraph does not include: 4
1. clinic facility fees unless the health care service is 5
provided by a health care provider not authorized to bill a professional fee separately for 6
the health care service; or 7
2. any room and board fees. 8
(iii) This paragraph may not be construed to supersede the authority 9
of the Health Services Cost Review Commission to set the appropriate rates for hospitals, 10
including setting the hospital facility fee for hospital–provided telehealth. 11
SECTION 2. AND BE IT FURTHER ENACTED, That this Act shall take effect June 12
1, 2023. 13