Section 3902.30 | Coverage for telemedicine services.
(A) As used in this section:
(1) "Health benefit plan," "health care services," and "health plan issuer" have the same meanings as in section 3922.01 of the Revised Code.
(2) "Health care professional" means any of the following:
(a) A physician licensed under Chapter 4731. of the Revised Code to practice medicine and surgery, osteopathic medicine and surgery, or podiatric medicine and surgery;
(b) A physician assistant licensed under Chapter 4731. of the Revised Code;
(c) An advanced practice registered nurse as defined in section 4723.01 of the Revised Code.
(3) "In-person health care services" means health care services delivered by a health care professional through the use of any communication method where the professional and patient are simultaneously present in the same geographic location.
(4) "Recipient" means a patient receiving health care services or a health care professional with whom the provider of health care services is consulting regarding the patient.
(5) "Telemedicine services" means a mode of providing health care services through synchronous or asynchronous information and communication technology by a health care professional, within the professional's scope of practice, who is located at a site other than the site where the recipient is located.
(B)(1) A health benefit plan shall provide coverage for telemedicine services on the same basis and to the same extent that the plan provides coverage for the provision of in-person health care services.
(2) A health benefit plan shall not exclude coverage for a service solely because it is provided as a telemedicine service.
(C) A health benefit plan shall not impose any annual or lifetime benefit maximum in relation to telemedicine services other than such a benefit maximum imposed on all benefits offered under the plan.
(D) This section shall not be construed as doing any of the following:
(1) Prohibiting a health benefit plan from assessing cost-sharing requirements to a covered individual for telemedicine services, provided that such cost-sharing requirements for telemedicine services are not greater than those for comparable in-person health care services;
(2) Requiring a health plan issuer to reimburse a health care professional for any costs or fees associated with the provision of telemedicine services that would be in addition to or greater than the standard reimbursement for comparable in-person health care services;
(3) Requiring a health plan issuer to reimburse a telemedicine provider for telemedicine services at the same rate as in-person services.
(E) This section applies to all health benefit plans issued, offered, or renewed on or after January 1, 2021.
Available Versions of this Section
- October 17, 2019 – Enacted by House Bill 166, 133rd General Assembly [ View October 17, 2019 Version ]