Bill Summary – FastDemocracy

Stricken language would be deleted from and underlined language would be added to present law.
 State of Arkansas
 93rd General Assembly                        A Bill
 Regular Session, 2021                                                             SENATE BILL 598
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 By: Senator Bledsoe
 By: Representatives Pilkington, L. Johnson, D. Ferguson
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                                   For An Act To Be Entitled
                AN ACT TO AMEND THE DEFINITIONS OF "HEALTH BENEFIT
                PLAN" AND "PROFESSIONAL RELATIONSHIP" WITHIN THE
                TELEMEDICINE ACT; TO AUTHORIZE ADDITIONAL INSURANCE
                REIMBURSEMENT FOR TELEMEDICINE VIA TELEPHONE; TO
                PROHIBIT HEALTH BENEFIT PLAN FINANCIAL INCENTIVES; TO
                DECLARE AN EMERGENCY; AND FOR OTHER PURPOSES.
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                                               Subtitle
                         TO AMEND THE DEFINITIONS WITHIN THE
                         TELEMEDICINE ACT; TO AUTHORIZE ADDITIONAL
                         INSURANCE REIMBURSEMENT FOR TELEMEDICINE;
                         TO PROHIBIT HEALTH BENEFIT PLAN FINANCIAL
                         INCENTIVES; AND TO DECLARE AN EMERGENCY.
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 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF ARKANSAS:
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         SECTION 1.       Arkansas Code  17-80-402(4), concerning the definition of
 a "professional relationship" as used under the Telemedicine Act, is amended
 to read as follows:
                (4)      Professional relationship means at a minimum a
 relationship established between a healthcare professional and a patient
 when:
                         (A)   The healthcare professional has previously conducted
 an in-person examination of the patient and is available to provide
 appropriate follow-up care, when necessary, at medically necessary intervals;
                         (B)   The healthcare professional personally knows the
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 patient and the patient's relevant health status through an ongoing personal
 or professional relationship and is available to provide appropriate follow-
 up care, when necessary, at medically necessary intervals;
                    (C)   The treatment is provided by a healthcare professional
 in consultation with, or upon referral by, another healthcare professional
 who has an ongoing professional relationship with the patient and who has
 agreed to supervise the patient's treatment, including follow-up care;
                    (D)   An on-call or cross-coverage arrangement exists with
 the patient's regular treating healthcare professional or another healthcare
 professional who has established a professional relationship with the
 patient;
                    (E)   A relationship exists in other circumstances as
 defined by rule of the Arkansas State Medical Board for healthcare
 professionals under its jurisdiction and their patients; or
                    (F)   A relationship exists in other circumstances as
 defined by rule of a licensing or certification board for other healthcare
 professionals under the jurisdiction of the appropriate board and their
 patients if the rules are no less restrictive than the rules of the Arkansas
 State Medical Board; or
                    (G)   A healthcare professional, who is licensed in Arkansas
 and has access to a patient's personal health record that is maintained by a
 physician, other licensed healthcare professional, or local educational
 agency, using real-time interactive audio technology, including the
 telephone;
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      SECTION 2.     Arkansas Code  17-80-403(c), concerning the establishment
 of a professional relationship, is amended to read as follows:
      (c)     Professional relationship does not include a relationship
 between a healthcare professional and a patient established only by the
 following:
              (1)   An internet questionnaire;
              (2)   An email message;
              (3)   Patient-generated medical history;
              (4)   Audio-only communication, including without limitation
 interactive audio;
              (5)   Text messaging;
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            (6)(5)     A facsimile machine; or
            (7)(6)     Any combination thereof of means listed in subdivisions
 (c)(1)-(5) of this section.
