OK
Oklahoma Senate Bill SB674

Oklahoma 2022 Regular Session

Oklahoma Senate Bill SB674 Compare Versions

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4-ENGR. H. A. to ENGR. S. B. NO. 674 Page 1
5-An Act
6-ENROLLED SENATE
7-BILL NO. 674 By: McCortney and Kirt of the
28+ENGROSSED HOUSE AMENDME NT
29+ TO
30+ENGROSSED SENATE BILL NO . 674 By: McCortney and Kirt of the
831 Senate
932
1033 and
1134
12- McEntire, Mize and Pittman
13-of the House
35+ McEntire of the House
1436
1537
1638
1739
40+[ telemedicine - coverage of health care services -
41+deductible - effective date ]
1842
19-An Act relating to telemedicine; amending 36 O.S.
43+
44+
45+
46+AUTHOR: Add the following House C oauthors: Mize and Pittman
47+
48+AMENDMENT NO. 1. Delete the stricken title, enacting clause and
49+entire bill and replace with:
50+
51+
52+"An Act relating to telemedicine; amending 36 O.S.
2053 2011, Section 6802, which relates to definitions;
2154 modifying and adding definitio ns; amending 36 O.S.
2255 2011, Section 6803, which relates to coverage of
2356 telemedicine services; modifying term; requiring
2457 certain coverage of health care services provided
2558 through telemedicine; prohibiting certain exclusion
2659 of service for coverage; requiring certain
2760 reimbursement; prohibiting application of certain
2861 deductible; requiring certain copayment or
2962 coinsurance not exceed certain amount; prohibiting
30-imposition of certain limits or maximums; prohibiting
31-imposition of certain utilization review; pr ohibiting
32-certain restriction of coverage; prohibiting certain
33-restrictions on prescribing; requiring the State
34-Department of Health to request a certain report by a
35-certain date; providing for contents of report; and
36-providing an effective date.
63+imposition of certain limits or maximums;
64+prohibiting imposition of certain utilization
65+review; prohibiting certain restriction of coverage;
66+prohibiting certain restrictions on prescribing;
67+requiring the State Department of Health to request
68+a certain report by a certain date; providing for
69+contents of report; and providing an effective date.
3770
3871
3972
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74+BE IT ENACTED BY THE PEOPLE OF THE STATE OF OKLAHOMA:
4175
42-SUBJECT: Telemedicine
43-
44-BE IT ENACTED BY THE PEOPLE OF THE STATE OF OKLAHOMA:
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45100
46101 SECTION 1. AMENDATORY 36 O.S. 2011, Section 6802, is
47102 amended to read as follows:
48-
49-ENR. S. B. NO. 674 Page 2
50-
51103 Section 6802. As used in this act, "telemedicine" means the
52104 practice of health care delivery, diagnosis, consultation,
53105 treatment, including but not limited to, the treatment and
54106 prevention of strokes, transfer of medical data, or exchange of
55107 medical education information by means of audio, video, or data
56108 communications. Telemedicine is not a consultation pro vided by
57109 telephone or facsimile machine
110+As used in the Oklahoma Telemedicine Act:
111+1. "Distant site" means a site at which a health care
112+professional licensed to practice in this state is located while
113+providing health care services by means of telemedicin e;
114+2. a. "Health benefit plan" means any plan or arrangement
115+that:
116+(1) provides benefits for medical or surgical
117+expenses incurred as a result of a health
118+condition, accident or illness, and
119+(2) is offered by any insurance company, group
120+hospital service corporation or health
121+maintenance organization that delivers or issues
122+for delivery an individual, group, blanket or
123+franchise insurance policy or insurance
124+agreement, a group hospital service contract or
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151+an evidence of coverage, or, to the extent
152+permitted by the Employee Retirement Income
153+Security Act of 1974, 29 U.S.C., Section 1001 et
154+seq., by a multiple employer welfare arrangement
155+as defined in Section 3 of the Employee
156+Retirement Income Security Act of 1974, or any
157+other analogous benefit arrangement, whether the
158+payment is fixed or by indemnity,
159+b. Health benefit plan shall not include:
160+(1) a plan that provides coverage:
161+(a) only for a specified disease or diseases or
162+under an individual limited benefit policy,
163+(b) only for accidental death or dismemb erment,
164+(c) only for dental or vision care,
165+(d) for a hospital confinement indemnity policy,
166+(e) for disability income insurance or a
167+combination of accident -only and disability
