MD
Maryland Senate Bill SB534

Maryland 2023 Regular Session

Maryland Senate Bill SB534 Compare Versions

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1- WES MOORE, Governor Ch. 382
21
3-– 1 –
4-Chapter 382
5-(Senate Bill 534)
62
7-AN ACT concerning
3+EXPLANATION: CAPITALS INDICATE MAT TER ADDED TO EXISTIN G LAW.
4+ [Brackets] indicate matter deleted from existing law.
5+ Underlining indicates amendments to bill.
6+ Strike out indicates matter stricken from the bill by amendment or deleted from the law by
7+amendment.
8+ *sb0534*
89
9-Preserve Telehealth Access Act of 2023
10+SENATE BILL 534
11+J1, J5 3lr2155
1012
11-FOR the purpose of extending to a certain date the inclusion of certain audio–only
12-telephone conversations under the definition of “telehealth” for the purpose of certain
13-provisions of law relating to reimbursement and coverage of telehealth by the
14-Maryland Medical Assistance Program and certain insurers, nonprofit health service
15-plans, and health maintenance organizations; extending to a certain date a
16-requirement on the Program and certain insurers, nonprofit health service plans,
17-and health maintenance organizations to provide reimbursement for certain health
18-care services provided through telehealth on a certain basis and at a certain rate;
19-requiring the Maryland Health Care Commission to study and make
20-recommendations regarding the delivery of health care services through telehealth,
21-including payment parity for the delivery of health care services through audiovisual
22-and audio–only telehealth technologies; and generally relating to the coverage and
23-reimbursement of health care services delivered through telehealth.
13+By: Senators Gile, Beidle, Ellis, Griffith, Hershey, Klausmeier, and Mautz
14+Introduced and read first time: February 3, 2023
15+Assigned to: Finance
16+Committee Report: Favorable with amendments
17+Senate action: Adopted
18+Read second time: February 26, 2023
2419
25-BY repealing and reenacting, with amendments,
26- Article – Health – General
27-Section 15–141.2(a)(7) and (g)
28- Annotated Code of Maryland
29- (2019 Replacement Volume and 2022 Supplement)
20+CHAPTER ______
3021
31-BY repealing and reenacting, with amendments,
32- Article – Insurance
33-Section 15–139(a) and (d)
34- Annotated Code of Maryland
35- (2017 Replacement Volume and 2022 Supplement)
22+AN ACT concerning 1
3623
37-BY repealing and reenacting, without amendments,
38- Article – Insurance
39- Section 15–139(b) and (c)
40- Annotated Code of Maryland
41- (2017 Replacement Volume and 2022 Supplement)
24+Preserve Telehealth Access Act of 2023 2
4225
43- SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND,
44-That the Laws of Maryland read as follows:
26+FOR the purpose of extending to a certain date the inclusion of certain audio–only 3
27+telephone conversations under the definition of “telehealth” for the purpose of certain 4
28+provisions of law relating to reimbursement and coverage of telehealth by the 5
29+Maryland Medical Assistance Program and certain insurers, nonprofit health service 6
30+plans, and health maintenance organizations; extending to a certain date a 7
31+requirement on the Program and certain insurers, nonprofit health service plans, 8
32+and health maintenance organizations to provide reimbursement for certain health 9
33+care services provided through telehealth on a certain basis and at a certain rate; 10
34+requiring the Maryland Health Care Commission to study and make 11
35+recommendations regarding the delivery of health care services through telehealth, 12
36+including payment parity for the delivery of health care services through audiovisual 13
37+and audio–only telehealth technologies; and generally relating to the coverage and 14
38+reimbursement of health care services delivered through telehealth. 15
4539
46-Article – Health – General
40+BY repealing and reenacting, with amendments, 16
41+ Article – Health – General 17
42+Section 15–141.2(a)(7) and (g) 18
43+ Annotated Code of Maryland 19
44+ (2019 Replacement Volume and 2022 Supplement) 20
4745
48-15–141.2.