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      SECTION 3.     Arkansas Code  23-79-1601(2)(C), concerning the definition
 of "health benefit plan", is amended to read as follows:
                     (C)   Health benefit plan does not include:
                            (i)     Disability income plans;
                            (ii)     Credit insurance plans;
                            (iii)    Insurance coverage issued as a supplement to
 liability insurance;
                            (iv)     Medical payments under automobile or homeowners
 insurance plans;
                            (v)     Health benefit plans provided under Arkansas
 Constitution, Article 5,  32, the Workers' Compensation Law,  11-9-101 et
 seq., or the Public Employee Workers' Compensation Act,  21-5-601 et seq.;
                            (vi)     Plans that provide only indemnity for hospital
 confinement;
                            (vii)    Accident-only plans;
                            (viii)     Specified disease plans; or
                            (ix)     Long-term-care-only plans; or
                            (x)     Stand-alone dental or vision benefit plans;
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      SECTION 4.     Arkansas Code  23-79-1601(7), concerning the definition of
 "telemedicine", is amended to read as follows:
            (7)(A)     Telemedicine means the use of electronic information
 and communication technology to deliver healthcare services, including
 without limitation the assessment, diagnosis, consultation, treatment,
 education, care management, and self-management of a patient.
                     (B)   Telemedicine includes store-and-forward technology
 and remote patient monitoring.
                     (C)   For the purposes of this subchapter, telemedicine
 does not include the use of:
                            (i)(a)     Audio-only communication, including without
 limitation interactive audio unless the audio-only communication is real-
 time, interactive, and substantially meets the requirements for a healthcare
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 service that would otherwise be covered by the health benefit plan.
                                 (b)   As with other medical services covered by
 a health benefit plan, documentation of the engagement between patient and
 provider via audio-only communication shall be placed in the medical record
 addressing the problem, content of conversation, medical decision-making, and
 plan of care after the contact.
                                 (c)   The documentation described in subdivision
 (7)(C)(i)(b) of this section is subject to the same audit and review process
 required by payers and governmental agencies when requesting documentation of
 other care delivery such as in-office or face-to-face visits;
                         (ii)    A facsimile machine;
                         (iii)    Text messaging; or
                         (iv)    Electronic mail systems Email.
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      SECTION 5.    Arkansas Code  23-79-1602(e), concerning prohibitions on
 the coverage for telemedicine services, is amended to read as follows:
      (e)   A health benefit plan shall not impose on coverage for healthcare
 services provided through telemedicine:
            (1)    An annual or lifetime dollar maximum on coverage for
 services provided through telemedicine other than an annual or lifetime
 dollar maximum that applies to the aggregate of all items and services
 covered;
            (2)    A deductible, copayment, coinsurance, benefit limitation, or
 maximum benefit that is not equally imposed upon all healthcare services
 covered under the health benefit plan; or
            (3)    A prior authorization requirement for services provided
 through telemedicine that exceeds the prior authorization requirement for in-
 person healthcare services under the health benefit plan; or
            (4)    A requirement or financial incentive of any kind for a
 covered person to choose any commercial telemedicine service provider or a
 restricted network of telemedicine-only providers rather than the covered
 person's regular doctor or provider of choice.
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      SECTION 6.    EMERGENCY CLAUSE.       It is found and determined by the
 General Assembly of the State of Arkansas that due to the coronavirus 2019
 (COVID-19) pandemic, the Governor removed barriers to the use of telemedicine
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 in an attempt to combat the coronavirus 2019 (COVID-19) pandemic; that these
 emergency actions will expire when the emergency proclamation expires, which
 could occur quickly; that on February 26, 2021, the Governor announced that
 the public health emergency was extended but that the Governor was going to
 lift some regulations related to the pandemic; that removing barriers to the
 use of telemedicine ensured that the citizens of Arkansas had the services
 that they needed, and removing these emergency proclamations regarding
 telemedicine would greatly disadvantage and harm the citizens of Arkansas who
 are utilizing telemedicine for healthcare services; that this bill maintains
 the policy changes allowed under the emergency proclamation, which would
 allow the citizens of Arkansas greater access to the use of telemedicine for
 healthcare services; and that this act is immediately necessary to ensure
 that the citizens of Arkansas have access to healthcare services provided via
 telemedicine. Therefore, an emergency is declared to exist, and this act
 being immediately necessary for the preservation of the public peace, health,
 and safety shall become effective on:
            (1)   The date of its approval by the Governor;
            (2)   If the bill is neither approved nor vetoed by the Governor,
 the expiration of the period of time during which the Governor may veto the
 bill; or
            (3)   If the bill is vetoed by the Governor and the veto is
 overridden, the date the last house overrides the veto.
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Statutes affected: 
SB 598: 17-80-402(4), 17-80-403(c), 23-79-1601(2), 23-79-1601(7), 23-79-1602(e)