Connecticut Seal

General Assembly

 

Raised Bill No. 164

February Session, 2016

 

LCO No. 1081

 

*_____SB00164HS____041216____*

Referred to Committee on AGING

 

Introduced by:

 

(AGE)

 

AN ACT CONCERNING MEDICAID COVERAGE OF TELEMONITORING SERVICES.

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

Section 1. (NEW) (Effective July 1, 2016) (a) For purposes of this section:

(1) "Department" means the Department of Social Services.

(2) "Evidence-based best practices" means the integration of the best available research with clinical expertise in the context of patient characteristics and preferences.

(3) "Home health care agency" has the same meaning as provided in section 19a-490 of the general statutes.

(4) "Home telemonitoring service" means a health service included in an integrated plan of care written by a treating physician that requires (A) scheduled remote monitoring of data related to a patient's health, including, but not limited to, monitoring of the patient's blood pressure, heart rate, weight and oxygen level, (B) interpretation of transmitted data by a home health care agency, (C) dissemination of such data by such home health care agency to a treating physician, and (D) follow-up by a health care professional in the home or referrals for care as determined medically necessary by a treating physician.

(b) To the extent permissible under federal law, the department shall provide Medicaid coverage for services performed by a home health care agency using a home telemonitoring service for a Medicaid beneficiary with (1) serious or chronic medical conditions that may result in frequent or recurrent hospitalizations and emergency room admissions, (2) a documented history of poor adherence to ordered medication regimes, (3) a documented history of falls in the six-month period prior to evaluation of the need for home telemonitoring services, (4) limited or absent informal support systems, (5) a documented history of challenges with access to care, or (6) a history of living alone or being home alone for extended periods of time. The department shall establish coverage criteria for home telemonitoring services based on evidence-based best practices.

(c) The department shall ensure that clinical information gathered by a home health care agency while providing home telemonitoring services is shared with the patient's treating physician and may impose other reasonable requirements on the use of home telemonitoring services. The Commissioner of Social Services shall adopt regulations, in accordance with the provisions of chapter 54 of the general statutes, to implement the provisions of this section.

(d) The Commissioner of Social Services may seek a waiver from federal Medicaid requirements or an amendment to the Medicaid state plan, pursuant to section 17b-8 of the general statutes, if necessary to implement the provisions of this section.

(e) The transmission, storage and dissemination of data and records related to home telemonitoring services shall be in accordance with federal and state laws and regulations concerning the privacy, security, confidentiality and safeguarding of individually identifiable information.

This act shall take effect as follows and shall amend the following sections:

Section 1

July 1, 2016

New section

AGE

Joint Favorable

 

HS

Joint Favorable