To enact sections 1739.051, 1751.69, 3923.235, and 5111.0216 of the Revised Code to require the Medicaid program and to authorize health care insurers to provide coverage of telehealth services.

Section 1. That sections 1739.051, 1751.69, 3923.235, and 5111.0216 of the Revised Code be enacted to read as follows:

Sec. 1739.051.  (A) As used in this section:

(1) "Asynchronous store and forward action" means the transmission of a patient's medical information from an originating site to a health care provider at a distant site for review of the information by the provider at the distant site without a synchronous interaction.

(2) "Distant site" means the location of a health care provider when providing telehealth services to a patient.

(3) "Health care provider" means a person or government entity licensed, certified, registered, or otherwise authorized to provide health care services to patients as a health care professional or a health care facility.

(4) "Originating site" means both of the following:

(a) The location of a patient when receiving telehealth services from a health care provider;

(b) The location where an asynchronous store and forward action originates.

(5) "Synchronous interaction" means a real-time interaction between a patient receiving telehealth services at an originating site and a health care provider delivering telehealth services from a distant site.

(6) "Telehealth" means the use of interactive audio, video, and other telecommunications technology by a health care provider to deliver health care services between a distant site and an originating site for diagnosis and treatment of a patient.

(7) "Telehealth service" means a health care service provided through telehealth, including a service provided through a synchronous interaction or asynchronous store and forward action.

(B) A multiple employer welfare arrangement operating a group self-insurance program may include coverage of telehealth services.

(C) If coverage of telehealth services is included in a group self-insurance program operated by a multiple employer welfare arrangement, all of the following apply:

(1) The coverage is applicable only to telehealth services that are medically appropriate and medically necessary.

(2) Except as provided in divisions (D)(3) and (4) of this section, the coverage of a telehealth service is to be the same in amount, duration, and scope as the coverage that applies to a service delivered in person to a patient.

(3) When the provision of a telehealth service includes actions performed by both a health care provider and a health care facility, the coverage of the service is limited to a single reimbursement amount for that provider and facility.

(4) The coverage is not applicable to a telehealth service unless, when the service is provided, the health care provider is licensed, certified, registered, or otherwise authorized in this state to provide the service.

(D) If a health care provider intends to seek reimbursement for providing a telehealth service, the provider shall retain relevant documentation of providing the service and any subsequent telehealth service as part of the patient records maintained by the provider.

(E) This section does not alter any coverage that may be available for telemedicine services provided to a patient in this state by a physician who is located outside this state and is practicing under a telemedicine certificate issued by the state medical board under section 4731.296 of the Revised Code.

Sec. 1751.69.  (A) As used in this section:

(1) "Asynchronous store and forward action" means the transmission of a patient's medical information from an originating site to a health care provider at a distant site for review of the information by the provider at the distant site without a synchronous interaction.

(2) "Distant site" means the location of a health care provider when providing telehealth services to a patient.

(3) "Health care provider" means a person or government entity licensed, certified, registered, or otherwise authorized to provide health care services to patients as a health care professional or a health care facility.

(4) "Originating site" means both of the following:

(a) The location of a patient when receiving telehealth services from a health care provider;

(b) The location where an asynchronous store and forward action originates.

(5) "Synchronous interaction" means a real-time interaction between a patient receiving telehealth services at an originating site and a health care provider delivering telehealth services from a distant site.

(6) "Telehealth" means the use of interactive audio, video, and other telecommunications technology by a health care provider to deliver health care services between a distant site and an originating site for diagnosis and treatment of a patient.

(7) "Telehealth service" means a health care service provided through telehealth, including a service provided through a synchronous interaction or asynchronous store and forward action.

(B) An individual or group health insuring corporation policy, contract, or agreement delivered, issued for delivery, or renewed in this state policy may include coverage of telehealth services.

(C) If coverage of telehealth services is included in an individual or group health insuring corporation policy, contract, or agreement, all of the following apply:

(1) The coverage is applicable only to telehealth services that are medically appropriate and medically necessary.

(2) Except as provided in divisions (D)(3) and (4) of this section, the coverage of a telehealth service is to be the same in amount, duration, and scope as the coverage that applies to a service delivered in person to a patient.

(3) When the provision of a telehealth service includes actions performed by both a health care provider and a health care facility, the coverage of the service is limited to a single reimbursement amount for that provider and facility.

(4) The coverage is not applicable to a telehealth service unless, when the service is provided, the health care provider is licensed, certified, registered, or otherwise authorized in this state to provide the service.

(D) If a health care provider intends to seek reimbursement for providing a telehealth service, the provider shall retain relevant documentation of providing the service and any subsequent telehealth service as part of the patient records maintained by the provider.

(E) This section does not alter any coverage that may be available for telemedicine services provided to a patient in this state by a physician who is located outside this state and is practicing under a telemedicine certificate issued by the state medical board under section 4731.296 of the Revised Code.

