§ 4406-g. Telehealth delivery of services.
1.A health maintenance\norganization shall not exclude from coverage a service that is otherwise\ncovered under an enrollee contract of a health maintenance organization\nbecause the service is delivered via telehealth, as that term is defined\nin subdivision two of this section; provided, however, that a health\nmaintenance organization may exclude from coverage a service by a health\ncare provider where the provider is not otherwise covered under the\nenrollee contract. A health maintenance organization may subject the\ncoverage of a service delivered via telehealth to co-payments,\ncoinsurance or deductibles provided that they are at least as favorable\nto the enrollee as those established for the same service when not\ndelivered via telehea
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§ 4406-g. Telehealth delivery of services. 1. A health maintenance\norganization shall not exclude from coverage a service that is otherwise\ncovered under an enrollee contract of a health maintenance organization\nbecause the service is delivered via telehealth, as that term is defined\nin subdivision two of this section; provided, however, that a health\nmaintenance organization may exclude from coverage a service by a health\ncare provider where the provider is not otherwise covered under the\nenrollee contract. A health maintenance organization may subject the\ncoverage of a service delivered via telehealth to co-payments,\ncoinsurance or deductibles provided that they are at least as favorable\nto the enrollee as those established for the same service when not\ndelivered via telehealth. A health maintenance organization may subject\nthe coverage of a service delivered via telehealth to reasonable\nutilization management and quality assurance requirements that are\nconsistent with those established for the same service when not\ndelivered via telehealth.\n 2. For purposes of this section, "telehealth" means the use of\nelectronic information and communication technologies by a health care\nprovider to deliver health care services to an enrollee while such\nenrollee is located at a site that is different from the site where the\nhealth care provider is located.\n * 3. A health maintenance organization that provides comprehensive\ncoverage for hospital, medical or surgical care shall reimburse covered\nservices delivered via telehealth on the same basis, at the same rate,\nand to the extent that such services are reimbursed when delivered in\nperson; provided that reimbursement of covered services delivered by\nmeans of telehealth shall not require reimbursement of costs not\nactually incurred in the provision of the telehealth services, including\ncharges related to the use of a clinic or other facility when neither\nthe originating site nor the distant site occur within the clinic or\nother facility. The commissioner, in consultation with the\nsuperintendent, may promulgate regulations to implement the provisions\nof this section.\n * NB Repealed April 1, 2026\n * 4. A health maintenance organization that provides comprehensive\ncoverage for hospital, medical, or surgical care with a network of\nhealth care providers shall ensure that such network is adequate to meet\nthe telehealth needs of insured individuals for services covered under\nthe policy when medically appropriate.\n * NB Repealed April 1, 2026\n