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To enact sections 1739.23, 1751.69, 3923.235, and | 1 |
5111.026 of the Revised Code regarding insurance | 2 |
and Medicaid coverage of telemedicine services. | 3 |
Section 1. That sections 1739.23, 1751.69, 3923.235, and | 4 |
5111.026 of the Revised Code be enacted to read as follows: | 5 |
Sec. 1739.23. (A) As used in this section: | 6 |
(1) "Physician" means an individual authorized under Chapter | 7 |
4731. of the Revised Code to practice medicine and surgery or | 8 |
osteopathic medicine and surgery, including the holder of a | 9 |
telemedicine certificate issued under section 4731.296 of the | 10 |
Revised Code. | 11 |
(2) "Telemedicine service" means a medical service delivered | 12 |
by a physician through the use of any communication, including | 13 |
oral, written, or electronic communication. | 14 |
(B) Notwithstanding section 3901.71 of the Revised Code, no | 15 |
multiple employer welfare arrangement operating a group | 16 |
self-insurance program shall exclude coverage for a telemedicine | 17 |
service solely because the service is not provided through a | 18 |
face-to-face consultation. The arrangement may require a | 19 |
deductible, copayment, or coinsurance for the telemedicine | 20 |
service. The amount of the deductible, copayment, or coinsurance | 21 |
shall not exceed the amount of the deductible, copayment, or | 22 |
coinsurance required for a comparable medical service provided | 23 |
through a face-to-face consultation. | 24 |
Sec. 1751.69. (A) As used in this section: | 25 |
(1) "Physician" means an individual authorized under Chapter | 26 |
4731. of the Revised Code to practice medicine and surgery or | 27 |
osteopathic medicine and surgery, including the holder of a | 28 |
telemedicine certificate issued under section 4731.296 of the | 29 |
Revised Code. | 30 |
(2) "Telemedicine service" means a medical service delivered | 31 |
by a physician through the use of any communication, including | 32 |
oral, written, or electronic communication. | 33 |
(B) Notwithstanding section 3901.71 of the Revised Code, no | 34 |
individual or group health insuring corporation policy, contract, | 35 |
or agreement that is delivered, issued for delivery, or renewed in | 36 |
this state shall exclude coverage for a telemedicine service | 37 |
solely because the service is not provided through a face-to-face | 38 |
consultation. The policy, contract, or agreement may require a | 39 |
deductible, copayment, or coinsurance for the telemedicine | 40 |
service. The amount of the deductible, copayment, or coinsurance | 41 |
shall not exceed the amount of the deductible, copayment, or | 42 |
coinsurance required for a comparable medical service provided | 43 |
through a face-to-face consultation. | 44 |
Sec. 3923.235. (A) As used in this section: | 45 |
(1) "Physician" means an individual authorized under Chapter | 46 |
4731. of the Revised Code to practice medicine and surgery or | 47 |
osteopathic medicine and surgery, including the holder of a | 48 |
telemedicine certificate issued under section 4731.296 of the | 49 |
Revised Code. | 50 |
(2) "Telemedicine service" means a medical service delivered | 51 |
by a physician through the use of any communication, including | 52 |
oral, written, or electronic communication. | 53 |
(B) Notwithstanding section 3901.71 of the Revised Code, no | 54 |
individual or group policy of sickness and accident insurance | 55 |
delivered, issued for delivery, or renewed in this state shall | 56 |
exclude coverage for a telemedicine service solely because the | 57 |
service is not provided through a face-to-face consultation. The | 58 |
policy may require a deductible, copayment, or coinsurance for the | 59 |
telemedicine service. The amount of the deductible, copayment, or | 60 |
coinsurance shall not exceed the amount of the deductible, | 61 |
copayment, or coinsurance required for a comparable medical | 62 |
service provided through a face-to-face consultation. | 63 |
Sec. 5111.026. (A) As used in this section: | 64 |
(1) "Physician" means an individual authorized under Chapter | 65 |
4731. of the Revised Code to practice medicine and surgery or | 66 |
osteopathic medicine and surgery, including the holder of a | 67 |
telemedicine certificate issued under section 4731.296 of the | 68 |
Revised Code. | 69 |
(2) "Telemedicine service" means a medical service delivered | 70 |
by a physician through the use of any communication, including | 71 |
oral, written, or electronic communication. | 72 |
(B) The director of job and family services shall do all of | 73 |
the following with respect to the provision of telemedicine | 74 |
services: | 75 |
(1) Ensure that the medicaid program does not exclude | 76 |
coverage for a telemedicine service solely because the service is | 77 |
not provided through a face-to-face consultation; | 78 |
(2) Ensure that the medicaid program does not require a | 79 |
medical service to be provided to a medicaid recipient through a | 80 |
telemedicine service when the service can reasonably be provided | 81 |
through a face-to-face consultation; | 82 |
(3) Establish a system to monitor the provision of | 83 |
telemedicine services to medicaid recipients for purposes of | 84 |
ensuring quality care and preventing fraud and abuse. | 85 |
(C) The director may require a face-to-face consultation | 86 |
between a medicaid recipient and a physician to occur following an | 87 |
initial telemedicine service only if the physician who provided | 88 |
the service had never before seen the recipient as a patient. The | 89 |
director may specify a period of time within which the | 90 |
consultation must occur. | 91 |