Sec. 3923.235.  (A) As used in this section:

(1) "Asynchronous store and forward action" means the transmission of a patient's medical information from an originating site to a health care provider at a distant site for review of the information by the provider at the distant site without a synchronous interaction.

(2) "Distant site" means the location of a health care provider when providing telehealth services to a patient.

(3) "Health care provider" means a person or government entity licensed, certified, registered, or otherwise authorized to provide health care services to patients as a health care professional or a health care facility.

(4) "Originating site" means both of the following:

(a) The location of a patient when receiving telehealth services from a health care provider;

(b) The location where an asynchronous store and forward action originates.

(5) "Synchronous interaction" means a real-time interaction between a patient receiving telehealth services at an originating site and a health care provider delivering telehealth services from a distant site.

(6) "Telehealth" means the use of interactive audio, video, and other telecommunications technology by a health care provider to deliver health care services between a distant site and an originating site for diagnosis and treatment of a patient.

(7) "Telehealth service" means a health care service provided through telehealth, including a service provided through a synchronous interaction or asynchronous store and forward action.

(B) An individual or group policy of sickness and accident insurance delivered, issued for delivery, or renewed in this state may include coverage of telehealth services. A public employee benefit plan established or modified in this state may include coverage of telehealth services.

(C) If coverage of telehealth services is included in an individual or group policy of sickness and accident insurance or a public employee benefit plan, all of the following apply:

(1) The coverage is applicable only to telehealth services that are medically appropriate and medically necessary.

(2) Except as provided in divisions (D)(3) and (4) of this section, the coverage of a telehealth service is to be the same in amount, duration, and scope as the coverage that applies to a service delivered in person to a patient.

(3) When the provision of a telehealth service includes actions performed by both a health care provider and a health care facility, the coverage of the service is limited to a single reimbursement amount for that provider and facility.

(4) The coverage is not applicable to a telehealth service unless, when the service is provided, the health care provider is licensed, certified, registered, or otherwise authorized in this state to provide the service.

(D) If a health care provider intends to seek reimbursement for providing a telehealth service, the provider shall retain relevant documentation of providing the service and any subsequent telehealth service as part of the patient records maintained by the provider.

(E) This section does not alter any coverage that may be available for telemedicine services provided to a patient in this state by a physician who is located outside this state and is practicing under a telemedicine certificate issued by the state medical board under section 4731.296 of the Revised Code.

Sec. 5111.0216.  (A) As used in this section:

(1) "Asynchronous store and forward action" means the transmission of a patient's medical information from an originating site to a health care provider at a distant site for review of the information by the provider at the distant site without a synchronous interaction.

(2) "Distant site" means the location of a health care provider when providing telehealth services to a patient.

(3) "Health care provider" means a person or government entity licensed, certified, registered, or otherwise authorized to provide health care services to patients as a health care professional or a health care facility.

(4) "Originating site" means both of the following:

(a) The location of a patient when receiving telehealth services from a health care provider;

(b) The location where an asynchronous store and forward action originates.

(5) "Synchronous interaction" means a real-time interaction between a patient receiving telehealth services at an originating site and a health care provider delivering telehealth services from a distant site.

(6) "Telehealth" means the use of interactive audio, video, and other telecommunications technology by a health care provider to deliver health care services between a distant site and an originating site for diagnosis and treatment of a patient.

(7) "Telehealth service" means a health care service provided through telehealth, including a service provided through a synchronous interaction or asynchronous store and forward action.

(B) The medicaid program shall provide coverage of telehealth services. The coverage shall be extended to all components of the medicaid program, including services provided through the care management system established under section 5111.16 of the Revised Code.

(C) With respect to the medicaid program's coverage of telehealth services, all of the following apply:

(1) The coverage is applicable only to telehealth services that are medically appropriate and medically necessary.

(2) Except as provided in divisions (D)(3) and (4) of this section, the coverage of a telehealth service is to be the same in amount, duration, and scope as the coverage that applies to a service delivered in person to a patient.

(3) When the provision of a telehealth service includes actions performed by both a health care provider and a health care facility, the coverage of the service is limited to a single reimbursement amount for that provider and facility.

(4) The coverage is not applicable to a telehealth service unless, when the service is provided, the health care provider is licensed, certified, registered, or otherwise authorized in this state to provide the service.

(5) The coverage is applicable only if the health care provider holds a valid medicaid provider agreement.

(D) If a health care provider intends to seek reimbursement for providing a telehealth service, the provider shall retain relevant documentation of providing the service and any subsequent telehealth service as part of the patient records maintained by the provider.

(E) This section does not alter any coverage that may be available for telemedicine services provided to a patient in this state by a physician who is located outside this state and is practicing under a telemedicine certificate issued by the state medical board under section 4731.296 of the Revised Code.