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. Italics indicate opposite chamber/conference committee amendments. *sb0372* SENATE BILL 372 J5, J1 (5lr1977) ENROLLED BILL — Finance/Health and Government Operations — Introduced by Senators Beidle, Gile, Kramer, Lam, and Mautz Mautz, Ellis, Hayes, Hershey, C. Jackson, Ready, and A. Washington Read and Examined by Proofreaders: _______________________________________________ Proofreader. _______________________________________________ Proofreader. Sealed with the Great Seal and presented to the Governor, for his approval this _______ day of _______________ at ________________________ o’clock, ________M. ______________________________________________ President. CHAPTER ______ AN ACT concerning 1 Preserve Telehealth Access Act of 2025 2 FOR the purpose of repealing the limitation on the period during which certain audio–only 3 telephone conversations are included under the definition of “telehealth” for the 4 purpose of certain provisions of law relating to reimbursement and coverage of 5 telehealth by the Maryland Medical Assistance Program and certain insurers, 6 nonprofit health service plans, and health maintenance organizations; repealing the 7 limitation on the period during which the Program and certain insurers, nonprofit 8 health service plans, and health maintenance organizations are required to provide 9 reimbursement for certain health care services provided through telehealth on a 10 certain basis and at a certain rate; altering the circumstances under which health 11 care practitioners are authorized to prescribe certain controlled dangerous substances 12 for the treatment of pain through telehealth; requiring the Maryland Health Care 13 Commission to submit a certain report regarding telehealth every certain number of 14 2 SENATE BILL 372 years; and generally relating to the coverage and reimbursement of health care 1 services delivered through telehealth. 2 BY repealing and reenacting, with amendments, 3 Article – Health – General 4 Section 15–141.2(a)(7) and (g) 5 Annotated Code of Maryland 6 (2023 Replacement Volume and 2024 Supplement) 7 BY adding to 8 Article – Health – General 9 Section 19–108.6 10 Annotated Code of Maryland 11 (2023 Replacement Volume and 2024 Supplement) 12 BY repealing and reenacting, with amendments, 13 Article – Health Occupations 14 Section 1–1003 15 Annotated Code of Maryland 16 (2021 Replacement Volume and 2024 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 2024 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 2024 Supplement) 27 SECTION 1. BE IT ENACTED BY THE GE NERAL ASSEMBLY OF MARYLAND, 28 That the Laws of Maryland read as follows: 29 Article – Health – General 30 15–141.2. 31 (a) (7) (i) “Telehealth” means the delivery of medically necessary somatic, 32 dental, or behavioral health services to a patient at an originating site by a distant site 33 provider through the use of technology–assisted communication. 34 (ii) “Telehealth” includes: 35 1. Synchronous and asynchronous interactions; 36 SENATE BILL 372 3 2. [From July 1, 2021, to June 30, 2025, both inclusive, an] 1 AN audio–only telephone conversation between a health care provider and a patient that 2 results in the delivery of a billable, covered health care service; and 3 3. Remote patient monitoring services. 4 (iii) “Telehealth” does not include the provision of health care 5 services solely through: 6 1. Except as provided in subparagraph (ii)2 of this 7 paragraph, an audio–only telephone conversation; 8 2. An e–mail message; or 9 3. A facsimile transmission. 10 (g) (1) Subject to paragraph (3) of this subsection, the Program shall 11 reimburse a health care provider for the diagnosis, consultation, and treatment of a 12 Program recipient for a health care service covered by the Program that can be 13 appropriately provided through telehealth. 14 (2) This subsection does not require the Program to reimburse a health 15 care provider for a health care service delivered in person or through telehealth that is: 16 (i) Not a covered health care service under the Program; or 17 (ii) Delivered by an out–of–network provider unless the health care 18 service is a self–referred service authorized under the Program. 19 (3) (i) [From July 1, 2021, to June 30, 2025, both inclusive, when] 20 WHEN appropriately provided through telehealth, the Program shall provide 21 reimbursement in accordance with paragraph (1) of this subsection on the same basis and 22 the same rate as if the health care service were delivered by the health care provider in 23 person. 24 (ii) The reimbursement required under subparagraph (i) of this 25 paragraph does not include: 26 1. Clinic facility fees unless the health care service is 27 provided by a health care provider not authorized to bill a professional fee separately for 28 the health care service; or 29 2. Any room and board fees. 30 19–108.6. 31 4 SENATE BILL 372 ON OR BEFORE DECEMBER 1 EVERY 4 YEARS, BEGINNING IN 2026, THE 1 COMMISSION SHALL SUBM IT A REPORT TO THE GOVERNOR AND , IN ACCORDANCE 2 WITH § 2–1257 OF THE STATE GOVERNMENT ARTICLE, THE GENERAL ASSEMBLY 3 THAT INCLUDES : 4 (1) ADVANCES OR DEVELOPME NTS IN THE AREA OF T ELEHEALTH, 5 INCLUDING: 6 (I) EVOLVING MODALITIES O F TELEHEALTH DELIVER Y; AND 7 (II) CHANGES IN THE COSTS OF DELIVERING TELEHE ALTH 8 SERVICES; AND 9 (2) ANY FINDINGS OR RECOM MENDATIONS OF THE COMMISSION. 10 Article – Health Occupations 11 1–1003. 12 (a) A health care practitioner providing telehealth services shall: 13 (1) Be held to the same standards of practice that are applicable to 14 in–person health care settings; and 15 (2) If clinically appropriate for the patient, provide or refer a patient to 16 in–person health care services or another type of telehealth service. 17 (b) (1) A health care practitioner shall perform a clinical evaluation that is 18 appropriate for the patient and the condition with which the patient presents before 19 providing treatment or issuing a prescription through telehealth. 20 (2) A health care practitioner may use a synchronous telehealth interaction 21 or an asynchronous telehealth interaction to perform the clinical evaluation required under 22 paragraph (1) of this subsection. 