Ind. Code § 27-13-7-22

Current through P.L. 171-2024

Section 27-13-7-22 - Coverage of telehealth services; prohibition on requiring use of specific information technology application

(a) An individual contract or a group contract must provide coverage for telehealth services in accordance with the same clinical criteria as the individual contract or the group contract provides coverage for the same health care services delivered to an enrollee in person.

(b) Coverage for telehealth services required by subsection (a) may not be subject to a dollar limit, copayment, or coinsurance requirement that is less favorable to an enrollee than the dollar limit, copayment, or coinsurance requirement that applies to the same health care services delivered to an enrollee in person.

(c) Any annual or lifetime dollar limit that applies to telehealth services must be the same annual or lifetime dollar limit that applies in the aggregate to all items and services covered under the individual contract or the group contract.

(d) This section does not do any of the following:

(1) Require an individual contract or a group contract to provide coverage for a telehealth service that is not a covered health care service under the individual contract or group contract.

(2) Require the use of telehealth services when the treating provider has determined that telehealth services are inappropriate.

(3) Prevent the use of utilization review concerning coverage for telehealth services in the same manner as utilization review is used concerning coverage for the same health care services delivered to an enrollee in person.

(e) A separate consent for telehealth services may not be required.

(f) If a policy provides coverage for telehealth services via:

(1) secure videoconferencing;

(2) store and forward technology; or

(3) remote patient monitoring technology;

between a provider in one (1) location and a patient in another location, the policy may not require the use of a specific information technology application for those services.

IC 27-13-7-22

Amended by P.L. 85-2021,SEC. 32, eff. 4/20/2021.

Added by P.L. 185-2015, SEC. 27, eff. 7/1/2015.