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HOUSE OF REPRESENTATIVES |
H.B. NO. |
693 |
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THIRTY-SECOND LEGISLATURE, 2023 |
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STATE OF HAWAII |
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A BILL FOR AN ACT
Relating to Telehealth.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:
SECTION 1. The legislature finds that many residents in underserved and low-income communities where cellular data plans and broadband are inaccessible are unable to utilize telehealth services that require internet connectivity. The legislature further finds that medical professionals have used standard telephone contacts for decades to provide necessary access to primary care when a patient is homebound or otherwise unable to access face-to-face care. The Centers for Medicare and Medicaid Services continues to authorize coverage of audio-only (telephone) services used in the treatment of mental health and substance abuse in certain circumstances, allowing federally qualified health centers and rural health clinics to use telehealth to care for patients in patients' homes. Consistent provisions for managed care plans and commercial health care plans are warranted to ensure pay parity for telephonic and telehealth services.
Accordingly, the purpose of this Act is to allow for the use of standard telephone contacts for telehealth purposes, consistent with the 2023 Medicare Physician Fee Schedule.
SECTION 2. Section 346-59.1, Hawaii Revised Statutes, is amended as follows:
1. By amending subsection (b) to read:
"(b) Reimbursement for services provided through telehealth via an interactive telecommunications system shall be equivalent to reimbursement for the same services provided via face-to-face contact between a health care provider and a patient. Nothing in this section shall require a health care provider to be physically present with the patient at an originating site unless a health care provider at the distant site deems it necessary."
2. By amending subsection (g) to read:
"(g) For the purposes of this section:
"Distant
site" means the location of the health care provider delivering services
through telehealth at the time the services are provided.
"Health care provider" means a provider of services, as defined in title 42 United States Code section 1395x(u), a provider of medical and other health services, as defined in title 42 United States Code section 1395x(s), other practitioners licensed by the State and working within their scope of practice, and any other person or organization who furnishes, bills, or is paid for health care in the normal course of business, including but not limited to primary care providers, mental health providers, oral health providers, physicians and osteopathic physicians licensed under chapter 453, advanced practice registered nurses licensed under chapter 457, psychologists licensed under chapter 465, and dentists licensed under chapter 448.
"Interactive telecommunications
system" means multimedia communications equipment that includes, at a
minimum, audio and video equipment permitting two-way, real-time interactive
communications between the patient and distant site physician or practitioner;
provided that, for services furnished for purposes of diagnosis, evaluation, or
treatment of a mental health disorder to a patient in the patient's home,
interactive telecommunications may include two-way, real-time audio-only
communication technology if the distant site physician or practitioner is
technically capable of using an interactive telecommunications system but the
patient is not capable of, or does not consent to, the use of video technology;
provided further that the term shall have the same meaning as the term is
defined in title 42 Code of Federal Regulations section 410.78, as amended.
"Originating
site" means the location where the patient is located, whether accompanied
or not by a health care provider, at the time services are provided by a health
care provider through telehealth, including but not limited to a health care
provider's office, hospital, critical access hospital, rural health clinic,
federally qualified health center, a patient's home, and other [non-medical]
nonmedical environments such as school-based health centers,
university-based health centers, or the work location of a patient.
"Telehealth"
means the use of telecommunications services, as defined in section 269‑1,
to encompass four modalities: store and
forward technologies, remote monitoring, live consultation, and mobile health;
and which shall include but not be limited to real-time video
conferencing-based communication, secure interactive and non‑interactive
web-based communication, and secure asynchronous information exchange, to
transmit patient medical information, including diagnostic-quality digital
images and laboratory results for medical interpretation and diagnosis, for the
purpose of delivering enhanced health care services and information while a
patient is at an originating site and the health care provider is at a distant
site. [Standard] Except as
otherwise provided in this section, standard telephone contacts, facsimile
transmissions, or e-mail text, in combination or [by itself, does] alone,
do not constitute [a] telehealth [service for the purposes of
this section.] services."
SECTION 3. Section 431:10A-116.3, Hawaii Revised Statutes, is amended as follows:
1. By amending subsection (c) to read:
"(c) Reimbursement for services provided through telehealth via an interactive telecommunications system shall be equivalent to reimbursement for the same services provided via face-to-face contact between a health care provider and a patient. Nothing in this section shall require a health care provider to be physically present with the patient at an originating site unless a health care provider at the distant site deems it necessary."
