130th Ohio General Assembly
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S. B. No. 28  As Introduced
As Introduced

129th General Assembly
Regular Session
2011-2012
S. B. No. 28


Senator Tavares 



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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