75th OREGON LEGISLATIVE ASSEMBLY--2009 Regular Session
NOTE: Matter within { + braces and plus signs + } in an
amended section is new. Matter within { - braces and minus
signs - } is existing law to be omitted. New sections are within
{ + braces and plus signs + } .
LC 1873
Senate Bill 468
Sponsored by Senator ATKINSON; Senator STARR (at the request of
Dr. Norwood Knight-Richardson)
SUMMARY
The following summary is not prepared by the sponsors of the
measure and is not a part of the body thereof subject to
consideration by the Legislative Assembly. It is an editor's
brief statement of the essential features of the measure as
introduced.
Requires health insurers, and Department of Human Services
through state medical assistance program, to cover services
performed using telemedicine. Requires Director of Department of
Consumer and Business Services and Director of Human Services to
adopt rules.
A BILL FOR AN ACT
Relating to telemedicine; creating new provisions; and amending
ORS 750.055 and 750.333.
Be It Enacted by the People of the State of Oregon:
SECTION 1. { + (1) As used in this section:
(a) 'Health professional' means a person licensed by a health
professional regulatory board as that term is defined in ORS
676.160.
(b) 'Telemedicine' means using telecommunications technology to
deliver health care, including but not limited to clinical
diagnosis, clinical services and patient consultation. '
Telemedicine' includes the practice of medicine across state
lines as defined in ORS 677.135.
(2) Whenever any policy of health insurance provides for
reimbursement for a service when performed in person, the insured
under the policy is entitled to reimbursement for the same
service performed using telemedicine if:
(a) The service is within the lawful scope of practice of the
health professional performing the service;
(b) Provision of the service using telemedicine is supported by
evidence-based medical criteria; and
(c) Provision of the service using telemedicine is medically
necessary.
(3) A health care service performed using telemedicine may be
subject to all terms and conditions of the policy, including but
not limited to a deductible, copayment or coinsurance requirement
that is applicable to a comparable service performed in an
in-person consultation.
(4) The Director of the Department of Consumer and Business
Services shall adopt any rules necessary to carry out the
purposes of this section that are consistent with rules adopted
by the Director of Human Services under section 2 of this 2009
Act and that further the goals of this section in improving
access to health care services in medically underserved areas and
improving patient access to health care specialists in geographic
areas where there is a shortage of such specialists. + }
SECTION 2. { + (1) The Director of Human Services shall adopt
rules setting reimbursement rates for telemedicine services
performed by health professionals through the state medical
assistance program. The reimbursement rates must take into
account the cost of technology investments needed to practice
telemedicine and may not be less than rates paid for comparable
in-person health care services. Subject to rules adopted by the
director under subsection (2) of this section, the director shall
set reimbursement rates under this section as follows:
(a) A health professional who is participating at an
originating site of a telecommunication transmission, is
physically present with the patient and is contemporaneously
communicating and interacting with a health professional at the
terminus of the transmission shall be reimbursed at the rate that
a health professional is entitled to receive under the state
medical assistance program for an office visit.
(b) A health professional who communicates with a patient in
the course of providing telemedicine services shall be reimbursed
at the rate that a health professional is entitled to receive
under the state medical assistance program for an in-person
consultation, whether the communication is contemporaneous or
asynchronous store and forward.
(c) A health professional shall be reimbursed for a
telemedicine consultation with another health professional at the
rate that a health professional is entitled to receive under the
state medical assistance program for an in-person consultation
with another health professional, whether the communication is
contemporaneous or asynchronous store and forward.
(d) A health professional shall be reimbursed for any health
care service provided using telemedicine at the rate that a
health professional is entitled to receive under the state
medical assistance program for the same service performed in an
in-person consultation, whether the communication is
contemporaneous or asynchronous store and forward.
(2) The director shall adopt rules to further the goals of this
section in improving access to health care services in medically
underserved areas and improving patient access to health care
specialists in geographic areas where there is a shortage of such
specialists, including but not limited to rules:
(a) Establishing protocols to ensure that telemedicine services
meet minimum standards of care, including that health
professionals perform telemedicine services in clinical settings
and that clinical records be maintained in accordance with
medical community standards;
(b) Placing appropriate limits on using telemedicine to provide
health care services, including:
(A) Prohibiting the use of telephones or facsimiles when
videoconference technology is available; and
(B) Prohibiting the use of telemedicine when an in-person
consultation with an appropriate health professional is available
within a reasonable distance from the location where the patient
resides or is employed;
(c) Establishing patient confidentiality standards to ensure
that telemedicine services meet the legal requirements for
protecting health information;
(d) Establishing procedures for obtaining informed consent to
perform health care services using telemedicine; and
(e) Providing for exceptions to the provisions of this section
if the Governor has declared a state of emergency under ORS
401.055 and exceptions are necessary to further the goals of this
section.
