<?xml version="1.0" encoding="ISO-8859-1"?><section number="31A-22-649.5"><effdate>5/3/2023</effdate><histories><history>Amended by Chapter <modchap sess="2023GS">328</modchap>, 2023 General Session</history><modyear>2023</modyear></histories><catchline>Insurance parity for telemedicine services -- Method of technology used.</catchline><subsection number="31A-22-649.5(1)">
As used in this section:
<subsection number="31A-22-649.5(1)(a)">
"Mental health condition" means a mental disorder or a substance-related disorder that falls under a diagnostic category listed in the Diagnostic and Statistical Manual, as periodically revised.</subsection><subsection number="31A-22-649.5(1)(b)">
"Telemedicine services" means the same as that term is defined in Section <xref depth="3" refnumber="26B-4-704" start="0">26B-4-704</xref>.</subsection></subsection><subsection number="31A-22-649.5(2)">
Notwithstanding the provisions of Section <xref depth="3" refnumber="31A-22-618.5" start="0">31A-22-618.5</xref>, a health benefit plan offered in the individual market, the small group market, or the large group market shall:
<subsection number="31A-22-649.5(2)(a)">
provide coverage for:<subsection number="31A-22-649.5(2)(a)(i)">
telemedicine services that are covered by Medicare; and</subsection><subsection number="31A-22-649.5(2)(a)(ii)">
treatment of a mental health condition through telemedicine services if:
<subsection number="31A-22-649.5(2)(a)(ii)(A)">
the health benefit plan provides coverage for the treatment of the mental health condition through in-person services; and</subsection><subsection number="31A-22-649.5(2)(a)(ii)(B)">
the health benefit plan determines treatment of the mental health condition through telemedicine services meets the appropriate standard of care; and</subsection></subsection></subsection><subsection number="31A-22-649.5(2)(b)">
reimburse a network provider that provides the telemedicine services described in Subsection <xref depth="4" refnumber="31A-22-649.5(2)(a)" start="0">(2)(a)</xref> at a negotiated commercially reasonable rate.</subsection></subsection><subsection number="31A-22-649.5(3)"><subsection number="31A-22-649.5(3)(a)">
Notwithstanding Section <xref depth="3" refnumber="31A-45-303" start="0">31A-45-303</xref>, a health benefit plan providing coverage under Subsection <xref depth="4" refnumber="31A-22-649.5(2)(a)" start="0">(2)(a)</xref> may not impose originating site restrictions, geographic restrictions, or distance-based restrictions.</subsection><subsection number="31A-22-649.5(3)(b)">
A network provider that provides the telemedicine services described in Subsection <xref depth="4" refnumber="31A-22-649.5(2)(a)" start="0">(2)(a)</xref> may utilize any synchronous audiovisual technology for the telemedicine services that is compliant with the federal Health Insurance Portability and Accountability Act of 1996.</subsection></subsection></section>