49- Ch. 382 2023 LAWS OF MARYLAND
46+BY repealing and reenacting, with amendments, 21
47+ Article – Insurance 22
48+Section 15–139(a) and (d) 23 2 SENATE BILL 534
5049
51-– 2 –
52- (a) (7) (i) “Telehealth” means the delivery of medically necessary somatic,
53-dental, or behavioral health services to a patient at an originating site by a distant site
54-provider through the use of technology–assisted communication.
5550
56- (ii) “Telehealth” includes:
51+ Annotated Code of Maryland 1
52+ (2017 Replacement Volume and 2022 Supplement) 2
5753
58- 1. Synchronous and asynchronous interactions;
54+BY repealing and reenacting, without amendments, 3
55+ Article – Insurance 4
56+ Section 15–139(b) and (c) 5
57+ Annotated Code of Maryland 6
58+ (2017 Replacement Volume and 2022 Supplement) 7
5959
60- 2. From July 1, 2021, to June 30, [2023] 2025, both
61-inclusive, an audio–only telephone conversation between a health care provider and a
62-patient that results in the delivery of a billable, covered health care service; and
60+ SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND, 8
61+That the Laws of Maryland read as follows: 9
6362
64- 3. Remote patient monitoring services.
63+Article – Health – General 10
6564
66- (iii) “Telehealth” does not include the provision of health care
67-services solely through:
65+15–141.2. 11
6866
69- 1. Except as provided in subparagraph (ii)2 of this
70-paragraph, an audio–only telephone conversation;
67+ (a) (7) (i) “Telehealth” means the delivery of medically necessary somatic, 12
68+dental, or behavioral health services to a patient at an originating site by a distant site 13
69+provider through the use of technology–assisted communication. 14
7170
72- 2. An e–mail message; or
71+ (ii) “Telehealth” includes: 15
7372
74- 3. A facsimile transmission.
73+ 1. Synchronous and asynchronous interactions; 16
7574
76- (g) (1) Subject to paragraph (3) of this subsection, the Program shall
77-reimburse a health care provider for the diagnosis, consultation, and treatment of a
78-Program recipient for a health care service covered by the Program that can be
79-appropriately provided through telehealth.
75+ 2. From July 1, 2021, to June 30, [2023] 2025, both 17
76+inclusive, an audio–only telephone conversation between a health care provider and a 18
77+patient that results in the delivery of a billable, covered health care service; and 19
8078
81- (2) This subsection does not require the Program to reimburse a health
82-care provider for a health care service delivered in person or through telehealth that is:
79+ 3. Remote patient monitoring services. 20
8380
84- (i) Not a covered health care service under the Program; or
81+ (iii) “Telehealth” does not include the provision of health care 21
82+services solely through: 22
8583
86- (ii) Delivered by an out–of–network provider unless the health care
87-service is a self–referred service authorized under the Program.
84+ 1. Except as provided in subparagraph (ii)2 of this 23
85+paragraph, an audio–only telephone conversation; 24
8886
89- (3) (i) From July 1, 2021, to June 30, [2023] 2025, both inclusive, when
90-appropriately provided through telehealth, the Program shall provide reimbursement in
91-accordance with paragraph (1) of this subsection on the same basis and the same rate as if
92-the health care service were delivered by the health care provider in person.
87+ 2. An e–mail message; or 25
9388
94- (ii) The reimbursement required under subparagraph (i) of this
95-paragraph does not include:
96- WES MOORE, Governor Ch. 382
89+ 3. A facsimile transmission. 26
9790
98-– 3 –
99- 1. Clinic facility fees unless the health care service is
100-provided by a health care provider not authorized to bill a professional fee separately for
101-the health care service; or
91+ (g) (1) Subject to paragraph (3) of this subsection, the Program shall 27
92+reimburse a health care provider for the diagnosis, consultation, and treatment of a 28
93+Program recipient for a health care service covered by the Program that can be 29
94+appropriately provided through telehealth. 30
10295
103- 2. Any room and board fees.
96+ (2) This subsection does not require the Program to reimburse a health 31
97+care provider for a health care service delivered in person or through telehealth that is: 32 SENATE BILL 534 3
10498
105-Article – Insurance
10699
107-15–139.
