Utah 2023 Regular Session

Utah House Bill HB0534 Compare Versions

Version 1 (Old)

Version 2 (New)

Old	New		Differences
1	1		H.B. 534
2	2		LEGISLATIVE GENERAL COUNSEL
3	3		6 Approved for Filing: D.M. Cheung 6
4	4		6 02-21-23 11:01 AM 6
5	5		H.B. 534
6	6		1 TELEMEDICINE AMENDMENTS
7	7		2 2023 GENERAL SESSION
8	8		3 STATE OF UTAH
9	9		4 Chief Sponsor: Melissa G. Ballard
10		-	5 Senate Sponsor: ~~Michael S. Kennedy~~
	10	+	5 Senate Sponsor: ____________
11	11		6
12	12		7LONG TITLE
13	13		8General Description:
14	14		9 This bill amends provisions relating to reimbursement for telemedicine services.
15	15		10Highlighted Provisions:
16	16		11 This bill:
17	17		12 <requires a health insurer to reimburse for telemedicine services at 90% or more of
18	18		13the rate that is paid for the equivalent in-person service if the network provider also
19	19		14provides the health care service in-person in the state.
20	20		15Money Appropriated in this Bill:
21	21		16 None
22	22		17Other Special Clauses:
23	23		18 None
24	24		19Utah Code Sections Affected:
25	25		20AMENDS:
26	26		21 31A-22-649.5, as last amended by Laws of Utah 2021, Chapters 19, 404 and last
27	27		22amended by Coordination Clause, Laws of Utah 2021, Chapter 404
28	28		23
29	29		24Be it enacted by the Legislature of the state of Utah:
30	30		25 Section 1. Section 31A-22-649.5 is amended to read:
31	31		26 31A-22-649.5. Insurance parity for telemedicine services -- Method of technology
32	32		27used.
33	33		HB0534 H.B. 534 02-21-23 11:01 AM
34		-	- 2 - ~~House Committee Amendments 2-27-2023 pf/dc~~
	34	+	- 2 -
35	35		28 (1) As used in this section:
36	36		29 (a) "Mental health condition" means a mental disorder or a substance-related disorder
37	37		30that falls under a diagnostic category listed in the Diagnostic and Statistical Manual, as
38	38		31periodically revised.
39	39		32 (b) "Telemedicine services" means the same as that term is defined in Section
40	40		3326-60-102.
41	41		34 (2) Notwithstanding the provisions of Section 31A-22-618.5, a health benefit plan
42	42		35offered in the individual market, the small group market, or the large group market shall:
43	43		36 (a) provide coverage for:
44	44		37 (i) telemedicine services that are covered by Medicare; and
45	45		38 (ii) treatment of a mental health condition through telemedicine services if:
46	46		39 (A) the health benefit plan provides coverage for the treatment of the mental health
47	47		40condition through in-person services; and
48	48		41 (B) the health benefit plan determines treatment of the mental health condition through
49	49		42telemedicine services meets the appropriate standard of care; [and]
50	50		43 (b) reimburse a network provider that provides the telemedicine services described in
51	51		44Subsection (2)(a) at a negotiated commercially reasonable rate[.]; and
52	52		45 (c) for a health benefit plan entered into or renewed on or after January 1, 2024, if a
53	53		46network provider also provides health care services at an in-person location in the state,
54	54		47reimburse the telemedicine services described in Subsection (2)(a) that are delivered by the
55		-	48network provider º , other than for telemedicine services related to urgent care as defined in
56		-	48a29 C.F.R. Sec. 2560.503-1, » at a rate that is at least 90% of the rate that is paid to the network
57		-	48bprovider for
	55	+	48network provider at a rate that is at least 90% of the rate that is paid to the network provider for
58	56		49the same health care service that is delivered in-person.
59	57		50 (3) (a) Notwithstanding Section 31A-45-303, a health benefit plan providing coverage
60	58		51under Subsection (2)(a) may not impose originating site restrictions, geographic restrictions, or
61	59		52distance-based restrictions.
62	60		53 (b) A network provider that provides the telemedicine services described in Subsection
63	61		54(2)(a) may utilize any synchronous audiovisual technology for the telemedicine services that is
64	62		55compliant with the federal Health Insurance Portability and Accountability Act of 1996.