168+income insurance, or
169+(f) as a supplement to liability insurance,
170+(2) a Medicare supplemental policy as defined by
171+Section 1882(g)(1) of the Social Security Act (42
172+U.S.C., Section 1395ss),
173+(3) workers' compensation insurance coverage,
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200+(4) medical payment insurance issued as part of a
201+motor vehicle insurance policy,
202+(5) a long-term care policy including a nursing home
203+fixed indemnity policy, unless a determination is
204+made that the policy provides benefit coverage so
205+comprehensive that the policy meets the
206+definition of a health benefit plan,
207+(6) short-term health insurance issued on a
208+nonrenewable basis with a duration of six (6)
209+months or less, or
210+(7) a plan offered by the Employees Group Insurance
211+Division of the Office of Management and
212+Enterprise Services;
213+3. "Health care professional" means a physician or other health
214+care practitioner licensed, accredited or certified to perform
215+specified health care services consistent with state law;
216+4. "Insurer" means any entity providing an accident and health
217+insurance policy in this state including, but not limited to, a
218+licensed insurance company, a not-for-profit hospital service and
219+medical indemnity corporation, a fraternal benefit society, a
220+multiple employer welfare arrangement or any other entity subject to
221+regulation by the Insurance Commissioner;
222+5. "mHealth", also referred to as "mobile health", means
223+patient medical and health information and includes the use of the
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250+Internet and wireless devices by patients to obtain or create
251+specialized health information and online discussion groups to
252+provide peer-to-peer support;
253+6. "Originating site" means a site at which a patient is
254+located at the time health care services are provided to him or her
255+by means of telemedicine, which may include, but shall not be
256+restricted to, a patient's home, workplace or school;
257+7. "Remote patient monit oring services" means the delivery of
258+home health services using telecommunications technology to enhance
259+the delivery of home health care including monitoring of clinical
260+patient data such as weight, blood pressure, pulse, pulse oximetry,
261+blood glucose and other condition-specific data, medication
262+adherence monitoring and interactive video conferencing with or
263+without digital image upload;
264+8. "Store and forward transfer" means the transmission of a
265+patient's medical information either to or from an origin ating site
266+or to or from the health care professional at the distant site, but
267+does not require the patient being present nor must it be in real
268+time;
269+9. "Telemedicine" or "telehealth" means technology-enabled
270+health and care management and delivery syste ms that extend capacity
271+and access, which includes:
272+a. synchronous mechanisms, which may include live
273+audiovisual interaction between a patient and a health
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300+care professional or real -time provider-to-provider
301+consultation through live interactive audiovisu al
302+means,
303+b. asynchronous mechanisms, which include store and
304+forward transfers, online exchange of health
305+information between a patient and a health care
306+professional and online exchange of health information
307+between health care professionals, but shall n ot
308+include the use of automated text messages or
309+automated mobile applications that serve as the sole
310+interaction between a patient and a health care
311+professional,
312+c. remote patient monitoring,
313+d. mHealth, and
314+e. other electronic means that support clinica l health
315+care, professional consultation, patient and
316+professional health-related education, public health
317+and health administration .
318+SECTION 2. AMENDATORY 36 O.S. 2011, Section 6803, is
319+amended to read as follows:
320+Section 6803. A. For services that a health care practitioner
321+professional determines to be appropriately provided by means of
322+telemedicine, health care service plans, disability insurer
323+programs, workers' compensation programs, or state Medicaid managed
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350+care program contracts issued, amended, or renewed on or after
351+January 1, 1998, shall not require person -to-person contact between
352+a health care practitioner professional and a patient.