108100
109- (a) (1) In this section, “telehealth” means, as it relates to the delivery of health
110-care services, the use of interactive audio, video, or other telecommunications or electronic
111-technology by a licensed health care provider to deliver a health care service within the
112-scope of practice of the health care provider at a location other than the location of the
113-patient.
101+ (i) Not a covered health care service under the Program; or 1
114102
115- (2) “Telehealth” includes from July 1, 2021, to June 30, [2023] 2025, both
116-inclusive, an audio–only telephone conversation between a health care provider and a
117-patient that results in the delivery of a billable, covered health care service.
103+ (ii) Delivered by an out–of–network provider unless the health care 2
104+service is a self–referred service authorized under the Program. 3
118105
119- (3) “Telehealth” does not include:
106+ (3) (i) From July 1, 2021, to June 30, [2023] 2025, both inclusive, when 4
107+appropriately provided through telehealth, the Program shall provide reimbursement in 5
108+accordance with paragraph (1) of this subsection on the same basis and the same rate as if 6
109+the health care service were delivered by the health care provider in person. 7
120110
121- (i) except as provided in paragraph (2) of this subsection, an
122-audio–only telephone conversation between a health care provider and a patient;
111+ (ii) The reimbursement required under subparagraph (i) of this 8
112+paragraph does not include: 9
123113
124- (ii) an electronic mail message between a health care provider and a
125-patient; or
114+ 1. Clinic facility fees unless the health care service is 10
115+provided by a health care provider not authorized to bill a professional fee separately for 11
116+the health care service; or 12
126117
127- (iii) a facsimile transmission between a health care provider and a
128-patient.
118+ 2. Any room and board fees. 13
129119
130- (b) This section applies to:
120+Article – Insurance 14
131121
132- (1) insurers and nonprofit health service plans that provide hospital,
133-medical, or surgical benefits to individuals or groups on an expense–incurred basis under
134-health insurance policies or contracts that are issued or delivered in the State; and
122+15–139. 15
135123
136- (2) health maintenance organizations that provide hospital, medical, or
137-surgical benefits to individuals or groups under contracts that are issued or delivered in
138-the State.
124+ (a) (1) In this section, “telehealth” means, as it relates to the delivery of health 16
125+care services, the use of interactive audio, video, or other telecommunications or electronic 17
126+technology by a licensed health care provider to deliver a health care service within the 18
127+scope of practice of the health care provider at a location other than the location of the 19
128+patient. 20
139129
140- (c) (1) An entity subject to this section:
130+ (2) “Telehealth” includes from July 1, 2021, to June 30, [2023] 2025, both 21
131+inclusive, an audio–only telephone conversation between a health care provider and a 22
132+patient that results in the delivery of a billable, covered health care service. 23
141133
142- (i) shall provide coverage under a health insurance policy or
143-contract for health care services appropriately delivered through telehealth regardless of
144-the location of the patient at the time the telehealth services are provided; Ch. 382 2023 LAWS OF MARYLAND
134+ (3) “Telehealth” does not include: 24
145135
146-– 4 –
136+ (i) except as provided in paragraph (2) of this subsection, an 25
137+audio–only telephone conversation between a health care provider and a patient; 26
147138
148- (ii) may not exclude from coverage a health care service solely
149-because it is provided through telehealth and is not provided through an in–person
150-consultation or contact between a health care provider and a patient; and
139+ (ii) an electronic mail message between a health care provider and a 27
140+patient; or 28
151141
152- (iii) may not exclude from coverage or deny coverage for a behavioral
153-health care service that is a covered benefit under a health insurance policy or contract
154-when provided in person solely because the behavioral health care service may also be
155-provided through a covered telehealth benefit.
142+ (iii) a facsimile transmission between a health care provider and a 29
143+patient. 30
156144
157- (2) The health care services appropriately delivered through telehealth
158-shall include counseling and treatment for substance use disorders and mental health
159-conditions.
