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| To enact sections 1739.051, 1751.69, 3923.235, and | 1 |
| 5111.0216 of the Revised Code regarding Medicaid | 2 |
| and health insurance coverage of telehealth | 3 |
| services. | 4 |
| Section 1. That sections 1739.051, 1751.69, 3923.235, and | 5 |
| 5111.0216 of the Revised Code be enacted to read as follows: | 6 |
| Sec. 1739.051. (A) As used in this section, "telehealth | 7 |
| service" means a health care service delivered to a patient | 8 |
| through the use of interactive audio, video, or other | 9 |
| telecommunications or electronic technology from a site other than | 10 |
| the site where the patient is located. | 11 |
| (B) A multiple employer welfare arrangement operating a group | 12 |
| self-insurance program may include coverage of telehealth | 13 |
| services. | 14 |
| (C) If coverage of telehealth services is included in a group | 15 |
| self-insurance program operated by a multiple employer welfare | 16 |
| arrangement, all of the following apply: | 17 |
| (1) The coverage applies only to telehealth services that | 18 |
| involve a health care provider's immediate or direct interaction | 19 |
| with a patient and only if the services are medically appropriate | 20 |
| and medically necessary. | 21 |
| (2) The coverage extends to telehealth services provided by | 22 |
| either a health care professional or health care facility, but the | 23 |
| coverage applies only if, at the time the telehealth services are | 24 |
| provided, the professional or facility is licensed, certified, or | 25 |
| registered in this state as a health care professional or health | 26 |
| care facility, as applicable. | 27 |
| (3) The coverage applies only to telehealth services provided | 28 |
| through systems that are secure, as evidenced by adherence to | 29 |
| standards established in federal regulations adopted pursuant to | 30 |
| the "Health Insurance Portability and Accountability Act of 1996," | 31 |
| Pub. L. No. 104-191, as amended, with respect to ensuring the | 32 |
| confidentiality, integrity, and security of electronic protected | 33 |
| health information, including the standards established in 45 | 34 |
| C.F.R. Part 160 and Subparts A and C of 45 C.F.R. Part 164. | 35 |
| (D) If a health care provider intends to seek reimbursement | 36 |
| for providing telehealth services covered pursuant to this | 37 |
| section, all of the following apply: | 38 |
| (1) Before providing telehealth services to a patient, the | 39 |
| health care provider, except as provided in division (D)(2) of | 40 |
| this section, shall do both of the following: | 41 |
| (a) Verbally inform the patient or the patient's authorized | 42 |
| representative that telehealth services may be used in providing | 43 |
| health care services to the patient. | 44 |
| (b) Obtain verbal consent to the use of telehealth services | 45 |
| from the patient or the patient's authorized representative. | 46 |
| (2) The health care provider is not required to provide the | 47 |
| information or obtain the consent described in division (D)(1) of | 48 |
| this section in any circumstance, such as an emergency, in which a | 49 |
| patient or the patient's authorized representative is unable to | 50 |
| provide consent before it is necessary to provide the services. | 51 |
| (3) The health care provider shall retain relevant | 52 |
| documentation of providing the telehealth services as part of the | 53 |
| patient records maintained by the provider, including | 54 |
| documentation of the consent obtained in accordance with division | 55 |
| (D)(1) of this section. | 56 |
| Sec. 1751.69. (A) As used in this section, "telehealth | 57 |
| service" means a health care service delivered to a patient | 58 |
| through the use of interactive audio, video, or other | 59 |
| telecommunications or electronic technology from a site other than | 60 |
| the site where the patient is located. | 61 |
| (B) An individual or group health insuring corporation | 62 |
| policy, contract, or agreement delivered, issued for delivery, or | 63 |
| renewed in this state policy may include coverage of telehealth | 64 |
| services. | 65 |
| (C) If coverage of telehealth services is included in an | 66 |
| individual or group health insuring corporation policy, contract, | 67 |
| or agreement, all of the following apply: | 68 |