(3) As used in this section:
(a) 'Asynchronous store and forward' means a telecommunication
technique in which information is sent to an intermediate station
where it is stored before being sent at a later time to its final
destination or to another intermediate station, with each
intermediate station verifying the integrity of the information
before forwarding it.
(b) 'Clinical setting' means a hospital, a location where a
health professional performs health care services in person, a
long term care facility, an intermediate care facility and any
other health care facility prescribed by the director by rule.
(c) 'Health professional' means a person licensed by a health
professional regulatory board as that term is defined in ORS
676.160.
(d) 'Telemedicine' means using telecommunications technology to
deliver health care, including but not limited to clinical
diagnosis, clinical services and patient consultation. '
Telemedicine' includes the practice of medicine across state
lines as defined in ORS 677.135. + }
SECTION 3. ORS 750.055, as amended by section 5, chapter 22,
Oregon Laws 2008, is amended to read:
750.055. (1) The following provisions of the Insurance Code
apply to health care service contractors to the extent not
inconsistent with the express provisions of ORS 750.005 to
750.095:
(a) ORS 705.137, 705.139, 731.004 to 731.150, 731.162, 731.216
to 731.362, 731.382, 731.385, 731.386, 731.390, 731.398 to
731.430, 731.428, 731.450, 731.454, 731.488, 731.504, 731.508,
731.509, 731.510, 731.511, 731.512, 731.574 to 731.620, 731.592,
731.594, 731.640 to 731.652, 731.730, 731.731, 731.735, 731.737,
731.750, 731.752, 731.804 and 731.844 to 731.992 and section 2,
chapter 22, Oregon Laws 2008.
(b) ORS 732.215, 732.220, 732.230, 732.245, 732.250, 732.320,
732.325 and 732.517 to 732.592, not including ORS 732.582.
(c) ORS 733.010 to 733.050, 733.080, 733.140 to 733.170,
733.210, 733.510 to 733.680 and 733.695 to 733.780.
(d) ORS chapter 734.
(e) ORS 742.001 to 742.009, 742.013, 742.061, 742.065, 742.150
to 742.162, 742.400, 742.520 to 742.540, 743.010, 743.013,
743.018 to 743.030, 743.050, 743.100 to 743.109, 743.402,
743.472, 743.492, 743.495, 743.498, 743.522, 743.523, 743.524,
743.526, 743.527, 743.528, 743.529, 743.549 to 743.552, 743.560,
743.600 to 743.610, 743.650 to 743.664, 743.804, 743.807,
743.808, 743.814 to 743.839, 743.842, 743.845, 743.847, 743.854,
743.856, 743.857, 743.858, 743.859, 743.861, 743.862, 743.863,
743.864, 743.911, 743.913, 743A.010, 743A.012, 743A.036,
743A.048, 743A.062, 743A.064, 743A.066, 743A.068, 743A.070,
743A.080, 743A.084, 743A.088, 743A.090, 743A.100, 743A.104,
743A.110, 743A.140, 743A.148, 743A.160, 743A.164, 743A.168,
743A.184, 743A.188 and 743A.190 { + and section 1 of this 2009
Act + }.
(f) The provisions of ORS chapter 744 relating to the
regulation of insurance producers.
(g) ORS 746.005 to 746.140, 746.160, 746.220 to 746.370,
746.600, 746.605, 746.607, 746.608, 746.610, 746.615, 746.625,
746.635, 746.650, 746.655, 746.660, 746.668, 746.670, 746.675,
746.680 and 746.690.
(h) ORS 743A.024, except in the case of group practice health
maintenance organizations that are federally qualified pursuant
to Title XIII of the Public Health Service Act unless the patient
is referred by a physician associated with a group practice
health maintenance organization.
(i) ORS 735.600 to 735.650.
(j) ORS 743.680 to 743.689.
(k) ORS 744.700 to 744.740.
(L) ORS 743.730 to 743.773.
(m) ORS 731.485, except in the case of a group practice health
maintenance organization that is federally qualified pursuant to
Title XIII of the Public Health Service Act and that wholly owns
and operates an in-house drug outlet.
(2) For the purposes of this section, health care service
contractors shall be deemed insurers.
(3) Any for-profit health care service contractor organized
under the laws of any other state that is not governed by the
insurance laws of the other state is subject to all requirements
of ORS chapter 732.