145+ (b) This section applies to: 31
146+ 4 SENATE BILL 534
160147
161- (d) (1) Subject to paragraph (2) of this subsection, an entity subject to this
162-section:
163148
164- (i) shall reimburse a health care provider for the diagnosis,
165-consultation, and treatment of an insured patient for a health care service covered under a
166-health insurance policy or contract that can be appropriately provided through telehealth;
149+ (1) insurers and nonprofit health service plans that provide hospital, 1
150+medical, or surgical benefits to individuals or groups on an expense–incurred basis under 2
151+health insurance policies or contracts that are issued or delivered in the State; and 3
167152
168- (ii) is not required to:
153+ (2) health maintenance organizations that provide hospital, medical, or 4
154+surgical benefits to individuals or groups under contracts that are issued or delivered in 5
155+the State. 6
169156
170- 1. reimburse a health care provider for a health care service
171-delivered in person or through telehealth that is not a covered benefit under the health
172-insurance policy or contract; or
157+ (c) (1) An entity subject to this section: 7
173158
174- 2. reimburse a health care provider who is not a covered
175-provider under the health insurance policy or contract; and
159+ (i) shall provide coverage under a health insurance policy or 8
160+contract for health care services appropriately delivered through telehealth regardless of 9
161+the location of the patient at the time the telehealth services are provided; 10
176162
177- (iii) 1. may impose a deductible, copayment, or coinsurance
178-amount on benefits for health care services that are delivered either through an in–person
179-consultation or through telehealth;
163+ (ii) may not exclude from coverage a health care service solely 11
164+because it is provided through telehealth and is not provided through an in–person 12
165+consultation or contact between a health care provider and a patient; and 13
180166
181- 2. may impose an annual dollar maximum as permitted by
182-federal law; and
167+ (iii) may not exclude from coverage or deny coverage for a behavioral 14
168+health care service that is a covered benefit under a health insurance policy or contract 15
169+when provided in person solely because the behavioral health care service may also be 16
170+provided through a covered telehealth benefit. 17
183171
184- 3. may not impose a lifetime dollar maximum.
172+ (2) The health care services appropriately delivered through telehealth 18
173+shall include counseling and treatment for substance use disorders and mental health 19
174+conditions. 20
185175
186- (2) (i) From July 1, 2021, to June 30, [2023] 2025, both inclusive, when
187-a health care service is appropriately provided through telehealth, an entity subject to this
188-section shall provide reimbursement in accordance with paragraph (1)(i) of this subsection
189-on the same basis and at the same rate as if the health care service were delivered by the
190-health care provider in person.
191- WES MOORE, Governor Ch. 382
176+ (d) (1) Subject to paragraph (2) of this subsection, an entity subject to this 21
177+section: 22
192178
193-– 5 –
194- (ii) The reimbursement required under subparagraph (i) of this
195-paragraph does not include:
179+ (i) shall reimburse a health care provider for the diagnosis, 23
180+consultation, and treatment of an insured patient for a health care service covered under a 24
181+health insurance policy or contract that can be appropriately provided through telehealth; 25
196182
197- 1. clinic facility fees unless the health care service is
198-provided by a health care provider not authorized to bill a professional fee separately for
199-the health care service; or
183+ (ii) is not required to: 26
200184
201- 2. any room and board fees.
185+ 1. reimburse a health care provider for a health care service 27
186+delivered in person or through telehealth that is not a covered benefit under the health 28
187+insurance policy or contract; or 29
202188
203- (iii) This paragraph may not be construed to supersede the authority
204-of the Health Services Cost Review Commission to set the appropriate rates for hospitals,
205-including setting the hospital facility fee for hospital–provided telehealth.
189+ 2. reimburse a health care provider who is not a covered 30
190+provider under the health insurance policy or contract; and 31
206191
207- SECTION 2. AND BE IT FURTHER ENACTED, That:
192+ (iii) 1. may impose a deductible, copayment, or coinsurance 32
193+amount on benefits for health care services that are delivered either through an in–person 33
194+consultation or through telehealth; 34
195+ SENATE BILL 534 5
208196
209- (a) The Maryland Health Care Commission shall study and make
210-recommendations regarding the delivery of health care services through telehealth,
211-including payment parity for the delivery of health care services through audiovisual and
212-audio–only telehealth technologies.
