(2) An insurer that provides comprehensive coverage for hospital,
medical or surgical care shall reimburse covered services delivered by
means of telehealth on the same basis, at the same rate, and to the same
extent that such services are reimbursed when delivered in person;
provided that reimbursement of covered services delivered via telehealth
shall not require reimbursement of costs not actually incurred in the
provision of the telehealth services, including charges related to the
use of a clinic or other facility when neither the originating site nor
distant site occur within the clinic or other facility.
(3) An insurer that provides comprehensive coverage for hospital,
medical, or surgical care with a network of health care providers shall
ensure that such network is adequate to meet the telehealth needs of
insured individuals for services covered under the policy when medically
appropriate.
* NB Effective until April 1, 2024
* (a) An insurer shall not exclude from coverage a service that is
otherwise covered under a policy that provides comprehensive coverage
for hospital, medical or surgical care because the service is delivered
via telehealth, as that term is defined in subsection (b) of this
section; provided, however, that an insurer may exclude from coverage a
service by a health care provider where the provider is not otherwise
covered under the policy. An insurer may subject the coverage of a
service delivered via telehealth to co-payments, coinsurance or
deductibles provided that they are at least as favorable to the insured
as those established for the same service when not delivered via
telehealth. An insurer may subject the coverage of a service delivered
via telehealth to reasonable utilization management and quality
assurance requirements that are consistent with those established for
the same service when not delivered via telehealth.
* NB Effective April 1, 2024
(b) For purposes of this section, "telehealth" means the use of
electronic information and communication technologies by a health care
provider to deliver health care services to an insured individual while
such individual is located at a site that is different from the site
where the health care provider is located.
Structure New York Laws
Article 32 - Insurance Contracts - Life, Accident and Health, Annuities
3201 - Approval of Life, Accident and Health, Credit Unemployment, and Annuity Policy Forms.
3202 - Withdrawal of Approval of Policy Forms.
3205 - Insurable Interest in the Person; Consent Required; Exceptions.
3206 - Policies Which Provide for an Adjustable Maximum Rate of Interest on Policy Loans.
3208 - Antedating of Life Insurance Policies and Burial Agreements Prohibited.
3209 - Life Insurance, Annuities and Funding Agreements Disclosure Requirements.
3210 - Incontestability After Reinstatement.
3212 - Exemption of Proceeds and Avails of Certain Insurance and Annuity Contracts.
3214 - Interest Upon Proceeds of Life Insurance Policies and Annuity Contracts.
3215 - Disability Benefits in Connection With Life Insurance and Annuities.
3216 - Individual Accident and Health Insurance Policy Provisions.
3217-A - Disclosure of Information.
3217-C - Primary and Preventive Obstetric and Gynecologic Care.
3217-D - Grievance Procedure and Access to Specialty Care.
3217-E - Choice of Health Care Provider.
3217-F - Prohibition on Lifetime and Annual Limits.
3217-G - Maternal Depression Screenings.
3217-H - Telehealth Delivery of Services.
3217-I - Essential Health Benefits Package and Limit on Cost-Sharing.
3217-J - Utilization Review Determinations for Medically Fragile Children.
3218 - Medicare Supplemental Insurance Policies.
3220 - Group Life Insurance Policies; Standard Provisions.
3221 - Group or Blanket Accident and Health Insurance Policies; Standard Provisions.
3224 - Standard Claim Forms; Accident and Health Insurance.
3224-B - Rules Relating to the Processing of Health Claims and Overpayments to Physicians.
3224-C - Coordination of Benefits.
3224-D - Prescription Synchronization.
3225 - Eligibility for Health Insurance in Cases of Exposure to Des.
3226 - Reinsurance Contracts Excepted.
3227 - Interest Upon Surrenders, Policy Loans and Other Funds.
3228 - Individual Accident and Health Insurance Policies; Premium Refund at Death of Insured.
3229 - Minimum Benefit Standards for Certain Long Term Care Plans.
3231 - Rating of Individual and Small Group Health Insurance Policies; Approval of Superintendent.
3231*2 - Health Insurance Policies and Subscriber Contracts; Prohibited Claims.
3232 - Pre-Existing Condition Provisions in Health Policies.
3232-A - Certification of Creditable Coverage.
3233 - Stabilization of Health Insurance Markets and Premium Rates.
3234 - Pre-Existing Condition Provisions in Group and Blanket Disability Policies.
3234*2 - Limitations on Administrative Services and Stop-Loss Coverage.
3236 - Public Health Law Assessments.
3237 - Health Insurance Coverage for Full-Time Students on Medical Leaves of Absence.
3238 - Pre-Authorization of Health Care Services.
3240*2 - Student Accident and Health Insurance.
3242 - Prescription Drug Coverage.
3245 - Liability to Providers in the Event of an Insolvency.