2. By amending subsection (g) to read:
"(g) For the purposes of this section:
"Distant
site" means the location of the health care provider delivering services
through telehealth at the time the services are provided.
"Health care provider" means a provider of services, as defined in title 42 United States Code section 1395x(u), a provider of medical and other health services, as defined in title 42 United States Code section 1395x(s), other practitioners licensed by the State and working within their scope of practice, and any other person or organization who furnishes, bills, or is paid for health care in the normal course of business, including but not limited to primary care providers, mental health providers, oral health providers, physicians and osteopathic physicians licensed under chapter 453, advanced practice registered nurses licensed under chapter 457, psychologists licensed under chapter 465, and dentists licensed under chapter 448.
"Interactive telecommunications
system" means multimedia communications equipment that includes, at a
minimum, audio and video equipment permitting two-way, real-time interactive
communications between the patient and distant site physician or practitioner;
provided that, for services furnished for purposes of diagnosis, evaluation, or
treatment of a mental health disorder to a patient in the patient's home,
interactive telecommunications may include two-way, real-time audio-only
communication technology if the distant site physician or practitioner is
technically capable of using an interactive telecommunications system but the
patient is not capable of, or does not consent to, the use of video technology;
provided further that the term shall have the same meaning as the term is
defined in title 42 Code of Federal Regulations section 410.78, as amended.
"Originating site" means the location where the patient is located, whether accompanied or not by a health care provider, at the time services are provided by a health care provider through telehealth, including but not limited to a health care provider's office, hospital, health care facility, a patient's home, and other nonmedical environments such as school-based health centers, university-based health centers, or the work location of a patient.
"Telehealth"
means the use of telecommunications services, as defined in section 269‑1,
to encompass four modalities: store and
forward technologies, remote monitoring, live consultation, and mobile health;
and which shall include but not be limited to real-time video conferencing-based
communication, secure interactive and non‑interactive web-based
communication, and secure asynchronous information exchange, to transmit
patient medical information, including diagnostic-quality digital images and
laboratory results for medical interpretation and diagnosis, for the purpose of
delivering enhanced health care services and information while a patient is at
an originating site and the health care provider is at a distant site. [Standard] Except as otherwise
provided for in this section, standard telephone contacts, facsimile
transmissions, or e-mail text, in combination or [by itself, does] alone,
do not constitute [a] telehealth [service for the purposes of
this chapter.] services."
SECTION 4. Section 432:1-601.5, Hawaii Revised Statutes, is amended as follows:
1. By amending subsection (c) to read:
"(c) Reimbursement for services provided through telehealth via an interactive telecommunications system shall be equivalent to reimbursement for the same services provided via face-to-face contact between a health care provider and a patient. Nothing in this section shall require a health care provider to be physically present with the patient at an originating site unless a health care provider at the distant site deems it necessary."
2. By amending subsection (g) to read:
"(g) For the purposes of this section:
"Health care provider" means a provider of services, as defined in title 42 United States Code section 1395x(u), a provider of medical and other health services, as defined in title 42 United States Code section 1395x(s), other practitioners licensed by the State and working within their scope of practice, and any other person or organization who furnishes, bills, or is paid for health care in the normal course of business, including but not limited to primary care providers, mental health providers, oral health providers, physicians and osteopathic physicians licensed under chapter 453, advanced practice registered nurses licensed under chapter 457, psychologists licensed under chapter 465, and dentists licensed under chapter 448.
"Interactive telecommunications
system" means multimedia communications equipment that includes, at a
minimum, audio and video equipment permitting two-way, real-time interactive
communications between the patient and distant site physician or practitioner;
provided that, for services furnished for purposes of diagnosis, evaluation, or
treatment of a mental health disorder to a patient in the patient's home,
interactive telecommunications may include two-way, real-time audio-only
communication technology if the distant site physician or practitioner is
technically capable of using an interactive telecommunications system but the
patient is not capable of, or does not consent to, the use of video technology;
provided further that the term shall have the same meaning as the term is
defined in title 42 Code of Federal Regulations section 410.78, as amended.
"Originating site" means the location where the patient is located, whether accompanied or not by a health care provider, at the time services are provided by a health care provider through telehealth, including but not limited to a health care provider's office, hospital, health care facility, a patient's home, and other nonmedical environments such as school-based health centers, university-based health centers, or the work location of a patient.
