Revision: Jan. 14, 2020, 12:45 p.m.
SB 647-FN - AS INTRODUCED
SENATE BILL 647-FN
SPONSORS: Sen. Kahn, Dist 10; Sen. Fuller Clark, Dist 21; Sen. Gray, Dist 6; Sen. Bradley, Dist 3; Sen. Sherman, Dist 24; Rep. Edwards, Rock. 4; Rep. Campion, Graf. 12; Rep. Marsh, Carr. 8; Rep. Long, Hills. 10
COMMITTEE: Health and Human Services
This bill clarifies medication assisted treatment (MAT) by telemedicine and telehealth services.
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Explanation: Matter added to current law appears in bold italics.
Matter removed from current law appears [in brackets and struckthrough.]
Matter which is either (a) all new or (b) repealed and reenacted appears in regular type.
STATE OF NEW HAMPSHIRE
In the Year of Our Lord Two Thousand Twenty
Be it Enacted by the Senate and House of Representatives in General Court convened:
1 Medicaid Coverage of Telehealth Services. Amend RSA 167:4-d, II(c)-(e) to read as follows:
(c) "Doorways" means the statewide points of entry for the delivery of substance use services.
(d) "Originating site" means the location of the patient, whether or not accompanied by a health care provider, at the time services are provided by a health care provider through telemedicine, including, but not limited to, a health care provider's office, a hospital, or a health care facility, or the patient's home or another nonmedical environment such as a school-based health center, a university-based health center, or the patient's workplace.
[(d)] (e) "Remote patient monitoring" means the use of electronic technology to remotely monitor a patient's health status through the collection and interpretation of clinical data while the patient remains at an originating site. Remote patient monitoring may or may not take place in real time. Remote patient monitoring shall include assessment, observation, education and virtual visits provided by all covered providers including licensed home health care providers.
[(e)] (f) "Store and forward," as it pertains to telemedicine and as an exception to 42 C.F.R. section 410.78, means the use of asynchronous electronic communications between a patient at an originating site and a health care service provider at a distant site for the purpose of diagnostic and therapeutic assistance in the care of patients. This includes the forwarding and/or transfer of stored medical data from the originating site to the distant site through the use of any electronic device that records data in its own storage and forwards its data to the distant site via telecommunication for the purpose of diagnostic and therapeutic assistance.
VI. With written consent of the patient receiving medication assisted treatment through telehealth services provided under this section, the health care provider shall provide notification of the patient’s medication assisted treatment to the doorway within the region where the patient resides.
III. It shall be unlawful for any person to prescribe by means of telemedicine a controlled drug classified in schedule II through IV, except for the use in medication assisted treatment (MAT) for substance use treatment. Methadone hydrochloride, as defined in RSA 318-B:10, VII (d)(2) shall not be included in the exemption.
IV.(a) The prescribing of a non-opioid controlled drug classified in schedule II through IV by means of telemedicine shall be limited to prescribers as defined in RSA 329:1-d, I and RSA 326-B:2, XII(a), who are treating a patient with whom the prescriber has an in-person practitioner-patient relationship, for purposes of monitoring or follow-up care[, or who are treating patients at a state designated community mental health center pursuant to RSA 135-C or at a Substance Abuse and Mental Health Services Administration (SAMHSA)-certified state opioid treatment program,] and shall require an initial in-person exam by a practitioner licensed to prescribe the drug. Subsequent in-person exams shall be by a practitioner licensed to prescribe the drug at intervals appropriate for the patient, medical condition, and drug, but not less than annually.
(b) The prescribing of an opioid controlled drug classified in schedule II through IV by means of telemedicine shall be limited to prescribers as defined in RSA 329:1-d, I and RSA 326-B:2, XII(a)[, who are treating patients at a SAMHSA-certified state opioid treatment program]. Such prescription authority shall require an initial in-person exam by a practitioner licensed to prescribe the drug and subsequent in-person exams shall be by a practitioner licensed to prescribe the drug at intervals appropriate for the patient, medical condition, and opioid, but not less than annually.
SB 647-FN- FISCAL NOTE
FISCAL IMPACT: [ X ] State [ ] County [ ] Local [ ] None
Estimated Increase / (Decrease)
[ X ] General [ ] Education [ ] Highway [ X ] Other - Federal matching funds.
This bill amends RSA 167:4-d by (1) adding a definition of "doorways" within the context of Medicaid coverage of telehealth services, and (2) requiring that notification of medication assisted treatment (MAT) via telehealth services be provided by a health care provider to the appropriate regional doorway, when a patient has consented to such. In addition, the bill amends RSA 329:1-d to (1) allow for the prescription of controlled drugs classified in schedule II-IV for the purposes of MAT for substance use treatment, and (2) remove references to prescribers treating patients at state-designated community mental health centers or state opioid treatment programs certified by the Substance Abuse and Mental Health Services Administration (SAMHSA). The Department of Health and Human Services expects that the proposed changes may increase utilization for telemedicine services, resulting in a potential increase in state Medicaid costs. However, the Department also expects the changes to result in an indeterminable long-term cost savings as a result of individuals receiving MAT for substance use treatment. The net result is an indeterminable impact on state expenditures.
Department of Health and Human Services