New York Legislature Broadens Telehealth Services Coverage for Adult Care Facilities

New York continues to drive legislative reform to promote telehealth services – clinical healthcare provided remotely through information technology. Most recently the state legislature passed a bill that expands the definition of “originating sites” where telehealth services may be provided to Medicaid patients in an effort to lower costs and health risks.

For background, in January 2016, New York became the 29th state to pass a telehealth coverage law requiring all commercial insurers to cover telehealth services if the services would otherwise be covered under the insurer’s policy had they been provided in a traditional in-person setting. While several commentators praised this amendment to the commercial insurance law as an effort to expand the use of telehealth, others questioned why the law governing the provision of telehealth services to Medicaid patients was not also amended to be equally expansive.

Although the 2016 law did not mandate where a telehealth provider or patient must be located for purposes of commercial insurance reimbursement, Medicaid patients in New York cannot receive telehealth services in locations that do not qualify as an “originating site,” originally defined as certain medical facilities licensed in New York and private physician offices located in New York.

The recent bill passed in the Senate aims to expand the definition of originating site to include adult care facilities licensed in New York. This change should benefit patients who are unable to live independently or are hindered by their inability to travel long distances for treatment. It will reduce the costs and health risks associated with travel by allowing specialists to treat seniors in adult care facilities via telehealth technologies. Physicians will be able to provide services quicker and to tailor treatment plans to individual needs of each patient.

The bill was passed by the Senate and is awaiting signature by the governor to be signed into law.