(4) The Director of the Department of Consumer and Business
Services may, after notice and hearing, adopt reasonable rules
not inconsistent with this section and ORS 750.003, 750.005,
750.025 and 750.045 that are deemed necessary for the proper
administration of these provisions.
SECTION 4. ORS 750.055, as amended by section 7, chapter 137,
Oregon Laws 2003, section 3, chapter 263, Oregon Laws 2003,
sections 501 and 502, chapter 22, Oregon Laws 2005, sections 5
and 6, chapter 255, Oregon Laws 2005, section 5, chapter 418,
Oregon Laws 2005, section 3, chapter 128, Oregon Laws 2007,
section 9, chapter 182, Oregon Laws 2007, section 6, chapter 313,
Oregon Laws 2007, section 4, chapter 504, Oregon Laws 2007,
section 4, chapter 566, Oregon Laws 2007, section 4, chapter 872,
Oregon Laws 2007, and section 6, chapter 22, Oregon Laws 2008, is
amended to read:
750.055. (1) The following provisions of the Insurance Code
apply to health care service contractors to the extent not
inconsistent with the express provisions of ORS 750.005 to
750.095:
(a) ORS 705.137, 705.139, 731.004 to 731.150, 731.162, 731.216
to 731.362, 731.382, 731.385, 731.386, 731.390, 731.398 to
731.430, 731.428, 731.450, 731.454, 731.488, 731.504, 731.508,
731.509, 731.510, 731.511, 731.512, 731.574 to 731.620, 731.592,
731.594, 731.640 to 731.652, 731.730, 731.731, 731.735, 731.737,
731.750, 731.752, 731.804 and 731.844 to 731.992 and section 2,
chapter 22, Oregon Laws 2008.
(b) ORS 732.215, 732.220, 732.230, 732.245, 732.250, 732.320,
732.325 and 732.517 to 732.592, not including ORS 732.582.
(c) ORS 733.010 to 733.050, 733.080, 733.140 to 733.170,
733.210, 733.510 to 733.680 and 733.695 to 733.780.
(d) ORS chapter 734.
(e) ORS 742.001 to 742.009, 742.013, 742.061, 742.065, 742.150
to 742.162, 742.400, 742.520 to 742.540, 743.010, 743.013,
743.018 to 743.030, 743.050, 743.100 to 743.109, 743.402,
743.472, 743.492, 743.495, 743.498, 743.522, 743.523, 743.524,
743.526, 743.527, 743.528, 743.529, 743.549 to 743.552, 743.560,
743.600 to 743.610, 743.650 to 743.656, 743.804, 743.807,
743.808, 743.814 to 743.839, 743.842, 743.845, 743.847, 743.854,
743.856, 743.857, 743.858, 743.859, 743.861, 743.862, 743.863,
743.864, 743.911, 743.913, 743A.010, 743A.012, 743A.036,
743A.048, 743A.062, 743A.064, 743A.066, 743A.068, 743A.070,
743A.080, 743A.084, 743A.088, 743A.090, 743A.100, 743A.104,
743A.110, 743A.140, 743A.148, 743A.160, 743A.164, 743A.168,
743A.184 and 743A.190 { + and section 1 of this 2009 Act + }.
(f) The provisions of ORS chapter 744 relating to the
regulation of insurance producers.
(g) ORS 746.005 to 746.140, 746.160, 746.220 to 746.370,
746.600, 746.605, 746.607, 746.608, 746.610, 746.615, 746.625,
746.635, 746.650, 746.655, 746.660, 746.668, 746.670, 746.675,
746.680 and 746.690.
(h) ORS 743A.024, except in the case of group practice health
maintenance organizations that are federally qualified pursuant
to Title XIII of the Public Health Service Act unless the patient
is referred by a physician associated with a group practice
health maintenance organization.
(i) ORS 735.600 to 735.650.
(j) ORS 743.680 to 743.689.
(k) ORS 744.700 to 744.740.
(L) ORS 743.730 to 743.773.
(m) ORS 731.485, except in the case of a group practice health
maintenance organization that is federally qualified pursuant to
Title XIII of the Public Health Service Act and that wholly owns
and operates an in-house drug outlet.
(2) For the purposes of this section, health care service
contractors shall be deemed insurers.
(3) Any for-profit health care service contractor organized
under the laws of any other state that is not governed by the
insurance laws of the other state is subject to all requirements
of ORS chapter 732.
(4) The Director of the Department of Consumer and Business
Services may, after notice and hearing, adopt reasonable rules
not inconsistent with this section and ORS 750.003, 750.005,
750.025 and 750.045 that are deemed necessary for the proper
administration of these provisions.
