CTRC Legislative/Regulatory November 2016 Update

CTRC Legislative/Regulatory November 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

Passed Legislation

State Bill Status Summary
California AB 1568 7/1/16: Chaptered This bill requires an access assessment to, among other items, measure managed care compliance with network adequacy requirements.  Network adequacy within Medicaid managed care contracts will account for the use of alternative modalities for accessing care, including telemedicine (among other components).
California SB 815 7/26/16: Chaptered This bill requires an access assessment to, among other items, measure managed care compliance with network adequacy requirements.  Network adequacy within Medicaid managed care contracts will account for the use of alternative modalities for accessing care, including telemedicine (among other components).

 

Dead Bills

State Bill Status Summary
California AB 1758 4/20/16: In Assembly Utilities and Commerce This bill, among other things, would allocate up to $10 million from the Broadband Infrastructure Grant Account to the California Telehealth Network.
California AB 2395 5/25/16: In committee: Set, first hearing. Referred to Appropriations suspense file. This bill relates to telecommunication and replacement of a public switched telephone network, which can be utilized for telemedicine (among other items).
California AB 2507 5/27/16: In Assembly Committee on Appropriations: Held in Committee

 

This bill would mandate that a health care service plan contract coverage and reimbursement for services provided to a patient through telehealth to the same extent as though provided in-person. The rate will be at least as favorable as if the services were provided in-person.
California SB 960 5/27/16: Held in Senate Appropriations Committee and under submission. This bill would allow for reproductive health care provided via store-and-forward to be reimbursed by Medi-Cal.

 

REGULATION

Pending Regulation

State Reg. Status Summary
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 15 CCR 1027.5, 1122.5, 1208.5, 1030 8/9/16: Proposed rule

Comment Deadline:  9/12/16

Title: Minimum Standards for Local Detention Facilities

Agency:  Board of State and Community Corrections

Provides a new definition for telehealth and allows a facility administrator for mentally disordered inmates to develop policies and procedures to identify and evaluate inmates through telehealth.

 

Approved Regulation

State 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.

California Title 10 CCR Section 2240, .1 thru .7, .15, .16 3/23/16:  Rule Adoption

Effective: 3/8/16

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 16 CCR Sec. 1815.5 5/26/16: Adopted

Effective: 7/1/16

Title:  Standards of Practice for Telehealth

Agency:  CA Board of Behavioral Sciences

This rule would establish Standards of Practice for telehealth.

 

Adopted Emergency Rules (with expiration dates)

State Reg. Status Summary
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).