AN ACT CONCERNING THE USE OF TELEMEDICINE TO PROMOTE EFFICIENCY IN THE DELIVERY OF HEALTH CARE SERVICES.

Be it enacted by the Senate and House of Representatives in General Assembly convened:

Section 1. (NEW) (Effective July 1, 2008) (a) As used in sections 1 to 5, inclusive, of this act, "health care provider" means a person licensed to practice under chapter 370, 372, 373, 375, 376c, 377, 378, 379, 380 or 382 of the general statutes; and "telemedicine" means the delivery of health care services and any diagnosis, consultation or treatment using interactive audio, interactive video or interactive data communication, and includes the types of services described in subsection (d) of section 20-9 of the general statutes.

(b) Prior to the delivery of health care services to a patient through telemedicine for the first time, a health care provider shall have in- person contact with the patient and shall obtain verbal and written informed consent from the patient or the patient's legal representative. The informed consent procedure shall, at a minimum, ensure that the following information is given to the patient or the patient's legal representative verbally and in writing:

(1) The patient retains the option to refuse the delivery of health care services via telemedicine at any time without affecting the patient's right to future care or treatment and without risking the loss or withdrawal of any program benefits to which the patient would otherwise be entitled;

(2) All applicable confidentiality protections apply to telemedicine services;

(3) All medical reports resulting from telemedicine services are part of a patient's health record and shall be made available to the patient in accordance with the provisions of sections 19a-490b and 20-7c of the general statutes; and

(4) A description of the potential risks, consequences and benefits of telemedicine.

Sec. 2. (NEW) (Effective July 1, 2008) (a) To the extent permitted by federal law and except as provided in subsection (b) of section 1 of this act, on and after July 1, 2008, in-person contact between a health care provider and a patient shall not be required for health care services delivered through telemedicine under the HUSKY Plan, Part A or Part B, the Charter Oak Health Plan, the state-administered general assistance program or the Medicaid program, provided such health care services are otherwise eligible for reimbursement under the HUSKY Plan, Part A or Part B, the Charter Oak Health Plan, the state-administered general assistance program or the Medicaid program, as appropriate.

(b) The Commissioner of Social Services, in consultation with the Commissioner of Public Health, shall adopt regulations, in accordance with the provisions of chapter 54 of the general statutes, establishing rates for transmission cost reimbursement for telemedicine services provided to beneficiaries under the HUSKY Plan, Part A or Part B, the Charter Oak Health Plan, the Medicaid program and state-administered general assistance program, considering, to the extent applicable, reductions in travel costs by health care providers and patients to deliver or to access health care services and such other factors as the Commissioner of Social Services deems relevant.

Sec. 3. (NEW) (Effective October 1, 2008) Each individual health insurance policy providing coverage of the type specified in subdivisions (1), (2), (4), (11) and (12) of section 38a-469 of the general statutes delivered, issued for delivery, amended, renewed or continued in this state on or after October 1, 2008, shall provide coverage for telemedicine services that meet the requirements of section 1 of this act, provided such health care services are otherwise covered under the policy.

Sec. 4. (NEW) (Effective October 1, 2008) Each group health insurance policy providing coverage of the type specified in subdivisions (1), (2), (4), (11) and (12) of section 38a-469 of the general statutes delivered, issued for delivery, amended, renewed or continued in this state on or after October 1, 2008, shall provide coverage for telemedicine services that meet the requirements of section 1 of this act, provided such health care services are otherwise covered under the policy.

Sec. 5. (NEW) (Effective July 1, 2008) (a) On or before October 1, 2009, the Department of Public Health shall establish one or more two-year pilot programs to (1) investigate the feasibility and appropriateness of using telemedicine to manage and treat patients with (A) congestive heart failure, (B) diabetes, its indicative conditions, or both, and (C) chronic obstructive pulmonary disease, and (2) develop methods and procedures for preventing fraud, abuse and overuse of telemedicine services. The Commissioner of Public Health shall contract, through a request for proposal process, with one or more entities to operate the pilot program or programs in accordance with this section. Each proposal shall include a detailed description of the entity's plan for administering the pilot program and methods and procedures for data collection and reporting.

(b) The course of treatment for any patient selected to participate in a pilot program under this section shall not differ from the usual and customary course of treatment for such patient if the patient had not participated in such pilot program.

(c) In selecting patients to participate in a pilot program authorized under this section, the entity shall consider the following factors: (1) The nature of the patient's medical condition and whether it has or will require health care services of unusually high frequency, urgency or duration, (2) the patient's cognitive ability, (3) whether the patient resides in a medically underserved area, (4) whether the patient has support from a relative or other caregiver, and (5) whether the patient has access to telecommunications technology services.

(d) The Commissioner of Public Health shall evaluate the pilot program or programs established under this section and shall submit a report of the commissioner's findings and recommendations to the joint standing committee of the General Assembly having cognizance of matters relating to public health, not later than December 31, 2011, in accordance with the provisions of section 11-4a of the general statutes. Such report shall include an evaluation of the data collected with respect to improved chronic disease management and cost savings, based on patient outcomes.

(e) Nothing in this section shall be construed to alter the scope of practice of any health care provider.