OLR Bill Analysis

sHB 5483

AN ACT CONCERNING COVERAGE OF TELEMEDICINE SERVICES UNDER MEDICAID.

SUMMARY:

To the extent permitted by federal law, and where deemed medically appropriate, this bill permits Medicaid-covered health care services to be provided by telemedicine in place of in-person contact between a patient and health care provider. Under the bill, “telemedicine” means the use of interactive audio, video, or data communication in the delivery of medical advice, diagnosis, care, or treatment.

It includes the provision, through electronic communications or interstate commerce, of diagnostic or treatment services, including primary diagnosis of pathology specimens, slides or images, to any person located in this state as well as similar “telehealth” services approved by federal Medicare regulations.

Facsimile and audio-only telephone transmissions are excluded from the definition of telemedicine.

EFFECTIVE DATE: January 1, 2013

MEDICALLY APPROPRIATE

Under the bill, “medically appropriate” means care that is (1) provided in a timely manner and meets professionally recognized standards of acceptable medical care, (2) delivered in the appropriate medical setting, and (3) the least costly of multiple, equally-effective alternative treatments or diagnostic modalities.

FEDERAL APPROVAL

If necessary, the bill requires the DSS commissioner to apply to the federal Centers for Medicare and Medicaid Services (CMS) for a state plan amendment for Medicaid coverage and reimbursement for telemedicine services. By law, he must submit notice of the proposed amendment to the Human Services and Appropriations committees before submitting the application to CMS.

RATE-SETTING

The bill also requires the Department of Social Services (DSS) commissioner, in consultation with the Department of Public Health commissioner, to adopt Medicaid reimbursement rate regulations in conformity with the requirements of the Uniform Administrative Procedure Act. The commissioners must consider, to the extent applicable, reductions in travel costs by health care providers and patients to deliver or access health care services. The DSS commissioner may consider other factors he deems relevant.

PRIVACY PROTECTIONS

The bill subjects telemedicine transmission, storage, and dissemination of data and records to federal and state law and regulations governing the privacy, security, confidentiality, and safeguarding of individually identifiable information.

COMMITTEE ACTION

Human Services Committee

Joint Favorable Substitute

Yea

16

Nay

0

(03/22/2012)