SECTION 5. ORS 750.333, as amended by section 7, chapter 22,
Oregon Laws 2008, is amended to read:
750.333. (1) The following provisions of the Insurance Code
apply to trusts carrying out a multiple employer welfare
arrangement:
(a) ORS 731.004 to 731.150, 731.162, 731.216 to 731.268,
731.296 to 731.316, 731.324, 731.328, 731.378, 731.386, 731.390,
731.398, 731.406, 731.410, 731.414, 731.418 to 731.434, 731.454,
731.484, 731.486, 731.488, 731.512, 731.574 to 731.620, 731.640
to 731.652 and 731.804 to 731.992.
(b) ORS 733.010 to 733.050, 733.140 to 733.170, 733.210,
733.510 to 733.680 and 733.695 to 733.780.
(c) ORS chapter 734.
(d) ORS 742.001 to 742.009, 742.013, 742.061 and 742.400.
(e) ORS 743.028, 743.053, 743.524, 743.526, 743.527, 743.528,
743.529, 743.530, 743.560, 743.562, 743.600, 743.601, 743.602,
743.610, 743.730 to 743.773 (except 743.760 to 743.773), 743.801,
743.804, 743.807, 743.808, 743.814 to 743.839, 743.842, 743.845,
743.847, 743.854, 743.856, 743.857, 743.858, 743.859, 743.861,
743.862, 743.863, 743.864, 743A.012, 743A.064, 743A.080,
743A.100, 743A.104, 743A.110 and 743A.184.
(f) ORS 743A.010, 743A.014, 743A.024, 743A.028, 743A.032,
743A.036, 743A.040, 743A.044, 743A.048, 743A.066, 743A.068,
743A.084, 743A.088, 743A.090, 743A.140, 743A.148, 743A.168,
743A.180, 743A.188 and 743A.190 { + and section 1 of this 2009
Act + }. Multiple employer welfare arrangements to which ORS
743.730 to 743.773 apply are subject to the sections referred to
in this paragraph only as provided in ORS 743.730 to 743.773.
(g) Provisions of ORS chapter 744 relating to the regulation of
insurance producers and insurance consultants, and ORS 744.700 to
744.740.
(h) ORS 746.005 to 746.140, 746.160 and 746.220 to 746.370.
(i) ORS 731.592 and 731.594.
(j) Section 2, chapter 22, Oregon Laws 2008.
(2) For the purposes of this section:
(a) A trust carrying out a multiple employer welfare
arrangement shall be considered an insurer.
(b) References to certificates of authority shall be considered
references to certificates of multiple employer welfare
arrangement.
(c) Contributions shall be considered premiums.
(3) The provision of health benefits under ORS 750.301 to
750.341 shall be considered to be the transaction of health
insurance.
SECTION 6. ORS 750.333, as amended by section 4, chapter 263,
Oregon Laws 2003, section 11, chapter 182, Oregon Laws 2007,
section 8, chapter 313, Oregon Laws 2007, section 6, chapter 504,
Oregon Laws 2007, section 6, chapter 566, Oregon Laws 2007,
section 6, chapter 872, Oregon Laws 2007, and section 8, chapter
22, Oregon Laws 2008, is amended to read:
750.333. (1) The following provisions of the Insurance Code
apply to trusts carrying out a multiple employer welfare
arrangement:
(a) ORS 731.004 to 731.150, 731.162, 731.216 to 731.268,
731.296 to 731.316, 731.324, 731.328, 731.378, 731.386, 731.390,
731.398, 731.406, 731.410, 731.414, 731.418 to 731.434, 731.454,
731.484, 731.486, 731.488, 731.512, 731.574 to 731.620, 731.640
to 731.652 and 731.804 to 731.992.
(b) ORS 733.010 to 733.050, 733.140 to 733.170, 733.210,
733.510 to 733.680 and 733.695 to 733.780.
(c) ORS chapter 734.
(d) ORS 742.001 to 742.009, 742.013, 742.061 and 742.400.
(e) ORS 743.028, 743.053, 743.524, 743.526, 743.527, 743.528,
743.529, 743.530, 743.560, 743.562, 743.600, 743.601, 743.602,
743.610, 743.730 to 743.773 (except 743.760 to 743.773), 743.801,
743.804, 743.807, 743.808, 743.814 to 743.839, 743.842, 743.845,
743.847, 743.854, 743.856, 743.857, 743.858, 743.859, 743.861,
743.862, 743.863, 743.864, 743A.012, 743A.064, 743A.080,
743A.100, 743A.104, 743A.110 and 743A.184.
