Rep. Norm Thurston — Voting Record

Bill

Number

H.B. 534 (2023GS)

Sponsor

Rep. Ballard, M.G.

Final action

House/ filed 3/3/2023

Outcome

Failed / filed without passage

Summary

What it does

• This bill:
• requires a health insurer to reimburse for telemedicine services at 90% or more of the rate that is paid for the equivalent in-person service if the network provider also provides the health care service in-person in the state.

Every vote on this bill

Bill text

TELEMEDICINE AMENDMENTS
GENERAL SESSION
STATE OF UTAH
Chief Sponsor: Melissa G. Ballard
Senate Sponsor: 
 Michael S. Kennedy
LONG TITLE
General Description:
This bill amends provisions relating to reimbursement for telemedicine services.
Highlighted Provisions:
This bill:
▸ requires a health insurer to reimburse for telemedicine services at 90% or more of
the rate that is paid for the equivalent in-person service if the network provider also
provides the health care service in-person in the state.
Money Appropriated in this Bill:
None
Other Special Clauses:
None
Utah Code Sections Affected:
AMENDS:
31A-22-649.5
, as last amended by Laws of Utah 2021, Chapters 19, 404 and last
amended by Coordination Clause, Laws of Utah 2021, Chapter 404
Be it enacted by the Legislature of the state of Utah:
Section 1. Section 
31A-22-649.5
 is amended to read:
31A-22-649.5.
Insurance parity for telemedicine services -- Method of technology
used.
(1) As used in this section:
(a) "Mental health condition" means a mental disorder or a substance-related disorder
that falls under a diagnostic category listed in the Diagnostic and Statistical Manual, as
periodically revised.
(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 shall:
(a) provide coverage for:
(i) telemedicine services that are covered by Medicare; and
(ii) treatment of a mental health condition through telemedicine services if:
(A) the health benefit plan provides coverage for the treatment of the mental health
condition through in-person services; and
(B) the health benefit plan determines treatment of the mental health condition through
telemedicine services meets the appropriate standard of care; [
and
]
(b) reimburse a network provider that provides the telemedicine services described in
Subsection (2)(a) at a negotiated commercially reasonable rate[
.
]
; and
(c) for a health benefit plan entered into or renewed on or after January 1, 2024, if a
network provider also provides health care services at an in-person location in the state,
reimburse the telemedicine services described in Subsection (2)(a) that are delivered by the
network provider at a rate that is at least 90% of the rate that is paid to the network provider for
the same health care service that is delivered in-person.
(3) (a) Notwithstanding Section 
31A-45-303
, a health benefit plan providing coverage
under Subsection (2)(a) may not impose originating site restrictions, geographic restrictions, or
distance-based restrictions.
(b) A network provider that provides the telemedicine services described in Subsection
(2)(a) may utilize any synchronous audiovisual technology for the telemedicine services that is
compliant with the federal Health Insurance Portability and Accountability Act of 1996.