353+B. Subsection A of this section shall apply to health care
354+service plan contracts w ith the state Medicaid managed care program
355+only to the extent that both of the following apply:
356+1. Telemedicine services are covered by, and reimbursed under,
357+the fee-for-service provisions of the state Medicaid managed care
358+program; and
359+2. State Medicaid managed care program contracts with health
360+care service plans are amended to add coverage of telemedicine
361+services and make any appropriate capitation rate adjustments.
362+C. Any health benefit plan that is offered, issued or renewed
363+in this state by an i nsurer on or after the effective date of this
364+act shall provide coverage of health care services provided through
365+telemedicine, as provided in this section.
366+D. An insurer shall not exclude a service for coverage solely
367+because the service is provided thro ugh telemedicine and is not
368+provided through in-person consultation or contact between a health
369+care professional and a patient when such services are appropriately
370+provided through telemedicine. An insurer may limit coverage of
371+services provided by teleh ealth consistent with coding and clinical
372+standards recognized by the American Medical Association or the
373+Centers for Medicare and Medicaid Services as covered if delivered
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400+by telehealth or telemedicine, except as agreed to by the insurer
401+and provider.
402+E. An insurer shall reimburse the treating health care
403+professional or the consulting health care professional for the
404+diagnosis, consultation or treatment of the patient delivered
405+through telemedicine services on the same basis and at least at the
406+rate of reimbursement that the insurer is responsible for coverage
407+for the provision of the same, or substantially similar, service s
408+through in-person consultation or contact.
409+F. An insurer shall not apply any deductible to telemedicine
410+services that accumulates s eparately from the deductible that
411+applies in the aggregate to all items and services covered under the
412+health benefit plan.
413+G. Any copayment or coinsurance applied to telemedicine
414+benefits by an insurer shall not exceed the copayment or coinsurance
415+applied to such benefits when provided through in -person
416+consultation or contact.
417+H. An insurer shall not impose any annual or lifetime
418+durational limits or annual or lifetime dollar maximums for benefits
419+or services provided through telemedicine that are not equally
420+imposed upon all terms and services covered under the health benefit
421+plan.
422+I. An insurer shall not impose any type of utilization review
423+on benefits provided through telemedicine unless such type of
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450+utilization review is imposed when such benefits are provided
451+through in-person consultation or contact. Any type of utilization
452+review that is imposed on benefits provided through telemedicine
453+shall not occur with greater frequency or more stringent application
454+than such form of utilization review is imposed on such benefits
455+provided through in-person consultation or contact.
456+J. An insurer shall not restrict coverage of telemedicine
457+benefits or services to benefits or services provided by a
458+particular vendor, or other third party, or benefits or servi ces
459+provided through a particular electronic communications technology
460+platform; provided, that nothing shall require an insurer to cover
461+any electronic communications technology platform that does not
462+comply with applicable state and federal privacy laws.
463+K. An insurer shall not place any restrictions on prescribing
464+medications through telemedicine that are more restrictive than what
465+is required under applicable state and federal law.
466+L. No later than January 1, 2023, the State Department of
467+Health shall request a report from the Statewide Health Information
468+Exchange that will provide the following data:
469+1. The number of providers using telehealth, in cluding the
470+location, frequency and specific services for which telehealth is
471+utilized; and
472+2. The overall cost and cost savings associated with the
473+utilization of telehealth services.
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500+SECTION 3. This act shall become effective January 1, 2022."
501+Passed the House of Representatives the 21st day of April, 2021.
502+
503+
504+
505+
506+
507+Presiding Officer of the House of
508+ Representatives
509+
510+
511+Passed the Senate the ____ day of __________, 2021.
