EXPLANATION: CAPITALS INDICATE MAT TER ADDED TO EXISTIN G LAW.
[Brackets] indicate matter deleted from existing law.
Underlining indicates amendments to bill.
Strike out indicates matter stricken from the bill by amendment or deleted from the law by
amendment.
*sb0534*
SENATE BILL 534
J1, J5 3lr2155
By: Senators Gile, Beidle, Ellis, Griffith, Hershey, Klausmeier, and Mautz
Introduced and read first time: February 3, 2023
Assigned to: Finance
Committee Report: Favorable with amendments
Senate action: Adopted
Read second time: February 26, 2023
CHAPTER ______
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
requiring the Maryland Health Care Commission to study and make 11
recommendations regarding the delivery of health care services through telehealth, 12
including payment parity for the delivery of health care services through audiovisual 13
and audio–only telehealth technologies; and generally relating to the coverage and 14
reimbursement of health care services delivered through telehealth. 15
BY repealing and reenacting, with amendments, 16
Article – Health – General 17
Section 15–141.2(a)(7) and (g) 18
Annotated Code of Maryland 19
(2019 Replacement Volume and 2022 Supplement) 20
BY repealing and reenacting, with amendments, 21
Article – Insurance 22
Section 15–139(a) and (d) 23 2 SENATE BILL 534
Annotated Code of Maryland 1
(2017 Replacement Volume and 2022 Supplement) 2
BY repealing and reenacting, without amendments, 3
Article – Insurance 4
Section 15–139(b) and (c) 5
Annotated Code of Maryland 6
(2017 Replacement Volume and 2022 Supplement) 7
SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND, 8
That the Laws of Maryland read as follows: 9
Article – Health – General 10
15–141.2. 11
(a) (7) (i) “Telehealth” means the delivery of medically necessary somatic, 12
dental, or behavioral health services to a patient at an originating site by a distant site 13
provider through the use of technology–assisted communication. 14
(ii) “Telehealth” includes: 15
1. Synchronous and asynchronous interactions; 16
2. From July 1, 2021, to June 30, [2023] 2025, both 17
inclusive, an audio–only telephone conversation between a health care provider and a 18
patient that results in the delivery of a billable, covered health care service; and 19
3. Remote patient monitoring services. 20
(iii) “Telehealth” does not include the provision of health care 21
services solely through: 22
1. Except as provided in subparagraph (ii)2 of this 23
paragraph, an audio–only telephone conversation; 24
2. An e–mail message; or 25
3. A facsimile transmission. 26
(g) (1) Subject to paragraph (3) of this subsection, the Program shall 27
reimburse a health care provider for the diagnosis, consultation, and treatment of a 28
Program recipient for a health care service covered by the Program that can be 29
appropriately provided through telehealth. 30
(2) This subsection does not require the Program to reimburse a health 31
care provider for a health care service delivered in person or through telehealth that is: 32 SENATE BILL 534 3
(i) Not a covered health care service under the Program; or 1
(ii) Delivered by an out–of–network provider unless the health care 2
service is a self–referred service authorized under the Program. 3
(3) (i) From July 1, 2021, to June 30, [2023] 2025, both inclusive, when 4
appropriately provided through telehealth, the Program shall provide reimbursement in 5
accordance with paragraph (1) of this subsection on the same basis and the same rate as if 6
the health care service were delivered by the health care provider in person. 7
(ii) The reimbursement required under subparagraph (i) of this 8
paragraph does not include: 9
1. Clinic facility fees unless the health care service is 10
provided by a health care provider not authorized to bill a professional fee separately for 11
the health care service; or 12
2. Any room and board fees. 13
Article – Insurance 14
15–139. 15
(a) (1) In this section, “telehealth” means, as it relates to the delivery of health 16
care services, the use of interactive audio, video, or other telecommunications or electronic 17
technology by a licensed health care provider to deliver a health care service within the 18
scope of practice of the health care provider at a location other than the location of the 19
patient. 20
(2) “Telehealth” includes from July 1, 2021, to June 30, [2023] 2025, both 21
inclusive, an audio–only telephone conversation between a health care provider and a 22
patient that results in the delivery of a billable, covered health care service. 23
(3) “Telehealth” does not include: 24
(i) except as provided in paragraph (2) of this subsection, an 25
audio–only telephone conversation between a health care provider and a patient; 26
(ii) an electronic mail message between a health care provider and a 27
patient; or 28
(iii) a facsimile transmission between a health care provider and a 29
patient. 30
(b) This section applies to: 31
4 SENATE BILL 534
(1) insurers and nonprofit health service plans that provide hospital, 1
