H.B. 16 Enrolled

1

MEDICAID COVERAGE FOR CERTAIN
2 TELEHEALTH SERVICES
3 2008 GENERAL SESSION
4 STATE OF UTAH
5 Chief Sponsor: Bradley G. Last
6 Senate Sponsor: Allen M. Christensen
7
8 LONG TITLE
9 General Description:
10 This bill amends the Medical Assistance Act in the Health Code.
11 Highlighted Provisions:
12 This bill:
13 . requires the state Medicaid program to allow the use of telemedicine for certain
14 services that are otherwise reimbursable under the state Medicaid plan;
15 . provides guidelines for reimbursing for telemedicine services; and
16 . requires rulemaking.
17 Monies Appropriated in this Bill:
18 None
19 Other Special Clauses:
20 None
21 Utah Code Sections Affected:
22 ENACTS:
23 26-18-12, Utah Code Annotated 1953
24
25 Be it enacted by the Legislature of the state of Utah:
26 Section 1. Section 26-18-12 is enacted to read:
27 26-18-12. Telemedicine -- Reimbursement -- Rulemaking.
28 (1) (a) On or after July 1, 2008, communication by telemedicine is considered face to
29 face contact between a health care provider and a patient under the state's medical assistance

30 program if:
31 (i) the communication by telemedicine meets the requirements of administrative rules
32 adopted in accordance with Subsection (3); and
33 (ii) the health care services are eligible for reimbursement under the state's medical
34 assistance program.
35 (b) This Subsection (1) applies to any managed care organization that contracts with
36 the state's medical assistance program.
37 (2) The reimbursement rate for telemedicine services approved under this section:
38 (a) shall be subject to reimbursement policies set by the state plan; and
39 (b) may be based on:
40 (i) a monthly reimbursement rate;
41 (ii) a daily reimbursement rate; or
42 (iii) an encounter rate.
43 (3) The department shall adopt administrative rules in accordance with Title 63,
44 Chapter 46a, Utah Administrative Rulemaking Act, which establish:
45 (a) the particular telemedicine services that are considered face to face encounters for
46 reimbursement purposes under the state's medical assistance program; and
47 (b) the reimbursement methodology for the telemedicine services designated under
48 Subsection (3)(a).