(f) ORS 743A.010, 743A.014, 743A.024, 743A.028, 743A.032,
743A.036, 743A.040, 743A.044, 743A.048, 743A.066, 743A.068,
743A.084, 743A.088, 743A.090, 743A.140, 743A.148, 743A.168,
743A.180 and 743A.190 { + and section 1 of this 2009 Act + }.
Multiple employer welfare arrangements to which ORS 743.730 to
743.773 apply are subject to the sections referred to in this
paragraph only as provided in ORS 743.730 to 743.773.
(g) Provisions of ORS chapter 744 relating to the regulation of
insurance producers and insurance consultants, and ORS 744.700 to
744.740.
(h) ORS 746.005 to 746.140, 746.160 and 746.220 to 746.370.
(i) ORS 731.592 and 731.594.
(j) Section 2, chapter 22, Oregon Laws 2008.
(2) For the purposes of this section:
(a) A trust carrying out a multiple employer welfare
arrangement shall be considered an insurer.
(b) References to certificates of authority shall be considered
references to certificates of multiple employer welfare
arrangement.
(c) Contributions shall be considered premiums.
(3) The provision of health benefits under ORS 750.301 to
750.341 shall be considered to be the transaction of health
insurance.
SECTION 7. ORS 750.333, as amended by section 8, chapter 137,
Oregon Laws 2003, section 4, chapter 263, Oregon Laws 2003,
section 3, chapter 446, Oregon Laws 2003, section 6, chapter 418,
Oregon Laws 2005, section 12, chapter 182, Oregon Laws 2007,
section 9, chapter 313, Oregon Laws 2007, section 7, chapter 504,
Oregon Laws 2007, section 7, chapter 566, Oregon Laws 2007,
section 7, chapter 872, Oregon Laws 2007, and section 9, chapter
22, Oregon Laws 2008, is amended to read:
750.333. (1) The following provisions of the Insurance Code
apply to trusts carrying out a multiple employer welfare
arrangement:
(a) ORS 731.004 to 731.150, 731.162, 731.216 to 731.268,
731.296 to 731.316, 731.324, 731.328, 731.378, 731.386, 731.390,
731.398, 731.406, 731.410, 731.414, 731.418 to 731.434, 731.454,
731.484, 731.486, 731.488, 731.512, 731.574 to 731.620, 731.640
to 731.652 and 731.804 to 731.992.
(b) ORS 733.010 to 733.050, 733.140 to 733.170, 733.210,
733.510 to 733.680 and 733.695 to 733.780.
(c) ORS chapter 734.
(d) ORS 742.001 to 742.009, 742.013, 742.061 and 742.400.
(e) ORS 743.028, 743.053, 743.524, 743.526, 743.527, 743.528,
743.529, 743.530, 743.560, 743.562, 743.600, 743.601, 743.602,
743.610, 743.730 to 743.773 (except 743.760 to 743.773), 743.801,
743.804, 743.807, 743.808, 743.814 to 743.839, 743.842, 743.845,
743.847, 743.854, 743.856, 743.857, 743.858, 743.859, 743.861,
743.862, 743.863, 743.864, 743A.012, 743A.064, 743A.080,
743A.100, 743A.104, 743A.110 and 743A.184.
(f) ORS 743A.010, 743A.014, 743A.024, 743A.028, 743A.032,
743A.036, 743A.040, 743A.048, 743A.066, 743A.068, 743A.084,
743A.088, 743A.090, 743A.140, 743A.148, 743A.168, 743A.180 and
743A.190 { + and section 1 of this 2009 Act + }. Multiple
employer welfare arrangements to which ORS 743.730 to 743.773
apply are subject to the sections referred to in this paragraph
only as provided in ORS 743.730 to 743.773.
(g) Provisions of ORS chapter 744 relating to the regulation of
insurance producers and insurance consultants, and ORS 744.700 to
744.740.
(h) ORS 746.005 to 746.140, 746.160 and 746.220 to 746.370.
(i) ORS 731.592 and 731.594.
(j) Section 2, chapter 22, Oregon Laws 2008.
(2) For the purposes of this section:
(a) A trust carrying out a multiple employer welfare
arrangement shall be considered an insurer.
(b) References to certificates of authority shall be considered
references to certificates of multiple employer welfare
arrangement.
(c) Contributions shall be considered premiums.
(3) The provision of health benefits under ORS 750.301 to
750.341 shall be considered to be the transaction of health
insurance.
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