213197
214- (b) In conducting the study required under subsection (a) of this section, the
215-Maryland Health Care Commission shall:
198+ 2. may impose an annual dollar maximum as permitted by 1
199+federal law; and 2
216200
217- (1) determine whether it is more or less costly for health care providers to
218-deliver health care services through telehealth;
201+ 3. may not impose a lifetime dollar maximum. 3
219202
220- (2) determine whether the delivery of health care services through
221-telehealth requires more or less clinical effort on the part of the health care provider;
203+ (2) (i) From July 1, 2021, to June 30, [2023] 2025, both inclusive, when 4
204+a health care service is appropriately provided through telehealth, an entity subject to this 5
205+section shall provide reimbursement in accordance with paragraph (1)(i) of this subsection 6
206+on the same basis and at the same rate as if the health care service were delivered by the 7
207+health care provider in person. 8
222208
223- (3) to help inform the debate on payment parity, identify the aspects of
224-telehealth that are subject to overuse or underuse or yield greater or lower value;
209+ (ii) The reimbursement required under subparagraph (i) of this 9
210+paragraph does not include: 10
225211
226- (4) assess the adequacy of reimbursement for behavioral health services
227-delivered in–person and by telehealth; and
212+ 1. clinic facility fees unless the health care service is 11
213+provided by a health care provider not authorized to bill a professional fee separately for 12
214+the health care service; or 13
228215
229- (5) address any other issues related to telehealth as determined necessary
230-by the Commission.
216+ 2. any room and board fees. 14
231217
232- (c) On or before December 1, 2024, the Maryland Health Care Commission shall
233-submit a report on its findings and recommendations to the General Assembly, in
234-accordance with § 2–1257 of the State Government Article.
218+ (iii) This paragraph may not be construed to supersede the authority 15
219+of the Health Services Cost Review Commission to set the appropriate rates for hospitals, 16
220+including setting the hospital facility fee for hospital–provided telehealth. 17
235221
236- SECTION 2. 3. AND BE IT FURTHER ENACTED, That this Act shall take effect
237-June 1, 2023.
222+ SECTION 2. AND BE IT FURTHER ENACTED, That: 18
238223
239-Approved by the Governor, May 3, 2023.
224+ (a) The Maryland Health Care Commission shall study and make 19
225+recommendations regarding the delivery of health care services through telehealth, 20
226+including payment parity for the delivery of health care services through audiovisual and 21
227+audio–only telehealth technologies. 22
228+
229+ (b) In conducting the study required under subsection (a) of this section, the 23
230+Maryland Health Care Commission shall: 24
231+
232+ (1) determine whether it is more or less costly for health care providers to 25
233+deliver health care services through telehealth; 26
234+
235+ (2) determine whether the delivery of health care services through 27
236+telehealth requires more or less clinical effort on the part of the health care provider; 28
237+
238+ (3) to help inform the debate on payment parity, identify the aspects of 29
239+telehealth that are subject to overuse or underuse or yield greater or lower value; 30
240+
241+ (4) assess the adequacy of reimbursement for behavioral health services 31
242+delivered in–person and by telehealth; and 32
243+ 6 SENATE BILL 534
244+
245+
246+ (5) address any other issues related to telehealth as determined necessary 1
247+by the Commission. 2
248+
249+ (c) On or before December 1, 2024, the Maryland Health Care Commission shall 3
250+submit a report on its findings and recommendations to the General Assembly, in 4
251+accordance with § 2–1257 of the State Government Article. 5
252+
253+ SECTION 2. 3. AND BE IT FURTHER ENACTED, That this Act shall take effect 6
254+June 1, 2023. 7
255+
256+
257+
258+
259+Approved:
260+________________________________________________________________________________
261+ Governor.
262+________________________________________________________________________________
263+ President of the Senate.
264+________________________________________________________________________________
265+ Speaker of the House of Delegates.