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S. B. No. 28 As Introduced
As Introduced
129th General Assembly | Regular Session | 2011-2012 |
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A BILL
To enact sections 1739.23, 1751.69, 3923.235, and
5111.026 of the Revised Code regarding insurance
and Medicaid coverage of telemedicine services.
BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF OHIO:
Section 1. That sections 1739.23, 1751.69, 3923.235, and
5111.026 of the Revised Code be enacted to read as follows:
Sec. 1739.23. (A) As used in this section:
(1) "Physician" means an individual authorized under Chapter
4731. of the Revised Code to practice medicine and surgery or
osteopathic medicine and surgery, including the holder of a
telemedicine certificate issued under section 4731.296 of the
Revised Code.
(2) "Telemedicine service" means a medical service delivered
by a physician through the use of any communication, including
oral, written, or electronic communication.
(B) Notwithstanding section 3901.71 of the Revised Code, no
multiple employer welfare arrangement operating a group
self-insurance program shall exclude coverage for a telemedicine
service solely because the service is not provided through a
face-to-face consultation. The arrangement may require a
deductible, copayment, or coinsurance for the telemedicine
service. The amount of the deductible, copayment, or coinsurance
shall not exceed the amount of the deductible, copayment, or
coinsurance required for a comparable medical service provided
through a face-to-face consultation.
Sec. 1751.69. (A) As used in this section:
(1) "Physician" means an individual authorized under Chapter
4731. of the Revised Code to practice medicine and surgery or
osteopathic medicine and surgery, including the holder of a
telemedicine certificate issued under section 4731.296 of the
Revised Code.
(2) "Telemedicine service" means a medical service delivered
by a physician through the use of any communication, including
oral, written, or electronic communication.
(B) Notwithstanding section 3901.71 of the Revised Code, no
individual or group health insuring corporation policy, contract,
or agreement that is delivered, issued for delivery, or renewed in
this state shall exclude coverage for a telemedicine service
solely because the service is not provided through a face-to-face
consultation. The policy, contract, or agreement may require a
deductible, copayment, or coinsurance for the telemedicine
service. The amount of the deductible, copayment, or coinsurance
shall not exceed the amount of the deductible, copayment, or
coinsurance required for a comparable medical service provided
through a face-to-face consultation.
Sec. 3923.235. (A) As used in this section:
(1) "Physician" means an individual authorized under Chapter
4731. of the Revised Code to practice medicine and surgery or
osteopathic medicine and surgery, including the holder of a
telemedicine certificate issued under section 4731.296 of the
Revised Code.
(2) "Telemedicine service" means a medical service delivered
by a physician through the use of any communication, including
oral, written, or electronic communication.
(B) Notwithstanding section 3901.71 of the Revised Code, no
individual or group policy of sickness and accident insurance
delivered, issued for delivery, or renewed in this state shall
exclude coverage for a telemedicine service solely because the
service is not provided through a face-to-face consultation. The
policy may require a deductible, copayment, or coinsurance for the
telemedicine service. The amount of the deductible, copayment, or
coinsurance shall not exceed the amount of the deductible,
copayment, or coinsurance required for a comparable medical
service provided through a face-to-face consultation.
Sec. 5111.026. (A) As used in this section:
(1) "Physician" means an individual authorized under Chapter
4731. of the Revised Code to practice medicine and surgery or
osteopathic medicine and surgery, including the holder of a
telemedicine certificate issued under section 4731.296 of the
Revised Code.
(2) "Telemedicine service" means a medical service delivered
by a physician through the use of any communication, including
oral, written, or electronic communication.
(B) The director of job and family services shall do all of
the following with respect to the provision of telemedicine
services:
(1) Ensure that the medicaid program does not exclude
coverage for a telemedicine service solely because the service is
not provided through a face-to-face consultation;
(2) Ensure that the medicaid program does not require a
medical service to be provided to a medicaid recipient through a
telemedicine service when the service can reasonably be provided
through a face-to-face consultation;
(3) Establish a system to monitor the provision of
telemedicine services to medicaid recipients for purposes of
ensuring quality care and preventing fraud and abuse.
(C) The director may require a face-to-face consultation
between a medicaid recipient and a physician to occur following an
initial telemedicine service only if the physician who provided
the service had never before seen the recipient as a patient. The
director may specify a period of time within which the
consultation must occur.
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