§ 26.1-36-09.15 — Coverage of telehealth services

North Dakota § 26.1-36-09.15

• Jurisdiction: North Dakota
• Title 26.1: Insurance
• Ch. 26.1-36: Accident and Health Insurance

Text

1. As used in this section:
a. "Distant site" means a site at which a health care provider or health care facility is
located while providing medical services by means of telehealth.
b. "E-visit" means a face-to-face digital communication initiated by a patient to a
provider through the provider's online patient portal.
c. "Health care facility" means any office or institution at which health services are
provided. The term includes hospitals; clinics; ambulatory surgery centers;
outpatient care facilities; nursing homes; nursing, basic, long-term, or assisted
living facilities; laboratories; and offices of any health care provider.
d. "Health care provider" includes an individual licensed under chapter 43-05, 43-06,
43-12.1 as a registered nurse or as an advanced practice registered nurse,
43-13, 43-15, 43-17, 43-26.1, 43-28, 43-32, 43-37, 43-40, 43-41, 43-42, 43-44,
43-45, 43-47, 43-58, or 43-60.
e. "Nonpublic facing product" means a remote communication product that, as a
default, allows only the intended parties to participate in the communication.
f. "Originating site" means a site at which a patient is located at the time health
services are provided to the patient by means of telehealth.
g. "Policy" means an accident and health insurance policy, contract, or evidence of
coverage on a group, individual, blanket, franchise, or association basis.
h. "Secure connection" means a connection made using a nonpublic facing remote
communication product that employs end-to-end encryption, and which allows
only an individual and the person with whom the individual is communicating to
see what is transmitted.
i. "Store-and-forward technology" means electronic information, imaging, and
communication that is transferred, recorded, or otherwise stored in order to be
reviewed at a distant site at a later date by a health care provider or health care
facility without the patient present in real time. The term includes telehome
monitoring and interactive audio, video, and data communication.
j. "Telehealth":
(1) Means the use of interactive audio, video, or other telecommunications
technology that is used by a health care provider or health care facility at a
distant site to deliver health services at an originating site and that is
delivered over a secure connection that complies with the requirements of
state and federal laws.
(2) Includes the use of electronic media for consultation relating to the health
care diagnosis or treatment of a patient in real time or through the use of
store-and-forward technology.
(3) Does not include the use of electronic mail, facsimile transmissions, or
audio-only telephone unless for the purpose of e-visits or a virtual check-in.

k. "Virtual check-in" means a brief communication via telephone or other
telecommunications device to decide whether an office visit or other service is
needed.
2. An insurer may not deliver, issue, execute, or renew a policy that provides health
benefits coverage unless that policy provides coverage for health services delivered by
means of telehealth which is the same as the coverage for health services delivered
by in-person means.
3. Payment or reimbursement of expenses for covered health services delivered by
means of telehealth under this section may be established through negotiations
conducted by the insurer with the health services providers in the same manner as the
insurer establishes payment or reimbursement of expenses for covered health
services that are delivered by in-person means.
4. Coverage under this section may be subject to deductible, coinsurance, and
copayment provisions.
5. This section does not require:
a. A policy to provide coverage for health services that are not medically necessary,
subject to the terms and conditions of the policy;
b. A policy to provide coverage for health services delivered by means of telehealth
if the policy would not provide coverage for the health services if delivered by
in-person means;
c. A policy to reimburse a health care provider or health care facility for expenses for
health services delivered by means of telehealth if the policy would not reimburse
that health care provider or health care facility if the health services had been
delivered by in-person means; or
d. A health care provider to be physically present with a patient at the originating site
unless the health care provider who is delivering health services by means of
telehealth determines the presence of a health care provider is necessary.