State SealARIZONA HOUSE OF REPRESENTATIVES

 

SB 1089: insurance; telemedicine

PRIME SPONSOR: Senator Carter, LD 15

BILL STATUS: House Engrossed

                                               

 

Overview

Modifies insurance regulations governing telemedicine.

History

Telemedicine is defined as the interactive use of audio, video, or other electronic media for the purpose of diagnosis, consultation, or treatment. The definition excludes the sole use of an audio-only telephone, video-only system, a facsimile machine, instant messages, or electronic mail (A.R.S. §§ 20-841.09; 20-1057.13; 20-1376.05; 20-1406.05).      

Health care services are defined as services provided for trauma, burn, cardiology, infectious diseases, mental health disorders, neurologic disease including strokes, dermatology, pulmonology, pain medicine, substance abuse, and urology (A.R.S. §§ 20-841.09; 20-1057.13; 20-1376.05; 20-1406.05).      

Hospital, Medical, Dental and Optometric Service Corporations (Corporation) are defined as corporations organized under Arizona law that establish, maintain, and operate nonprofit hospital service plans or medical, dental, or optometric service plans, or a combination of these plans (A.R.S. § 20-822).

Heath Care Services Organizations (HCSO) means any person who undertakes to conduct one or more health care plans. This includes provider sponsored HCSOs (A.R.S. § 20-1051).

Current law requires a Corporation, HCSO, disability insurance, and group and blanket disability insurance providers to cover health care services delivered through telemedicine if those services would be covered in an in-person consultation. Insurers can impose deductibles, copayments or coinsurance for telemedical services as long as the imposed charge does not exceed the applicable deductible, copayment, or coinsurance amount for the same service provided in-person. Services provided through telemedicine must comply with Arizona licensure requirements, accreditation standards, and any practice guidelines of relevant national medical provider associations. Telemedicine may be limited to providers within the insurer's network (A.R.S. §§ 20-841.09; 20-1057.13; 20-1376.05; 20-1406.05).      

Provisions

1.       Prohibits a Corporation, HCSO, disability insurers, and group and blanket disability insurers from limiting or denying coverage of health care services because it is provided through telemedicine if the same services would be covered when provided in-person. (Sec 1-4)

2.       Allows a Corporation, HCSO, disability insurers, and group and blanket disability insurers to apply the same limits and exclusions on a health care service that would be applicable to an in-person consultation for the same service. (Sec 1-4)

3.       Subjects services provided through telemedicine or resulting from a telemedicine consultation to all Arizona laws that govern prescribing, dispensing, and administering prescription pharmaceuticals and devices. (Sec 1-4)

4.       Amends the definition of telemedicine to included asynchronous store-and-forward technologies and remote patient monitoring technologies. (Sec 1-4)

5.       Contains a delayed effective date. (Sec 5)

6.       Makes technical and conforming changes. (Sec 1-4)

 

 

 

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Fifty-fourth Legislature                               SB 1089

First Regular Session                    Version 3: House Engrossed

 

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