Rep. Norm Thurston — Voting Record

Bill

Number

H.B. 313 First Substitute (2020GS)

Sponsor

Rep. Ballard, M.G.

Final action

Governor Signed 3/24/2020

Outcome

Became law — signed by Gov. Gary R. Herbert

Summary

What it does

• This bill:
• amends the definition of telemedicine services;
• clarifies the scope of telehealth practice; and
• requires certain health benefit plans to provide coverage parity and commercially reasonable reimbursement for telehealth services and telemedicine services.

Every vote on this bill

Bill text

TELEHEALTH PARITY AMENDMENTS
GENERAL SESSION
STATE OF UTAH
Chief Sponsor: Melissa G. Ballard
Senate Sponsor: 
Allen M. Christensen
LONG TITLE
General Description:
This bill amends provisions related to insurance coverage for telehealth services and
telemedicine services.
Highlighted Provisions:
This bill:
▸ amends the definition of telemedicine services;
▸ clarifies the scope of telehealth practice; and
▸ requires certain health benefit plans to provide coverage parity and commercially
reasonable reimbursement for telehealth services and telemedicine services.
Money Appropriated in this Bill:
None
Other Special Clauses:
None
Utah Code Sections Affected:
AMENDS:
26-60-102
, as enacted by Laws of Utah 2017, Chapter 241
26-60-103
, as enacted by Laws of Utah 2017, Chapter 241
ENACTS:
31A-22-649.5
, Utah Code Annotated 1953
Be it enacted by the Legislature of the state of Utah:
Section 1. Section 
26-60-102
 is amended to read:
26-60-102.
Definitions.
As used in this chapter:
(1) "Asynchronous store and forward transfer" means the transmission of a patient's
health care information from an originating site to a provider at a distant site.
(2) "Distant site" means the physical location of a provider delivering telemedicine
services.
(3) "Originating site" means the physical location of a patient receiving telemedicine
services.
(4) "Patient" means an individual seeking telemedicine services.
(5) (a) "Patient-generated medical history" means medical data about a patient that the
patient creates, records, or gathers.
(b) "Patient-generated medical history" does not include a patient's medical record that
a healthcare professional creates and the patient personally delivers to a different healthcare
professional.
[
(5)
] 
(6)
 "Provider" means an individual who is:
(a) licensed under Title 26, Chapter 21, Health Care Facility Licensing and Inspection
Act;
(b) licensed under Title 58, Occupations and Professions, to provide health care; or
(c) licensed under Title 62A, Chapter 2, Licensure of Programs and Facilities.
[
(6)
] 
(7)
 "Synchronous interaction" means real-time communication through interactive
technology that enables a provider at a distant site and a patient at an originating site to interact
simultaneously through two-way audio and video transmission.
[
(7)
] 
(8)
 "Telehealth services" means the transmission of health-related services or
information through the use of electronic communication or information technology.
[
(8)
] 
(9)
 "Telemedicine services" means telehealth services:
(a) including:
(i) clinical care;
(ii) health education;
(iii) health administration;
(iv) home health; [
or
]
(v) facilitation of self-managed care and caregiver support; [
and
] 
or
(vi) remote patient monitoring occurring incidentally to general supervision; and
(b) provided by a provider to a patient through a method of communication that:
(i) (A) uses asynchronous store and forward transfer; or
(B) uses synchronous interaction; and
(ii) meets industry security and privacy standards, including compliance with:
(A) the federal Health Insurance Portability and Accountability Act of 1996, Pub. L.
No. 104-191, 110 Stat. 1936, as amended; and
(B) the federal Health Information Technology for Economic and Clinical Health Act,
Pub. L. No. 111-5, 123 Stat. 226, 467, as amended.
Section 2. Section 
26-60-103
 is amended to read:
26-60-103.
Scope of telehealth practice.
(1) A provider offering telehealth services shall:
(a) at all times:
(i) act within the scope of the provider's license under Title 58, Occupations and
Professions, in accordance with the provisions of this chapter and all other applicable laws and
rules; and
(ii) be held to the same standards of practice as those applicable in traditional health
care settings;
(b) if the provider does not already have a provider-patient relationship with the
patient, establish a provider-patient relationship during the patient encounter in a manner
consistent with the standards of practice, determined by the Division of Professional Licensing
in rule made in accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act,
including providing the provider's licensure and credentials to the patient;
[
(b)
] 
(c)
 in accordance with Title 58, Chapter 82, Electronic Prescribing Act, before
providing treatment or prescribing a prescription drug, establish a diagnosis and identify
underlying conditions and contraindications to a recommended treatment after:
(i) obtaining from the patient or another provider the patient's relevant clinical history;
and
(ii) documenting the patient's relevant clinical history and current symptoms;
[
(c)
] 
(d)
 be available to a patient who receives telehealth services from the provider for
subsequent care related to the initial telemedicine services, in accordance with community
standards of practice;
[
(d)
] 
(e)
 be familiar with available medical resources, including emergency resources
near the originating site, in order to make appropriate patient referrals when medically
indicated; [
and
]
[
(e)
] 
(f)
 in accordance with any applicable state and federal laws, rules, and
regulations, generate, maintain, and make available to each patient receiving telehealth services
the patient's medical records[
.
]
; and
(g) if the patient has a designated health care provider who is not the telemedicine
provider:
(i) consult with the patient regarding whether to provide the patient's designated health
care provider a medical record or other report containing an explanation of the treatment
provided to the patient and the telemedicine provider's evaluation, analysis, or diagnosis of the
patient's condition;
(ii) collect from the patient the contact information of the patient's designated health
care provider; and
(iii) within two weeks after the day on which the telemedicine provider provides
services to the patient, and to the extent allowed under HIPAA as that term is defined in
Section 
26-18-17
, provide the medical record or report to the patient's designated health care
provider, unless the patient indicates that the patient does not want the telemedicine provider to
send the medical record or report to the patient's designated health care provider.
(2) Subsection (1)(g) does not apply to prescriptions for eyeglasses or contacts.
(3) Except as specifically provided in Title 58, Chapter 83, Online Prescribing,
Dispensing, and Facilitation Licensing Act, and unless a provider has established a
provider-patient relationship with a patient, a provider offering telemedicine services may not
diagnose a patient, provide treatment, or prescribe a prescription drug based solely on one of
the following:
(a) an online questionnaire;
(b) an email message; or
(c) a patient-generated medical history.
[
(2)
] 
(4)
 A provider may not offer telehealth services if:
(a) the provider is not in compliance with applicable laws, rules, and regulations
regarding the provider's licensed practice; or
(b) the provider's license under Title 58, Occupations and Professions, is not active and
in good standing.
Section 3. Section 
31A-22-649.5
 is enacted to read:
 31A-22-649.5.
Insurance parity for telemedicine services.
(1) As used in this section:
(a) "Telehealth services" means the same as that term is defined in Section 
26-60-102
.
(b) "Telemedicine services" means the same as that term is defined in Section
26-60-102
.
(2) Notwithstanding the provisions of Section 
31A-22-618.5
, a health benefit plan
offered in the individual market, the small group market, or the large group market and entered
into or renewed on or after January 1, 2021, shall:
(a) provide coverage for telemedicine services that are covered by Medicare; and
(b) reimburse, at a commercially reasonable rate, a network provider that provides the
telemedicine services described in Subsection (2)(a).
(3) Notwithstanding Section 
31A-45-303
, a health benefit plan providing treatment
under Subsection (2) may not impose originating site restrictions, geographic restrictions, or
distance-based restrictions.