Amended in Senate July 1, 2014

Amended in Senate June 10, 2014

Amended in Assembly May 24, 2013

California Legislature—2013–14 Regular Session

Assembly Bill No. 1310

Introduced by Assembly Member Bonta

(Principal coauthor: Assembly Member Brown)

February 22, 2013

An act to amend begin delete Section end delete begin insert Sections 14122 and end insert 14132.72 of the Welfare and Institutions Code, relating to Medi-Cal.

LEGISLATIVE COUNSEL’S DIGEST

AB 1310, as amended, Bonta. Medi-Cal: telehealth.

Existing law provides for the Medi-Cal program, which is administered by the State Department of Health Care Services, under which qualified low-income individuals receive health care services. The Medi-Cal program is, in part, governed and funded by federal Medicaid Program provisions. Existing law prohibits a requirement of in-person contact between a health care provider and patient under the Medi-Cal program for any service otherwise covered by the Medi-Cal program when the service is appropriately provided by telehealth, as defined. Existing law, for purposes of payment of covered treatment or services provided through telehealth, prohibits the department from limiting the type of setting where services are provided for the patient or by the health care provider.

This bill would prohibit the department from requiring a health care provider licensed in California to be located in California as a condition of Medi-Cal provider enrollment or reimbursement for telehealth services provided to begin delete Medicare or Medicaid end delete begin insert Medi-Cal end insert beneficiaries located in California at the time of service.

Vote: majority. Appropriation: no. Fiscal committee: yes. State-mandated local program: no.

The people of the State of California do enact as follows:

begin insert

begin insert SECTION 1. end insert   

end insert

begin insert Section 14122 of the end insert begin insert Welfare and Institutions
Code end insert begin insert is amended to read: end insert

14122.  

begin insert (a) end insert begin insert   end insert The department may provide, by regulation and
consistent with the requirements of the Federal Social Security
Act, for the care and treatment, or both, of persons eligible for
medical assistance pursuant to Sections 14005.1, begin delete 14005. 4, end delete begin insert 14005.4, end insert
and 14005.7 by providers in another state in those cases where
out-of-state care or treatment is rendered on an emergency basis
or is otherwise in the best interests of the person under the
circumstances.

begin insert

(b) This section shall not apply to services provided pursuant
to Section 14132.72.

end insert

begin delete SECTION 1. end delete
begin insert SEC. 2. end insert   

Section 14132.72 of the Welfare and Institutions Code
is amended to read:

14132.72.  

(a) For purposes of this section, the definitions in
subdivision (a) of Section 2290.5 of the Business and Professions
Code shall apply.

(b) It is the intent of the Legislature to recognize the practice
of telehealth as a legitimate means by which an individual may
receive health care services from a health care provider without
in-person contact with the provider.

(c) In-person contact between a health care provider and a
patient shall not be required under the Medi-Cal program for
services appropriately provided through telehealth, subject to
reimbursement policies adopted by the department to compensate
a licensed health care provider who provides health care services
through telehealth that are otherwise reimbursed pursuant to the
Medi-Cal program.  Nothing in this section or the Telehealth
Advancement Act of 2011 (Chapter 547 of the Statutes of 2011)
shall be construed to conflict with or supersede the provisions of
begin delete Section 14091.3 of this code or end delete any other existing state laws or
regulations related to reimbursement for services provided by a
noncontracted provider.

(d) The department shall not require a health care provider to
document a barrier to an in-person visit for Medi-Cal coverage of
services provided via telehealth.

(e)  begin delete Notwithstanding Section 14122 or any other law, the end delete begin insert The end insert
department shall not require a health care provider licensed in
California to be located in California as a condition of Medi-Cal
provider enrollment or reimbursement for telehealth services
provided to begin delete Medicare or Medicaid end delete begin insert Medi-Cal end insert beneficiaries located
in California at the time of service.

(f) For the purposes of payment for covered treatment or services
provided through telehealth, the department shall not limit the type
of setting where services are provided for the patient or by the
health care provider.

(g) Nothing in this section shall be interpreted to authorize the
department to require the use of telehealth when the health care
provider has determined that it is not appropriate.

(h) Notwithstanding Chapter 3.5 (commencing with Section
11340) of Part 1 of Division 3 of Title 2 of the Government Code,
the department may implement, interpret, and make specific this
section by means of all-county letters, provider bulletins, and
similar instructions.