1.As used in this section, unless the context otherwise requires:
a.“Covered person” means the same as defined in section 514J.102.
b.“Facility” means the same as defined in section 514J.102.
c.“Health care professional” means the same as defined in section 514J.102.
d.“Health care services” means the same as defined in section 514J.102 and includes
services for mental health conditions, illnesses, injuries, or diseases.
e.“Health carrier” means the same as defined in section 514J.102.
f.“Telehealth” means the delivery of health care services through the use of real-time
interactive audio and video, or other real-time interactive electronic media, regardless of
where the health care professional and the covered person are each located. “Telehealth”
does not include the delivery of h
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1. As used in this section, unless the context otherwise requires:
a. “Covered person” means the same as defined in section 514J.102.
b. “Facility” means the same as defined in section 514J.102.
c. “Health care professional” means the same as defined in section 514J.102.
d. “Health care services” means the same as defined in section 514J.102 and includes
services for mental health conditions, illnesses, injuries, or diseases.
e. “Health carrier” means the same as defined in section 514J.102.
f. “Telehealth” means the delivery of health care services through the use of real-time
interactive audio and video, or other real-time interactive electronic media, regardless of
where the health care professional and the covered person are each located. “Telehealth”
does not include the delivery of health care services delivered solely through an audio-only
telephone, electronic mail message, or facsimile transmission.
2. Notwithstanding the uniformity of treatment requirements of section 514C.6, a policy,
contract, or plan providing for third-party payment or prepayment of health or medical
expenses shall not discriminate between coverage benefits for health care services that are
provided in person and the same health care services that are delivered through telehealth.
3. a. Health care services that are delivered by telehealth must be appropriate and
delivered in accordance with applicable law and generally accepted health care practices
and standards prevailing at the time the health care services are provided, including all rules
adopted by the appropriate professional licensing board, pursuant to chapter 147, having
oversight of the health care professional providing the health care services.
b. A health carrier shall not exclude a health care professional who provides services
for mental health conditions, illnesses, injuries, or diseases and who is physically located
out-of-state from participating as a provider, via telehealth, under a policy, plan, or contract
offered by the health carrier in the state if all of the following requirements are met:
(1) The health care professional is licensed in this state by the appropriate professional
licensing board and is able to deliver health care services for mental health conditions,
illnesses, injuries, or diseases via telehealth in compliance with paragraph “a”.
§514C.34, SPECIAL HEALTH AND ACCIDENT INSURANCE COVERAGES 32
(2) The health care professional is able to satisfy the same criteria that the health carrier
uses to qualify a health care professional who is located in the state, and who holds the same
license as the out-of-state professional, to participate as a provider, via telehealth, under a
policy, plan, or contract offered by the health carrier in the state.
4. a. A health carrier shall reimburse a health care professional and a facility for health
careservicesprovidedbytelehealthtoacoveredpersonforamentalhealthcondition, illness,
injury, or disease on the same basis and at the same rate as the health carrier would apply to
thesamehealthcareservicesforamentalhealthcondition, illness, injury, ordiseaseprovided
in person to a covered person by the health care professional or the facility.
b. As a condition of reimbursement pursuant to paragraph “a”, a health carrier shall not
require that an additional health care professional be located in the same room as a covered
person while health care services for a mental health condition, illness, injury, or disease are
provided via telehealth by another health care professional to the covered person.
5. This section applies to the following classes of third-party payment provider policies,
contracts, or plans delivered, issued for delivery, continued, or renewed in this state on or
after January 1, 2019:
a. Individual or group accident and sickness insurance providing coverage on an
expense-incurred basis.
b. An individual or group hospital or medical service contract issued pursuant to chapter
509, 514, or 514A.
c. An individual or group health maintenance organization contract regulated under
chapter 514B.
d. A plan established pursuant to chapter 509A for public employees.
6. This section shall not apply to accident-only, specified disease, short-term hospital
or medical, hospital confinement indemnity, credit, dental, vision, Medicare supplement,
long-term care, basic hospital and medical-surgical expense coverage as defined by the
commissioner, disability income insurance coverage, coverage issued as a supplement to
liability insurance, workers’ compensation or similar insurance, or automobile medical
payment insurance.
7. The commissioner of insurance may adopt rules pursuant to chapter 17A as necessary
to administer this section.