"Telehealth"
means the use of telecommunications services, as defined in section 269‑1,
to encompass four modalities: store and
forward technologies, remote monitoring, live consultation, and mobile health;
and which shall include but not be limited to real-time video
conferencing-based communication, secure interactive and non‑interactive
web-based communication, and secure asynchronous information exchange, to
transmit patient medical information, including diagnostic-quality digital
images and laboratory results for medical interpretation and diagnosis, for the
purpose of delivering enhanced health care services and information while a
patient is at an originating site and the health care provider is at a distant
site. [Standard] Except as
otherwise provided in this section, standard telephone contacts, facsimile
transmissions, or e-mail text, in combination or [by itself, does] alone,
do not constitute [a] telehealth [service for the purposes of
this chapter.] services."
SECTION 5. Section 432D-23.5, Hawaii Revised Statutes, is amended as follows:
1. By amending subsection (c) to read:
"(c) Reimbursement for services provided through telehealth via an interactive telecommunications system shall be equivalent to reimbursement for the same services provided via face-to-face contact between a health care provider and a patient. Nothing in this section shall require a health care provider to be physically present with the patient at an originating site unless a health care provider at the distant site deems it necessary."
2. By amending subsection (g) to read:
"(g) For the purposes of this section:
"Distant
site" means the location of the health care provider delivering services
through telehealth at the time the services are provided.
"Health care provider" means a provider of services, as defined in title 42 United States Code section 1395x(u), a provider of medical and other health services, as defined in title 42 United States Code section 1395x(s), other practitioners licensed by the State and working within their scope of practice, and any other person or organization who furnishes, bills, or is paid for health care in the normal course of business, including but not limited to primary care providers, mental health providers, oral health providers, physicians and osteopathic physicians licensed under chapter 453, advanced practice registered nurses licensed under chapter 457, psychologists licensed under chapter 465, and dentists licensed under chapter 448.
"Interactive telecommunications
system" means multimedia communications equipment that includes, at a
minimum, audio and video equipment permitting two-way, real-time interactive
communications between the patient and distant site physician or practitioner;
provided that, for services furnished for purposes of diagnosis, evaluation, or
treatment of a mental health disorder to a patient in the patient's home,
interactive telecommunications may include two-way, real-time audio-only
communication technology if the distant site physician or practitioner is
technically capable of using an interactive telecommunications system but the
patient is not capable of, or does not consent to, the use of video technology;
provided further that the term shall have the same meaning as the term is
defined in title 42 Code of Federal Regulations section 410.78, as amended.
"Originating site" means the location where the patient is located, whether accompanied or not by a health care provider, at the time services are provided by a health care provider through telehealth, including but not limited to a health care provider's office, hospital, health care facility, a patient's home, and other nonmedical environments such as school-based health centers, university-based health centers, or the work location of a patient.
"Telehealth"
means the use of telecommunications services, as defined in section 269‑1,
to encompass four modalities: store and
forward technologies, remote monitoring, live consultation, and mobile health;
and which shall include but not be limited to real-time video
conferencing-based communication, secure interactive and non‑interactive
web-based communication, and secure asynchronous information exchange, to
transmit patient medical information, including diagnostic-quality digital
images and laboratory results for medical interpretation and diagnosis, for the
purpose of delivering enhanced health care services and information while a
patient is at an originating site and the health care provider is at a distant
site. [Standard] Except as
otherwise provided in this section, standard telephone contacts, facsimile
transmissions, or e-mail text, in combination or [by itself, does] alone,
do not constitute [a] telehealth [service for the purposes of
this chapter.] services."
SECTION 6. Statutory material to be repealed is bracketed and stricken. New statutory material is underscored.
SECTION 7. This Act shall take effect upon its approval.
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INTRODUCED BY: |
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Report Title:
Telehealth; Interactive Telecommunications System; Audio-Only Communication Technology; Mental Health Disorders
Description:
Clarifies reimbursement for services provided through telehealth via an interactive telecommunications system. Defines "interactive telecommunications system". Clarifies that, for services furnished for purposes of diagnosis, evaluation, or treatment of a mental health disorder to a patient in the patient's home, interactive telecommunications may include audio-only communication in certain circumstances.
The summary description
of legislation appearing on this page is for informational purposes only and is
not legislation or evidence of legislative intent.