| (1) The coverage applies only to telehealth services that | 69 |
| involve a health care provider's immediate or direct interaction | 70 |
| with a patient and only if the services are medically appropriate | 71 |
| and medically necessary. | 72 |
| (2) The coverage extends to telehealth services provided by | 73 |
| either a health care professional or health care facility, but the | 74 |
| coverage applies only if, at the time the telehealth services are | 75 |
| provided, the professional or facility is licensed, certified, or | 76 |
| registered in this state as a health care professional or health | 77 |
| care facility, as applicable. | 78 |
| (3) The coverage applies only to telehealth services provided | 79 |
| through systems that are secure, as evidenced by adherence to | 80 |
| standards established in federal regulations adopted pursuant to | 81 |
| the "Health Insurance Portability and Accountability Act of 1996," | 82 |
| Pub. L. No. 104-191, as amended, with respect to ensuring the | 83 |
| confidentiality, integrity, and security of electronic protected | 84 |
| health information, including the standards established in 45 | 85 |
| C.F.R. Part 160 and Subparts A and C of 45 C.F.R. Part 164. | 86 |
| (D) If a health care provider intends to seek reimbursement | 87 |
| for providing telehealth services covered pursuant to this | 88 |
| section, all of the following apply: | 89 |
| (1) Before providing telehealth services to a patient, the | 90 |
| health care provider, except as provided in division (D)(2) of | 91 |
| this section, shall do both of the following: | 92 |
| (a) Verbally inform the patient or the patient's authorized | 93 |
| representative that telehealth services may be used in providing | 94 |
| health care services to the patient. | 95 |
| (b) Obtain verbal consent to the use of telehealth services | 96 |
| from the patient or the patient's authorized representative. | 97 |
| (2) The health care provider is not required to provide the | 98 |
| information or obtain the consent described in division (D)(1) of | 99 |
| this section in any circumstance, such as an emergency, in which a | 100 |
| patient or the patient's authorized representative is unable to | 101 |
| provide consent before it is necessary to provide the services. | 102 |
| (3) The health care provider shall retain relevant | 103 |
| documentation of providing the telehealth services as part of the | 104 |
| patient records maintained by the provider, including | 105 |
| documentation of the consent obtained in accordance with division | 106 |
| (D)(1) of this section. | 107 |
| Sec. 3923.235. (A) As used in this section, "telehealth | 108 |
| service" means a health care service delivered to a patient | 109 |
| through the use of interactive audio, video, or other | 110 |
| telecommunications or electronic technology from a site other than | 111 |
| the site where the patient is located. | 112 |
| (B) An individual or group policy of sickness and accident | 113 |
| insurance delivered, issued for delivery, or renewed in this state | 114 |
| may include coverage of telehealth services. A public employee | 115 |
| benefit plan established or modified in this state may include | 116 |
| coverage of telehealth services. | 117 |
| (C) If coverage of telehealth services is included in an | 118 |
| individual or group policy of sickness and accident insurance or a | 119 |
| public employee benefit plan, all of the following apply: | 120 |
| (1) The coverage applies only to telehealth services that | 121 |
| involve a health care provider's immediate or direct interaction | 122 |
| with a patient and only if the services are medically appropriate | 123 |
| and medically necessary. | 124 |
| (2) The coverage extends to telehealth services provided by | 125 |
| either a health care professional or health care facility, but the | 126 |
| coverage applies only if, at the time the telehealth services are | 127 |
| provided, the professional or facility is licensed, certified, or | 128 |
| registered in this state as a health care professional or health | 129 |
| care facility, as applicable. | 130 |
| (3) The coverage applies only to telehealth services provided | 131 |
| through systems that are secure, as evidenced by adherence to | 132 |
| standards established in federal regulations adopted pursuant to | 133 |
| the "Health Insurance Portability and Accountability Act of 1996," | 134 |
