ENGR. H. A. to ENGR. S. B. NO. 674 Page 1
An Act
ENROLLED SENATE
BILL NO. 674 By: McCortney and Kirt of the
Senate
and
McEntire, Mize and Pittman
of the House
An Act relating to telemedicine; amending 36 O.S.
2011, Section 6802, which relates to definitions;
modifying and adding def initions; amending 36 O.S.
2011, Section 6803, which relates to coverage of
telemedicine services; modifying term; requiring
certain coverage of health care services provided
through telemedicine; prohibiting certain exclusion
of service for coverage; requ iring certain
reimbursement; prohibiting application of certain
deductible; requiring certain copayment or
coinsurance not exceed certain amount; prohibiting
imposition of certain limits or maximums; prohibiting
imposition of certain utilization review; pr ohibiting
certain restriction of coverage; prohibiting certain
restrictions on prescribing; requiring the State
Department of Health to request a certain report by a
certain date; providing for contents of report; and
providing an effective date.
SUBJECT: Telemedicine
BE IT ENACTED BY THE PEOPLE OF THE STATE OF OKLAHOMA:
SECTION 1. AMENDATORY 36 O.S. 2011, Section 6802, is
amended to read as follows:
ENR. S. B. NO. 674 Page 2
Section 6802. As used in this act, "telemedicine" means the
practice of health care delivery, diagnosis, consultation,
treatment, including but not limited to, the treatment and
prevention of strokes, transfer of medical data, or exchange of
medical education information by means of audio, video, or data
communications. Telemedicine is not a consultation pro vided by
telephone or facsimile machine
As used in the Oklahoma Telemedicine Act:
1. "Distant site" means a site at which a health care
professional licensed to practice in this state is located while
providing health care services by means of telemedicin e;
2. a. "Health benefit plan" means any plan or arrangement
that:
(1) provides benefits for medical or surgical
expenses incurred as a result of a health
condition, accident or illness, and
(2) is offered by any insurance company, group
hospital service corporation or health
maintenance organization that delivers or issues
for delivery an individual, group, blanket or
franchise insurance policy or insurance
agreement, a group hospital service contract or
an evidence of coverage, or, to the extent
permitted by the Employee Retirement Income
Security Act of 1974, 29 U.S.C., Section 1001 et
seq., by a multiple employer welfare arrangement
as defined in Section 3 of the Employee
Retirement Income Security Act of 197 4, or any
other analogous benefit arrangement, whether the
payment is fixed or by indemnity,
b. Health benefit plan shall not include:
(1) a plan that provides coverage:
ENR. S. B. NO. 674 Page 3
(a) only for a specified disease or diseases or
under an individual limited benefit policy,
(b) only for accidental death or dismemb erment,
(c) only for dental or vision care,
(d) for a hospital confinement indemnity policy,
(e) for disability income insurance or a
combination of accident -only and disability
income insurance, or
(f) as a supplement to liability insurance,
(2) a Medicare supplemental policy as defined by
Section 1882(g)(1) of the Social Security Act (42
U.S.C., Section 1395ss),
(3) workers' compensation insurance coverage,
(4) medical payment insurance issued as pa rt of a
motor vehicle insurance policy,
(5) a long-term care policy including a nursing home
fixed indemnity policy, unless a determination is
made that the policy provides benefit coverage so
comprehensive that the policy meets the
definition of a health benefit plan,
(6) short-term health insurance issued on a
nonrenewable basis with a duration of six (6)
months or less, or
(7) a plan offered by the Employees Group Insurance
Division of the Office of Management and
Enterprise Services;
3. "Health care professional" means a physician or other health
care practitioner licensed, accredited or certified to perform
specified health care services consistent with state law;
ENR. S. B. NO. 674 Page 4
4. "Insurer" means any entity providing an accident and health
insurance policy in this state including, but not limited to, a
licensed insurance company, a not-for-profit hospital service and
medical indemnity corporation, a fraternal benefit society, a
multiple employer welfare arrangement or any other entity subject to
regulation by the Insurance Commissioner;
5. "mHealth", also referred to as "mobile health", means
patient medical and health information and includes the use of the
Internet and wireless devices by patients to obtain or create
specialized health information and online discussion groups to
provide peer-to-peer support;
6. "Originating site" means a site at which a patient is
located at the time health care services are provided to him or her
by means of telemedicine, which may include, but shall not be
restricted to, a patient's home, workplace or school;
7. "Remote patient monit oring services" means the delivery of
home health services using telecommunications technology to enhance
the delivery of home health care including monitoring of clinical
patient data such as weight, blood pressure, pulse, pulse oximetry,
blood glucose and other condition-specific data, medication
adherence monitoring and interactive video conferencing with or
without digital image upload;
8. "Store and forward transfer" means the transmiss ion of a
patient's medical information either to or from an origin ating site
or to or from the health care professional at the distant site, but
does not require the patient being present nor must it be in real
time;
9. "Telemedicine" or "telehealth" means technology-enabled
health and care management and delivery syste ms that extend capacity
and access, which includes:
a. synchronous mechanisms, which may include live
audiovisual interaction between a patient and a health
care professional or real -time provider-to-provider
consultation through live interactive audiovisu al
means,
ENR. S. B. NO. 674 Page 5
b. asynchronous mechanisms, which include store and
forward transfers, online exchange of health
information between a patient and a health care
professional and online exchange of health information
between health care professionals, but shall n ot
include the use of automated text messages or
automated mobile applications that serve as the sole
interaction between a patient and a health care
professional,
c. remote patient monitoring,
d. mHealth, and
e. other electronic means that support clinica l health
care, professional consultation, patient and
professional health-related education, public health
and health administration .
