Report Title:

Telemedicine; Telehealth Reimbursements

 

Description:

Requires reimbursement for telehealth services provided to medicaid patients in Hawaii's health facilities.

 

THE SENATE

S.B. NO.

975

TWENTY-FIRST LEGISLATURE, 2001

 

STATE OF HAWAII

 


 

A BILL FOR AN ACT

 

relating to telemedicine.

 

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:

SECTION 1. The legislature is committed to improving access to, and quality of, health care for people living in our communities. People living in rural areas have limited access to basic health care due to geographic isolation, as well as the relative scarcity of rural physicians, limitations on physician reimbursement, poor, limited, and expensive transportation to larger cities, and weather and road conditions. Telemedicine holds great promise to enhance health care delivery in our communities by allowing physicians or other health professionals to examine patients while linked by video or other means to an expert consultant at a distant site. Radiologists and other specialists can review medical images transmitted over telephone lines. Pathologists can review biopsies done in another hospital while the patient is still under anesthesia. Without telemedicine, these services would require travel on the part of either the patient or the consultant, or would simply not be available to all.

Through the State Telehealth Access Network, Hawaii has the opportunity to greatly improve the access and quality of health care to all our citizens. Nearly all of Hawaii's hospitals have telemedicine capacity. However, reimbursement policies for telemedicine services are limited and inconsistent. Recently, the United States Health Care Financing Administration expanded reimbursement for telehealth services for medicare patients.

The purpose of this Act is to require reimbursement for telehealth services provided to medicaid patients in Hawaii's health facilities.

SECTION 2. Section 346-1, Hawaii Revised Statutes, is amended by adding three new definitions to be appropriately inserted and to read as follows:

""Advanced telecommunications technology" means transmission of data that includes:

(1) Compressed digital interactive video, audio, and data transmission;

(2) Clinical data transmission via computer imaging for teleradiology or telepathology; and

(3) Other technology that facilitates access in rural counties to health care services or medical specialty expertise.

"Health professional" means an advanced nurse practitioner, an allied health professional, a mental health professional, a physician, or a physician assistant who is licensed in this State or is permitted to perform telehealth services pursuant to law.

"Telemedical consultation" means a medical consultation for purposes of patient diagnosis or treatment that may appropriately be provided through the use of advanced telecommunications technology in accordance with generally accepted health care practices and standards prevailing in the applicable professional community at the time the services were provided."

SECTION 3. Section 346-14, Hawaii Revised Statutes, is amended to read as follows:

"§346-14 Duties generally. Except as otherwise provided by law, the department of human services shall:

(1) Establish and administer programs and standards, and adopt rules as deemed necessary for all public assistance programs;

(2) Establish, extend, and strengthen services for the protection and care of abused or neglected children and children in danger of becoming delinquent to make paramount the safety and health of children who have been harmed or are in life circumstances that threaten harm;

(3) Establish and administer programs, and adopt rules as deemed necessary, for the prevention of domestic and sexual violence and the protection and treatment of victims of domestic and sexual violence;

(4) Assist in preventing family breakdown;

(5) Place, or cooperate in placing, abused or neglected children in suitable private homes or institutions and place, or cooperate in placing, children in suitable adoptive homes;

(6) Have authority to establish, maintain, and operate receiving homes for the temporary care and custody of abused or neglected children until suitable plans are made for their care; and accept from the police and other agencies, for temporary care and custody, any abused or neglected child until satisfactory plans are made for the child;

(7) Administer the medical assistance programs for eligible public welfare and other medically needy individuals by establishing standards, eligibility, and health care participation rules, payment methodologies, reimbursement allowances, systems to monitor recipient and provider compliance, and assuring compliance with federal requirements to maximize federal financial participation;

(8) Cooperate with the federal government in carrying out the purposes of the Social Security Act and in other matters of mutual concern pertaining to public welfare, public assistance, and child welfare services, including the making of reports, the adoption of methods of administration, and the making of rules as are found by the federal government, or any properly constituted authority thereunder, to be necessary or desirable for the efficient operation of the plans for public welfare, assistance, and child welfare services or as may be necessary or desirable for the receipt of financial assistance from the federal government;

(9) Carry on research and compile statistics relative to public and private welfare activities throughout the State, including those dealing with dependence, defectiveness, delinquency, and related problems;

(10) Develop plans in cooperation with other public and private agencies for the prevention and treatment of conditions giving rise to public welfare problems;

(11) Adopt rules governing the procedure in hearings, investigations, recording, registration, determination of allowances, and accounting and conduct other activities as may be necessary or proper to carry out this chapter;

(12) Supervise or administer any other activities authorized or required by this chapter, including the development of the staff of the department through in-service training and educational leave to attend schools and other appropriate measures, and any other activities placed under the jurisdiction of the department by any other law;

(13) Make, prescribe, and enforce policies and rules governing the activities provided for in section 346-31 it deems advisable, including the allocation of moneys available for assistance to persons assigned to work projects among the several counties or to particular projects where the apportionment has not been made pursuant to other provisions of law, if any, governing expenditures of the funds;

(14) Determine the appropriate level for the Hawaii security net, by developing a tracking and monitoring system to determine what segments of the population are not able to afford the basic necessities of life, and advise the legislature annually regarding the resources required to maintain the security net at the appropriate level;

(15) Subject to the appropriation of state funds and availability of federal matching assistance, expand optional health care to low-income persons as follows:

(A) Pregnant women and infants under one year of age living in families with incomes up to one hundred eighty-five per cent of the federal poverty level and without any asset restrictions;

(B) Children under six years of age living in families with incomes up to one hundred thirty-three per cent of the federal poverty level and without any asset restrictions;

(C) Older children to the extent permitted under optional federal medicaid rules;

(D) Elder persons;

(E) Aliens;

(F) The homeless; and

(G) Other handicapped and medically needy persons; [and]

(16) Subject to the appropriation of state funds and availability of federal matching assistance, establish the income eligibility level for the medically needy program at one hundred thirty-three per cent of the assistance allowance[.];

(17) Establish reimbursement rates for health professionals performing telemedical consultation services for medicaid patients in health facilities that are consistent with the rates paid for the same or similar services performed face-to-face; and

(18) Establish reimbursement rates for health facilities for use of the advanced telecommunications technology."

SECTION 4. Section 432D-23.6, Hawaii Revised Statutes, is repealed.

["[§432D-23.6] Federally funded programs; exemption. Requirements relating to mandated coverages shall not be applicable to any health maintenance organization offering health insurance under a federally funded program under the Social Security Act, as amended; provided that this exemption shall apply only to that part of the health maintenance organization's business under the federally funded program."]

SECTION 5. Statutory material to be repealed is bracketed and stricken. New statutory material is underscored.

SECTION 6. This Act shall take effect on July 1, 2001.

INTRODUCED BY:

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