BILL ANALYSIS Ó
Senate Appropriations Committee Fiscal Summary
Senator Christine Kehoe, Chair
AB 415 (Logue)
Hearing Date: 8/25/2011 Amended: 8/15/2011
Consultant: Katie Johnson Policy Vote: Health 8-0 BP&ED
9-0
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BILL SUMMARY: AB 415 would enact the Telehealth Advancement Act
of 2011. In doing so, it would repeal and recast existing laws
related to the delivery of health care services via telemedicine
and would replace the term telemedicine with telehealth.
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Fiscal Impact (in thousands)
Major Provisions 2011-12 2012-13 2013-14 Fund
DMHC $53 $105 $105 Special*
Potential increased unknown,
potentially significant General/**
number of Medi-Cal visits Federal/
Local
*Managed Care Fund
**50 percent federal funds, 50 percent non-federal funds
(usually General Fund, but would be local funds if provided by
designated public hospitals or paid for the Low-Income Health
Care Program)
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STAFF COMMENTS: SUSPENSE FILE.
This bill would remove various requirements imposed by health
care service plans, health insurers, and Medi-Cal for patients
to receive health care services through telehealth and would
amend the informed consent requirements prior to the delivery of
health care via telehealth.
This bill would repeal the definition of telemedicine, which
means the practice of health care delivery, diagnosis,
consultation, treatment, transfer of medical data, and education
using interactive audio, video, or data communications, not
AB 415 (Logue)
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including by means of a telephone conversation nor an electronic
mail message between a health care practitioner and patient. It
would, instead, define telehealth as the mode of delivering
health care services and public health via information and
communication technologies to facilitate the diagnosis,
consultation, treatment, education, care management, and
self-management of a patient's health care while the patient is
at the originating site and the health care provider is at a
distant site.
This bill would repeal the requirement that prior to the
delivery of health care via telemedicine, the health care
practitioner must obtain verbal and written informed consent
from the patient, as specified, and the requirement that a
patient must sign a written statement prior to the delivery of
health care via telemedicine. The written statement is made part
of the patient's medical record. Instead, this bill would
require a health care practitioner to obtain verbal consent from
the patient prior to the provision of health care services via
telehealth and to document that verbal consent was given in the
medical record.
This bill would prohibit the department from requiring that a
health care provider document a barrier to an in-person visit
prior to paying for services provided via telehealth to a
Medi-Cal beneficiary. This bill would repeal the prohibition for
paying for a service provided by telephone or facsimile and
would instead prohibit the department from limiting the type of
setting where services are provided for the patient.
This bill would prohibit health plans and insurers from
requiring that in-person contact occur between a health care
provider and a patient before payment is made for the services
appropriately provided through telehealth, subject to the terms
of the relevant contract. This bill would repeal the prohibition
for paying for a service provided by telephone or facsimile and
would instead prohibit them from limiting the type of setting
where services are provided for the patient or by the health
care provider. These provisions would apply to plans contracting
with DHCS to provide Medi-Cal managed care and would repeal the
requirements that telemedicine could only be used 1) for
telemedicine services that are reimbursed by the Medi-Cal
fee-for-service program and 2) that Medi-Cal contracts with
health plans are amended to add coverage of telemedicine
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services and to make any appropriate capitation rate adjustment.
This bill would repeal the existing January 1, 2013, sunset date
on the use of teleopthalmology and teledermatology by store and
forward technology and would update and define terminology
related to telehealth and current practice.
Fiscal Effect
To the extent that this bill would increase the number of visits
or services for which Medi-Cal pays, there could be a
significant increase in costs to the program. However, to the
extent that this bill would enable an individual to receive
necessary care at the right time and contribute to an overall
improvement in or maintenance of an individual's health and to
the prevention of disease over-time, then there could be
long-term cost avoidance.