SECTION 2. AMENDATORY 3 6 O.S. 2011, Section 6803, is
amended to read as follows:
Section 6803. A. For services that a health care practitioner
professional determines to be appropriately provided by means of
telemedicine, health care service plans, disability insurer
programs, workers' compensation programs, or state Medicaid managed
care program contracts issued, amended, or renewed on or after
January 1, 1998, shall not require person -to-person contact between
a health care practitioner professional and a patient.
B. Subsection A of this section shall apply to health care
service plan contracts w ith the state Medicaid managed care program
only to the extent that both of the following apply:
1. Telemedicine services are covered by, and reimbursed under,
the fee-for-service provisions of the state Medicaid managed care
program; and
2. State Medicaid managed care program contracts with health
care service plans are amended to add coverage of telemedicine
services and make any appropriate capitation rate adjustments.
ENR. S. B. NO. 674 Page 6
C. Any health benefit plan that is offered, issued or renewed
in this state by an i nsurer on or after the effective date of this
act shall provide coverage of health care services provided through
telemedicine, as provided in this section.
D. An insurer shall not exclude a service for coverage solely
because the service is provided thro ugh telemedicine and is not
provided through in-person consultation or contact between a health
care professional and a patient when such services are appropriately
provided through telemedicine. An insurer may limit coverage of
services provided by teleh ealth consistent with coding and clinical
standards recognized by the American Medical Association or the
Centers for Medicare and Medicaid Services as covered if delivered
by telehealth or telemedicine, except as agreed to by the insurer
and provider.
E. An insurer shall reimburse the treating health care
professional or the consulting health care professional for the
diagnosis, consultation or treatment of the patient deliver ed
through telemedicine services on the same basis and at least at the
rate of reimbursement that the insurer is responsible for coverage
for the provision of the same, or substantially similar, service s
through in-person consultation or contact.
F. An insurer shall not apply any deductible to telemedicine
services that accumulates s eparately from the deductible that
applies in the aggregate to all items and services covered under the
health benefit plan.
G. Any copayment or coinsurance applied to telem edicine
benefits by an insurer shall not exceed the copayment or coinsurance
applied to such benefits when provided through in -person
consultation or contact.
H. An insurer shall not impose any annual or lifetime
durational limits or annual or lifetime d ollar maximums for benefits
or services provided through telemedicine that are not equally
imposed upon all terms and services covered under the health benefit
plan.
I. An insurer shall not impose any type of utilization review
on benefits provided throu gh telemedicine unless such type of
ENR. S. B. NO. 674 Page 7
utilization review is imposed when such benefits are provided
through in-person consultation or contact. Any type of utilization
review that is imposed on benefits provided through telemedicine
shall not occur with grea ter frequency or more stringent application
than such form of utilization review is imposed on such benefits
provided through in-person consultation or contact.
J. An insurer shall not restrict coverage of telemedicine
benefits or services to benefits or services provided by a
particular vendor, or other third party, or benefits or servi ces
provided through a particular electronic communications technology
platform; provided, that nothing shall require an insurer to cover
any electronic communications tec hnology platform that does not
comply with applicable state and federal privacy laws.
K. An insurer shall not place any restrictions on prescribing
medications through telemedicine that are more restrictive than what
is required under applicable state an d federal law.
L. No later than January 1, 2023, the State Department of
Health shall request a report from the Statewide Health Information
Exchange that will provide the following data:
1. The number of providers using telehealth, in cluding the
location, frequency and specific services for which telehealth is
utilized; and
2. The overall cost and cost savings associated with the
utilization of telehealth services.
SECTION 3. This act shall become effective January 1, 2022.
ENR. S. B. NO. 674 Page 8
Passed the Senate the 29th day of April, 2021.
Presiding Officer of the Senate
Passed the House of Representatives the 21st day of April, 2021.
Presiding Officer of the House
of Representatives
OFFICE OF THE GOVERNOR
Received by the Office of the Governor this ____________________
day of _________________ __, 20_______, at _______ o'clock _______ M.
By: _______________________________ __
Approved by the Governor of the State of Oklahoma this _____ ____
day of _________________ __, 20_______, at _______ o 'clock _______ M.
_________________________________
Governor of the State of Oklahoma
OFFICE OF THE SECRETARY OF STATE
Received by the Office of the Secretary of State this _______ ___
day of __________________, 20 _______, at _______ o'clock _______ M .
By: _______________________________ __