medical, or surgical benefits to individuals or groups on an expense–incurred basis under 2
health insurance policies or contracts that are issued or delivered in the State; and 3
(2) health maintenance organizations that provide hospital, medical, or 4
surgical benefits to individuals or groups under contracts that are issued or delivered in 5
the State. 6
(c) (1) An entity subject to this section: 7
(i) shall provide coverage under a health insurance policy or 8
contract for health care services appropriately delivered through telehealth regardless of 9
the location of the patient at the time the telehealth services are provided; 10
(ii) may not exclude from coverage a health care service solely 11
because it is provided through telehealth and is not provided through an in–person 12
consultation or contact between a health care provider and a patient; and 13
(iii) may not exclude from coverage or deny coverage for a behavioral 14
health care service that is a covered benefit under a health insurance policy or contract 15
when provided in person solely because the behavioral health care service may also be 16
provided through a covered telehealth benefit. 17
(2) The health care services appropriately delivered through telehealth 18
shall include counseling and treatment for substance use disorders and mental health 19
conditions. 20
(d) (1) Subject to paragraph (2) of this subsection, an entity subject to this 21
section: 22
(i) shall reimburse a health care provider for the diagnosis, 23
consultation, and treatment of an insured patient for a health care service covered under a 24
health insurance policy or contract that can be appropriately provided through telehealth; 25
(ii) is not required to: 26
1. reimburse a health care provider for a health care service 27
delivered in person or through telehealth that is not a covered benefit under the health 28
insurance policy or contract; or 29
2. reimburse a health care provider who is not a covered 30
provider under the health insurance policy or contract; and 31
(iii) 1. may impose a deductible, copayment, or coinsurance 32
amount on benefits for health care services that are delivered either through an in–person 33
consultation or through telehealth; 34
SENATE BILL 534 5
2. may impose an annual dollar maximum as permitted by 1
federal law; and 2
3. may not impose a lifetime dollar maximum. 3
(2) (i) From July 1, 2021, to June 30, [2023] 2025, both inclusive, when 4
a health care service is appropriately provided through telehealth, an entity subject to this 5
section shall provide reimbursement in accordance with paragraph (1)(i) of this subsection 6
on the same basis and at the same rate as if the health care service were delivered by the 7
health care provider in person. 8
(ii) The reimbursement required under subparagraph (i) of this 9
paragraph does not include: 10
1. clinic facility fees unless the health care service is 11
provided by a health care provider not authorized to bill a professional fee separately for 12
the health care service; or 13
2. any room and board fees. 14
(iii) This paragraph may not be construed to supersede the authority 15
of the Health Services Cost Review Commission to set the appropriate rates for hospitals, 16
including setting the hospital facility fee for hospital–provided telehealth. 17
SECTION 2. AND BE IT FURTHER ENACTED, That: 18
(a) The Maryland Health Care Commission shall study and make 19
recommendations regarding the delivery of health care services through telehealth, 20
including payment parity for the delivery of health care services through audiovisual and 21
audio–only telehealth technologies. 22
(b) In conducting the study required under subsection (a) of this section, the 23
Maryland Health Care Commission shall: 24
(1) determine whether it is more or less costly for health care providers to 25
deliver health care services through telehealth; 26
(2) determine whether the delivery of health care services through 27
telehealth requires more or less clinical effort on the part of the health care provider; 28
(3) to help inform the debate on payment parity, identify the aspects of 29
telehealth that are subject to overuse or underuse or yield greater or lower value; 30
(4) assess the adequacy of reimbursement for behavioral health services 31
delivered in–person and by telehealth; and 32
6 SENATE BILL 534
(5) address any other issues related to telehealth as determined necessary 1
by the Commission. 2
(c) On or before December 1, 2024, the Maryland Health Care Commission shall 3
submit a report on its findings and recommendations to the General Assembly, in 4
accordance with § 2–1257 of the State Government Article. 5
SECTION 2. 3. AND BE IT FURTHER ENACTED, That this Act shall take effect 6
June 1, 2023. 7
Approved:
________________________________________________________________________________
Governor.
________________________________________________________________________________
President of the Senate.
________________________________________________________________________________
Speaker of the House of Delegates.