23 (c) (1) A health care practitioner may not prescribe an opiate described in the 24 list of Schedule II substances under § 5–403 of the Criminal Law Article for the treatment 25 of pain through telehealth, unless: 26 (i) The individual receiving the prescription is a patient in a health 27 care facility, as defined in § 19–114 of the Health – General Article; [or] 28 (ii) The Governor has declared a state of emergency due to a 29 catastrophic health emergency; OR 30 SENATE BILL 372 5 (III) THERE IS AN ESTABLISH ED BONA FIDE 1 PRACTITIONER –PATIENT RELATIONSHIP IN WHICH THE HEALTH CARE 2 PRACTITIONER HAS ONG OING RESPONSIBILITY FOR THE ASSESSMENT , CARE, AND 3 TREATMENT OF THE PAT IENT AND THE HEALTH CARE PRACTITIONER , OR ANOTHER 4 HEALTH CARE PRACTITI ONER IN THE SAME GRO UP PRACTICE , PREVIOUSLY 5 CONDUCTED AN IN –PERSON ASSE SSMENT OF THE PATIEN T. 6 (2) Subject to paragraph (1) of this subsection, a health care practitioner 7 who through telehealth prescribes a controlled dangerous substance, as defined in § 5–101 8 of the Criminal Law Article, is subject to any applicable regulation, limitation, and 9 prohibition in federal and State law relating to the prescription of controlled dangerous 10 substances. 11 Article – Insurance 12 15–139. 13 (a) (1) In this section, “telehealth” means, as it relates to the delivery of health 14 care services, the use of interactive audio, video, or other telecommunications or electronic 15 technology by a licensed health care provider to deliver a health care service within the 16 scope of practice of the health care provider at a location other than the location of the 17 patient. 18 (2) “Telehealth” includes [from July 1, 2021, to June 30, 2025, both 19 inclusive,] an audio–only telephone conversation between a health care provider and a 20 patient that results in the delivery of a billable, covered health care service. 21 (3) “Telehealth” does not include: 22 (i) except as provided in paragraph (2) of this subsection, an 23 audio–only telephone conversation between a health care provider and a patient; 24 (ii) an electronic mail message between a health care provider and a 25 patient; or 26 (iii) a facsimile transmission between a health care provider and a 27 patient. 28 (b) This section applies to: 29 (1) insurers and nonprofit health service plans that provide hospital, 30 medical, or surgical benefits to individuals or groups on an expense–incurred basis under 31 health insurance policies or contracts that are issued or delivered in the State; and 32 6 SENATE BILL 372 (2) health maintenance organizations that provide hospital, medical, or 1 surgical benefits to individuals or groups under contracts that are issued or delivered in 2 the State. 3 (c) (1) An entity subject to this section: 4 (i) shall provide coverage under a health insurance policy or 5 contract for health care services appropriately delivered through telehealth regardless of 6 the location of the patient at the time the telehealth services are provided; 7 (ii) may not exclude from coverage a health care service solely 8 because it is provided through telehealth and is not provided through an in–person 9 consultation or contact between a health care provider and a patient; and 10 (iii) may not exclude from coverage or deny coverage for a behavioral 11 health care service that is a covered benefit under a health insurance policy or contract 12 when provided in person solely because the behavioral health care service may also be 13 provided through a covered telehealth benefit. 14 (2) The health care services appropriately delivered through telehealth 15 shall include counseling and treatment for substance use disorders and mental health 16 conditions. 17 (d) (1) Subject to paragraph (2) of this subsection, an entity subject to this 18 section: 19 (i) shall reimburse a health care provider for the diagnosis, 20 consultation, and treatment of an insured patient for a health care service covered under a 21 health insurance policy or contract that can be appropriately provided through telehealth; 22 (ii) is not required to: 23 1. reimburse a health care provider for a health care service 24 delivered in person or through telehealth that is not a covered benefit under the health 25 insurance policy or contract; or 26 2. reimburse a health care provider who is not a covered 27 provider under the health insurance policy or contract; and 28 (iii) 1. may impose a deductible, copayment, or coinsurance 29 amount on benefits for health care services that are delivered either through an in–person 30 consultation or through telehealth; 31 2. may impose an annual dollar maximum as permitted by 32 federal law; and 33 3. may not impose a lifetime dollar maximum. 34 SENATE BILL 372 7 (2) (i) [From July 1, 2021, to June 30, 2025, both inclusive, when] 1 WHEN a health care service is appropriately provided through telehealth, an entity subject 2 to this section shall provide reimbursement in accordance with paragraph (1)(i) of this 3 subsection on the same basis and at the same rate as if the health care service were 4 delivered by the health care provider in person. 5 (ii) The reimbursement required under subparagraph (i) of this 6 paragraph does not include: 7 1. clinic facility fees unless the health care service is 8 provided by a health care provider not authorized to bill a professional fee separately for 9 the health care service; or 10 2. any room and board fees. 11 (iii) This paragraph may not be construed to supersede the authority 12 of the Health Services Cost Review Commission to set the appropriate rates for hospitals, 13 including setting the hospital facility fee for hospital–provided telehealth. 14 SECTION 2. AND BE IT FURTHER ENACTED, That this Act shall take effect June 15 1, 2025. 16 Approved: ________________________________________________________________________________ Governor. ________________________________________________________________________________ President of the Senate. ________________________________________________________________________________ Speaker of the House of Delegates.