2023 New York Laws › ISC - Insurance › Article 43 - Non-Profit Medical and Dental Indemnity, or Health and Hospital Service Corporations › 4306-G - Telehealth Delivery of Services.

§  4306-g.  Telehealth  delivery  of services. * (a) (1) A corporation
shall not exclude from coverage a  service  that  is  otherwise  covered
under  a  contract  that  provides  comprehensive coverage for hospital,
medical  or  surgical  care  because  the  service  is   delivered   via
telehealth,  as  that term is defined in subsection (b) of this section;
provided, however, that  a  corporation  may  exclude  from  coverage  a
service  by  a  health care provider where the provider is not otherwise
covered under the contract.  A corporation may subject the coverage of a
service  delivered  via  telehealth  to  co-payments,   coinsurance   or
deductibles  provided that they are at least as favorable to the insured
as those established  for  the  same  service  when  not  delivered  via
telehealth.  A  corporation  may  subject  the  coverage  of  a  service
delivered  via  telehealth  to  reasonable  utilization  management  and
quality   assurance   requirements   that   are  consistent  with  those
established for the same service when not delivered via telehealth.
(2) A corporation that provides comprehensive coverage  for  hospital,
medical  or  surgical care shall reimburse covered services delivered by
means of telehealth on the same basis, at the same rate, and to the same
extent that such services  are  reimbursed  when  delivered  in  person;
provided that reimbursement of covered services delivered via telehealth
shall  not  require  reimbursement of costs not actually incurred in the
provision of the telehealth services, including charges related  to  the
use  of a clinic or other facility when neither the originating site nor
the distant  site  occur  within  the  clinic  or  other  facility.  The
superintendent may promulgate regulations to implement the provisions of
this section.
(3)  A  corporation that provides comprehensive coverage for hospital,
medical, or surgical care with a network of health care providers  shall
ensure  that  such  network  is adequate to meet the telehealth needs of
insured individuals for services covered under the policy when medically
appropriate.
* NB Effective until April 1, 2026
* (a) A corporation shall not exclude from coverage a service that  is
otherwise  covered under a contract that provides comprehensive coverage
for hospital, medical or surgical care because the service is  delivered
via  telehealth,  as  that  term  is  defined  in subsection (b) of this
section; provided, however, that a corporation may exclude from coverage
a service by a health care provider where the provider is not  otherwise
covered  under the contract. A corporation may subject the coverage of a
service  delivered  via  telehealth  to  co-payments,   coinsurance   or
deductibles  provided that they are at least as favorable to the insured
as those established  for  the  same  service  when  not  delivered  via
telehealth.  A  corporation  may  subject  the  coverage  of  a  service
delivered  via  telehealth  to  reasonable  utilization  management  and
quality   assurance   requirements   that   are  consistent  with  those
established for the same service when not delivered via telehealth.
* NB Effective April 1, 2026
(b) For purposes of  this  section,  "telehealth"  means  the  use  of
electronic  information  and communication technologies by a health care
provider to deliver health care services to an insured individual  while
such  individual  is  located  at a site that is different from the site
where the health care provider is located.