512+
513+
514+
515+
516+
517+Presiding Officer of the Senate
518+
519+
520+ENGROSSED SENATE
521+BILL NO. 674 By: McCortney and Kirt of the
522+Senate
523+
524+ and
525+
526+ McEntire of the House
527+
528+
529+
530+
531+
532+[ telemedicine - coverage of health care services -
533+deductible - effective date ]
534+
535+
536+
537+
538+BE IT ENACTED BY THE PEOPLE OF THE STATE OF OKLAHOMA:
539+SECTION 4. AMENDATORY 36 O.S. 2011, Section 6802, is
540+amended to read as follows:
541+Section 6802. As used in this act, "tel emedicine" means the
542+practice of health care delivery, diagnosis, consultation,
543+treatment, including but not limited to, the treatment and
544+prevention of strokes, transfer of medical data, or exchange of
545+medical education information by means of audio, vide o, or data
546+communications. Telemedicine is not a consultation provided by
547+telephone or facsimile machine
59548 As used in the Oklahoma Telemedicine Act:
60-
61549 1. "Distant site" means a site at which a health care
62550 professional licensed to practice in this state is lo cated while
63551 providing health care services by means of telemedicine;
64552
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65578 2. a. "Health benefit plan" means any plan or arrangement
66579 that:
67-
68580 (1) provides benefits for medical or surgical
69581 expenses incurred as a result of a health
70582 condition, accident or illness, an d
71-
72583 (2) is offered by any insurance company, group
73584 hospital service corporation or health
74585 maintenance organization that delivers or issues
75586 for delivery an individual, group, blanket or
76587 franchise insurance policy or insurance
77588 agreement, a group hospital servi ce contract or
78589 an evidence of coverage, or, to the extent
79590 permitted by the Employee Retirement Income
80591 Security Act of 1974, 29 U.S.C., Section 1001 et
81592 seq., by a multiple employer welfare arrangement
82593 as defined in Section 3 of the Employee
83594 Retirement Income Security Act of 1974, or any
84595 other analogous benefit arrangement, whether the
85-payment is fixed or by indemnity,
86-
596+payment is fixed or by indemnity.
87597 b. Health benefit plan shall not include:
88-
89598 (1) a plan that provides coverage:
90-
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93599 (a) only for a specified disease or diseases or
94600 under an individual limited benefit policy,
95-
96601 (b) only for accidental death or dismemberment,
97602
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98628 (c) only for dental or vision care,
99-
100-(d) for a hospital confinement indemnity policy,
101-
102-(e) for disability income insurance or a
103-combination of accident -only and disability
104-income insurance, or
105-
629+(d) a hospital confinement indemnity policy,
630+(e) disability income insurance or a combination
631+of accident-only and disability income
632+insurance, or
106633 (f) as a supplement to liability insurance,
107-
108634 (2) a Medicare supplemental policy as defined by
109635 Section 1882(g)(1) of the Social Security Act (42
110636 U.S.C., Section 1395ss),
111-
112637 (3) workers' compensation insurance coverage,
113-
114638 (4) medical payment insurance issued as part of a
115639 motor vehicle insurance policy,
116-
117640 (5) a long-term care policy including a nursing home
118641 fixed indemnity policy, unless a determination is
119642 made that the policy provides benefit coverage so
120643 comprehensive that the policy meets the
121644 definition of a healt h benefit plan,
122-
123645 (6) short-term health insurance issued on a
124646 nonrenewable basis with a duration of six (6)
125647 months or less, or
126-
127648 (7) a plan offered by the Employees Group Insurance
128649 Division of the Office of Management and
129650 Enterprise Services;
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131677 3. "Health care professional" means a physician or other health
132678 care practitioner licensed, accredited or certified to perform
133679 specified health care services consistent with state law;
134-
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137680 4. "Insurer" means any entity providing an accident and health
138681 insurance policy in thi s state including, but not limited to, a
139682 licensed insurance company, a not -for-profit hospital service and
140683 medical indemnity corporation, a fraternal benefit society, a
141684 multiple employer welfare arrangement or any other entity subject to
142685 regulation by the Insurance Commissioner;
143-
144-5. "mHealth", also referred to as "mobile health", means
686+5. "mHealth," also referred to as "mobile health," means
145687 patient medical and health information and includes the use of the
146-Internet and wireless devices by patients to obtain or create
688+internet and wireless devices for patients to obtain or create
