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H.B. 16

             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      Committee Note:
             10          The Health and Human Services Interim Committee recommended this bill.
             11      General Description:
             12          This bill amends the Medical Assistance Act in the Health Code.
             13      Highlighted Provisions:
             14          This bill:
             15          .    requires the state Medicaid program to allow the use of telemedicine for certain
             16      services that are otherwise reimbursable under the state Medicaid plan; and
             17          .    provides guidelines for reimbursing for telemedicine services.
             18      Monies Appropriated in this Bill:
             19          None
             20      Other Special Clauses:
             21          None
             22      Utah Code Sections Affected:
             23      ENACTS:
             24          26-18-12, Utah Code Annotated 1953
             25     
             26      Be it enacted by the Legislature of the state of Utah:
             27          Section 1. Section 26-18-12 is enacted to read:


             28          26-18-12. Telemedicine -- Reimbursement -- Disclosure.
             29          (1) (a) On or after July 1, 2008, communication by telemedicine is considered face to
             30      face contact between a health care provider and a patient under the state's medical assistance
             31      program if:
             32          (i) the communication by telemedicine meets the requirements of administrative rules
             33      adopted in accordance with Subsection (3); and
             34          (ii) the health care services are eligible for reimbursement under the state's medical
             35      assistance program.
             36          (b) This Subsection (1) applies to any managed care organization that contracts with
             37      the state's medical assistance program.
             38          (2) The reimbursement rate for telemedicine services approved under this section:
             39          (a) shall be subject to reimbursement policies set by the state plan; and
             40          (b) may be based on:
             41          (i) a monthly reimbursement rate;
             42          (ii) a daily reimbursement rate; or
             43          (iii) an encounter rate.
             44          (3) The department shall adopt administrative rules in accordance with Title 63,
             45      Chapter 46a, Utah Administrative Rulemaking Act, which establish:
             46          (a) the particular telemedicine services that are considered face to face encounters for
             47      reimbursement purposes under the state's medical assistance program; and
             48          (b) the reimbursement methodology for the telemedicine services designated under
             49      Subsection (3)(a).




Legislative Review Note
    as of 9-19-07 1:35 PM


Office of Legislative Research and General Counsel


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