Senate File 92 - Introduced SENATE FILE 92 BY ZAUN A BILL FOR An Act relating to reimbursement rates for health care services 1 provided to covered persons by telehealth, and including 2 effective date and retroactive applicability provisions. 3 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA: 4 TLSB 1976XS (1) 89 ko/rn

S.F. 92 Section 1. Section 514C.34, Code 2021, is amended to read 1 as follows: 2 514C.34 Health care services delivered by telehealth —— 3 coverage. 4 1. As used in this section , unless the context otherwise 5 requires: 6 0a. “Covered person” means the same as defined in section 7 514J.102. 8 a. “Health care professional” means the same as defined in 9 section 514J.102 . 10 b. “Health care services” means the same as defined in 11 section 514J.102 and includes services for mental health 12 conditions, illnesses, injuries, or diseases. 13 0c. “Health carrier” means the same as defined in section 14 514J.102. 15 c. “Telehealth” means the delivery of health care services 16 through the use of interactive audio and video. “Telehealth” 17 does not include the delivery of health care services through 18 an audio-only telephone, electronic mail message , or facsimile 19 transmission. 20 2. Notwithstanding the uniformity of treatment requirements 21 of section 514C.6 , a policy, contract, or plan providing for 22 third-party payment or prepayment of health or medical expenses 23 shall not discriminate between coverage benefits for health 24 care services that are provided in person and the same health 25 care services that are delivered through telehealth. 26 3. Health care services that are delivered by telehealth 27 must be appropriate and delivered in accordance with applicable 28 law and generally accepted health care practices and standards 29 prevailing at the time the health care services are provided, 30 including all rules adopted by the appropriate professional 31 licensing board, pursuant to chapter 147 , having oversight 32 of the health care professional providing the health care 33 services. 34 3A. A health carrier shall reimburse a health care 35 -1- LSB 1976XS (1) 89 ko/rn 1/ 3

S.F. 92 professional for health care services provided to a covered 1 person by telehealth on the same basis and at the same rate as 2 the health carrier would apply to the same health care services 3 provided to a covered person by the health care professional 4 in person. 5 4. This section applies to the following classes of 6 third-party payment provider policies, contracts, or plans 7 delivered, issued for delivery, continued, or renewed in this 8 state on or after January 1, 2019 : 9 a. Individual or group accident and sickness insurance 10 providing coverage on an expense-incurred basis. 11 b. An individual or group hospital or medical service 12 contract issued pursuant to chapter 509 , 514 , or 514A . 13 c. An individual or group health maintenance organization 14 contract regulated under chapter 514B . 15 d. A plan established pursuant to chapter 509A for public 16 employees. 17 e. The medical assistance program established pursuant to 18 chapter 249A, including a managed care organization acting 19 pursuant to a contract with the department of human services to 20 provide coverage to medical assistance program members. 21 5. This section shall not apply to accident-only, 22 specified disease, short-term hospital or medical, hospital 23 confinement indemnity, credit, dental, vision, Medicare 24 supplement, long-term care, basic hospital and medical-surgical 25 expense coverage as defined by the commissioner, disability 26 income insurance coverage, coverage issued as a supplement 27 to liability insurance, workers’ compensation or similar 28 insurance, or automobile medical payment insurance. 29 6. The commissioner of insurance may shall adopt rules 30 pursuant to chapter 17A as necessary to administer this 31 section . 32 Sec. 2. EFFECTIVE DATE. This Act, being deemed of immediate 33 importance, takes effect upon enactment. 34 Sec. 3. RETROACTIVE APPLICABILITY. This Act applies 35 -2- LSB 1976XS (1) 89 ko/rn 2/ 3

S.F. 92 retroactively to third-party payment provider contracts, 1 policies, or plans delivered, issued for delivery, continued, 2 or renewed in this state on or after January 1, 2021. 3 EXPLANATION 4 The inclusion of this explanation does not constitute agreement with 5 the explanation’s substance by the members of the general assembly. 6 This bill requires health carriers to reimburse health care 7 professionals for health care services provided to covered 8 persons by telehealth on the same basis and at the same rate as 9 the health carrier would apply to the same health care services 10 provided to a covered person by a health care professional in 11 person. Current law excludes health care services delivered 12 through an audio-only telephone from the definition of 13 “telehealth”. The bill includes audio-only telephone in the 14 definition. 15 The bill applies to the third-party payment providers 16 enumerated in the bill. The bill specifies the types of 17 specialized health-related insurance which are not subject to 18 the bill. 19 The commissioner of insurance must adopt rules to administer 20 the requirements of the bill. 21 The bill becomes effective upon enactment and applies 22 retroactively to third-party payment provider contracts, 23 policies, or plans delivered, issued for delivery, continued, 24 or renewed in this state on or after January 1, 2021. 25 -3- LSB 1976XS (1) 89 ko/rn 3/ 3