147689 specialized health information and online di scussion groups to
148690 provide peer-to-peer support;
149-
150691 6. "Originating site" means a site at which a patient is
151692 located at the time health care services are provided to him or her
152693 by means of telemedicine, which may include, but shall not be
153694 restricted to, a patient's home, workplace or school;
154-
155695 7. "Remote patient monitoring services" means the delivery of
156696 home health services using telecommunications technology to enhance
157697 the delivery of home health care including monitoring of clinical
158698 patient data such as wei ght, blood pressure, pulse, pulse oximetry,
159699 blood glucose and other condition -specific data, medication
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160726 adherence monitoring and interactive video conferencing with or
161727 without digital image upload;
162-
163728 8. "Store and forward transfer" means the transmission of a
164729 patient's medical information either to or from an originating site
165730 or to or from the health care professional at the distant site, but
166731 does not require the patient being present nor must it be in real
167732 time;
168-
169-9. "Telemedicine" or "telehealth" means technology-enabled
170-health and care management and delivery syste ms that extend capacity
171-and access, which includes:
172-
733+9. "Telemedicine" means technology -enabled health and care
734+management and delivery systems that extend capacity and access,
735+which includes:
173736 a. synchronous mechanisms, which may include live
174737 audiovisual interaction between a patient and a health
175-care professional or real -time provider-to-provider
738+care professional or real -time provider to provider
176739 consultation through live interactive audiovisual
177740 means,
178-
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181741 b. asynchronous mechanisms, which include store and
182742 forward transfers, online exchange of health
183743 information between a patient and a health care
184744 professional and online exchange of health information
185745 between health care professionals, but shall not
186746 include the use of automated text messages or
187747 automated mobile applications that serve as the sole
188748 interaction between a patient and a health care
189749 professional,
190750
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191776 c. remote patient monitoring,
192-
193777 d. mHealth, and
194-
195778 e. other electronic means that support clinical health
196779 care, professional consultation, patient and
197780 professional health-related education, public health
198781 and health administration .
199-
200-SECTION 2. AMENDATORY 3 6 O.S. 2011, Section 6803, is
782+SECTION 5. AMENDATORY 36 O.S. 2011, Section 6803, is
201783 amended to read as follows:
202-
203784 Section 6803. A. For services that a health care practitioner
204785 professional determines to be appropriately provided by means of
205786 telemedicine, health care service plans, disability insurer
206787 programs, workers' compensation progra ms, or state Medicaid managed
207788 care program contracts issued, amended, or renewed on or after
208789 January 1, 1998, shall not require person -to-person contact between
209790 a health care practitioner professional and a patient.
210-
211791 B. Subsection A of this section shall a pply to health care
212792 service plan contracts with the state Medicaid managed care program
213793 only to the extent that both of the following apply:
214-
215794 1. Telemedicine services are covered by, and reimbursed under,
216795 the fee-for-service provisions of the state Medicai d managed care
217796 program; and
218-
219797 2. State Medicaid managed care program contracts with health
220798 care service plans are amended to add coverage of telemedicine
221799 services and make any appropriate capitation rate adjustments.
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225826 C. Any health benefit plan that is offe red, issued or renewed
226827 in this state by an insurer on or after the effective date of this
227828 act shall provide coverage of health care services provided through
228829 telemedicine, as provided in this section.
229-
230830 D. An insurer shall not exclude a service for coverage solely
231831 because the service is provided through telemedicine and is not
232832 provided through in-person consultation or contact between a health
233-care professional and a patient when such services are appropriately
234-provided through telemedicine. An insurer may limit coverage of
235-services provided by teleh ealth consistent with coding and clinical
236-standards recognized by the American Medical Association or the
237-Centers for Medicare and Medicaid Services as covered if delivered
238-by telehealth or telemedicine, except as agreed to by the insurer
239-and provider.
