CTRC Legislative/Regulatory February 2016 Update

Please Note: CCHP has a pending legislation/regulation webpage located at the following link: http://cchpca.org/state-laws-and-reimbursement-policies

LEGISLATION

Pending Legislation

State Bill # Status Summary
California AB 238 1/4/2016: Amended This bill, among other things, would allocate up to $10 million from the Broadband Infrastructure Grant Account to the California Telehealth Network.

 

Approved Legislation

State Bill # Status Summary
       

 

REGULATION

Approved Regulation

Stat Reg. Status Summary
California Title 16 CCR Sections 1820; .5, .7; 1822 1/1/16: Effective this date Title: LPCCS Treatment of Couples and Families

Agency: Board of Behavioral Sciences

This rule would increase the number of hours of supervised experience toward the 3,000 hours required for licensure for a licensed professional clinical counselor, which can be obtained via telehealth from 250 to 375 hours.

 

Pending Regulation

Stat Reg. Status Summary
       
California Title 16 CCR Sec. 1815.5 7/10/15: Proposed rule notice

Comment Deadline: 8/24/15

Title:  Standards of Practice for Telehealth

Agency:  CA Board of Behavioral Sciences

This rule would establish Standards of Practice for telehealth.

California Title 16 CCR Section 4172 9/25/15: Proposed rule notice

Comment deadline: 11/9/15

Title:  Telehealth

Agency:  Board of Occupational Therapy

Clarifies that an occupational therapist does not need to obtain a patient’s/client’s consent for subsequent telehealth services once the patient initially consents to receive occupational therapy services via telehealth. Deletes informed from the language and otherwise reconstructs the language in the subsection to make it read better.

California Title 10 CCR Section 2240, .1 thru .7, .15, .16 12/18/15: Additional amendments made

Public Comment Deadline: 1/4/2016

Title: Provider Network Adequacy

Agency:  Department of Insurance

This rule would strengthen requirements regarding network design, demonstration of insurer compliance, submission of data that will support the analysis of emerging trends, as well as requirements regarding accuracy of provider directories and other consumer notices.  Among other requirements, it requires insurers to file a network adequacy report with the Department of Insurance that provides a description of the implementation and use of triage, telemedicine and health information technology to provide timely access to care.  It also provides for a waiver of the network access standards.  An application for such a waiver must include an explanation of alternatives that were considered, including but not limited to telemedicine or phone consultations (among other requirements).

California Title 10 CCR

Health Benefit Exchange

 

12/31/15: Emergency Rule Re-adoption

 

Agency: Health Benefit Exchange

Title: Eligibility and Enrollment Process – Individual Exchange

These regulations established the Health Benefit Exchange’s policies and procedures for eligibility determination and redetermination, enrollment, and termination.  Specific to telehealth, it refers to Section 2290.5 of the Business and Professions Code to define the term telemedicine or telehealth.

 

Adopted Emergency Rules (with expiration dates)

Stat Reg. Status Summary
California Title 10 CCR Section 2240, .1, .15, .16, .4, .5, .6, .7

 

7/27/15: Emergency rule adoption

Effective: 7/27/15

Expires: 1/26/2016

Title: Provider Network Adequacy

Agency: Department of Insurance

Updates the Department’s existing regulation, and addresses concerns regarding inadequate network access, non-network providers in network facilities, and inaccurate provider directories, by implementing the proposed amendments and additions in this regulation.  Section was added to require insurers to submit documents describing the implementation and use of triage, telemedicine and health information technology to provide timely access to care. This allows insurers to demonstrate alternative means of providing adequate access, as appropriate.

California Title 10 CCR Sec. 6428, 6430 2/5/15: Notice of Approval of Emergency Regulatory Action

Effective: 2/5/15

Expires: 2/5/17

Title: 2016 Qualified Health Plan Recertification/New Entrant

Agency: Health Benefit Exchange

Establishes the process and requirements for eligible health issuers in the individual and SHOP exchanges to submit proposed qualified health plans (QHP) for recertification and for new health issuer entrants who are eligible and elect to propose QHPs for the Plan Year 2016. Among the application questions, it asks health issuers strategies they use to implement, or intend to implement, to promote access and care coordination through the use of telemedicine (among other things).