| Pub. L. No. 104-191, as amended, with respect to ensuring the | 135 |
| confidentiality, integrity, and security of electronic protected | 136 |
| health information, including the standards established in 45 | 137 |
| C.F.R. Part 160 and Subparts A and C of 45 C.F.R. Part 164. | 138 |
| (D) If a health care provider intends to seek reimbursement | 139 |
| for providing telehealth services covered pursuant to this | 140 |
| section, all of the following apply: | 141 |
| (1) Before providing telehealth services to a patient, the | 142 |
| health care provider, except as provided in division (D)(2) of | 143 |
| this section, shall do both of the following: | 144 |
| (a) Verbally inform the patient or the patient's authorized | 145 |
| representative that telehealth services may be used in providing | 146 |
| health care services to the patient. | 147 |
| (b) Obtain verbal consent to the use of telehealth services | 148 |
| from the patient or the patient's authorized representative. | 149 |
| (2) The health care provider is not required to provide the | 150 |
| information or obtain the consent described in division (D)(1) of | 151 |
| this section in any circumstance, such as an emergency, in which a | 152 |
| patient or the patient's authorized representative is unable to | 153 |
| provide consent before it is necessary to provide the services. | 154 |
| (3) The health care provider shall retain relevant | 155 |
| documentation of providing the telehealth services as part of the | 156 |
| patient records maintained by the provider, including | 157 |
| documentation of the consent obtained in accordance with division | 158 |
| (D)(1) of this section. | 159 |
| Sec. 5111.0216. (A) As used in this section, "telehealth | 160 |
| service" means a health care service delivered to a patient | 161 |
| through the use of interactive audio, video, or other | 162 |
| telecommunications or electronic technology from a site other than | 163 |
| the site where the patient is located. | 164 |
| (B) The office of medical assistance shall establish | 165 |
| standards for medicaid reimbursement for health care services the | 166 |
| office determines are appropriate to be covered by the medicaid | 167 |
| program when provided as telehealth services. The standards shall | 168 |
| be established in rules adopted under section 5111.02 of the | 169 |
| Revised Code. | 170 |
| (C) With respect to any medicaid coverage of telehealth | 171 |
| services, all of the following apply: | 172 |
| (1) The coverage applies only to telehealth services that | 173 |
| involve a health care provider's immediate or direct interaction | 174 |
| with a patient and only if the services are medically appropriate | 175 |
| and medically necessary. | 176 |
| (2) The coverage extends to telehealth services provided by | 177 |
| either a health care professional or health care facility, but the | 178 |
| coverage applies only if, at the time the telehealth services are | 179 |
| provided, both of the following are the case: | 180 |
| (a) The professional or facility is licensed, certified, or | 181 |
| registered in this state as a health care professional or health | 182 |
| care facility, as applicable. | 183 |
| (b) The professional or facility holds a valid medicaid | 184 |
| provider agreement. | 185 |
| (3) The coverage applies only if either of the following is | 186 |
| the case: | 187 |
| (a) The coverage is at least as cost effective as the | 188 |
| program's coverage of health care services when provided by a | 189 |
| health care provider at the same site where the patient is | 190 |
| located. | 191 |
| (b) The coverage is provided as necessary to support the | 192 |
| medicaid program's administrative responsibilities under the | 193 |
| "Social Security Act," section 1902, 42 U.S.C. 1396a(a)(30)(A), | 194 |
| with respect to enlisting a sufficient number of providers under | 195 |
| the program. | 196 |
| (4) The coverage applies only to telehealth services provided | 197 |
| through systems that are secure, as determined by the office of | 198 |
| medical assistance. | 199 |
| (D) If a health care provider intends to seek reimbursement | 200 |
| for providing telehealth services, the provider shall retain | 201 |
| relevant documentation of providing the services as part of the | 202 |
| patient records maintained by the provider. | 203 |