240-
833+care professional and a patient for services appropriately provided
834+through telemedicine.
241835 E. An insurer shall reimb urse the treating health care
242836 professional or the consulting health care professional for the
243837 diagnosis, consultation or treatment of the patient delivered
244838 through telemedicine services on the same basis and at least at the
245839 rate of reimbursement that the i nsurer is responsible for coverage
246-for the provision of the same, or substantially similar, service s
840+for the provision of the same, or substantially similar, service
247841 through in-person consultation or contact.
248-
249842 F. An insurer shall not apply any deductible to telemedicine
250843 services that accumulates separately from the deduc tible that
251844 applies in the aggregate to all items and services covered under the
252845 health benefit plan.
846+G. Any copayment or coinsurance applied to telemedicine
847+benefits by an insurer shall be equivalent to the copayment or
848+coinsurance applied to such benefit s when provided through in -person
849+consultation or contact.
253850
254-G. Any copayment or coinsurance applied to telem edicine
255-benefits by an insurer shall not exceed the copayment or coinsurance
256-applied to such benefits when provided through in -person
257-consultation or contact.
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259876 H. An insurer shall not impose any annual or lifetime
260877 durational limits or annual or lifetime dollar maximums for benefits
261878 or services provided through telemedicine that are not equally
262879 imposed upon all terms and services covered under the health benefit
263880 plan.
264-
265881 I. An insurer shall not impose any type of utilization review
266882 on benefits provided through telemedicine unless such type of
267-
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269883 utilization review is imposed when such benefits are provided
270884 through in-person consultation or contact. Any type of utilization
271885 review that is imposed on benefits provided through telemedicine
272886 shall not occur with greater frequency or more stringent application
273887 than such form of utilization review is imposed on such be nefits
274888 provided through in-person consultation or contact.
275-
276889 J. An insurer shall not restrict coverage of telemedicine
277890 benefits or services to benefits or services provided by a
278891 particular vendor, or other third party, or benefits or services
279892 provided through a particular electronic communications technology
280893 platform; provided, that nothing shall require an insurer to cover
281894 any electronic communications technology platform that does not
282895 comply with applicable state and federal privacy laws.
283-
284896 K. An insurer shall not place any restrictions on prescribing
285897 medications through telemedicine that are more restrictive than what
286898 is required under applicable state and federal law.
899+SECTION 6. This act shall become effective November 1, 2021.
287900
288-L. No later than January 1, 2023, the State Department of
289-Health shall request a report from the Statewide Health Information
290-Exchange that will provide the following data:
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292-1. The number of providers using telehealth, in cluding the
293-location, frequency and specific services for which telehealth is
294-utilized; and
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296-2. The overall cost and cost savings associated with the
297-utilization of telehealth services.
298-
299-SECTION 3. This act shall become effective January 1, 2022.
300-
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302-ENR. S. B. NO. 674 Page 8
303-Passed the Senate the 29th day of April, 2021.
926+Passed the Senate the 10th day of March, 2021.
304927
305928
306929
307930 Presiding Officer of the Senate
308931
309932
310-Passed the House of Representatives the 21st day of April, 2021.
933+Passed the House of Representatives the ____ day of __________,
934+2021.
311935
312936
313937
314938 Presiding Officer of the House
315939 of Representatives
316940
317-OFFICE OF THE GOVERNOR
318-Received by the Office of the Governor this ____________________
319-day of _________________ __, 20_______, at _______ o'clock _______ M.
320-By: _______________________________ __
321-Approved by the Governor of the State of Oklahoma this _____ ____
322-day of _________________ __, 20_______, at _______ o 'clock _______ M.
323941
324- _________________________________
325- Governor of the State of Oklahoma
326-
327-
328-OFFICE OF THE SECRETARY OF STATE
329-Received by the Office of the Secretary of State this _______ ___
330-day of __________________, 20 _______, at _______ o'clock _______ M .
331-By: _______________________________ __