Utah Code 49-20-414. Telemedicine services — Reimbursement — Reporting
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(1) As used in this section:
Terms Used In Utah Code 49-20-414
- Program: means the Public Employees' Benefit and Insurance Program. See Utah Code 49-20-102
- State: when applied to the different parts of the United States, includes a state, district, or territory of the United States. See Utah Code 68-3-12.5
(1)(a) “Network provider” means a health care provider who has an agreement with the program to provide health care services to a patient with an expectation of receiving payment, other than coinsurance, copayments, or deductibles, directly from the managed care organization.
(1)(b) “Telemedicine services” means the same as that term is defined in Section 26B-4-704.
(2) This section applies to the risk pool established for the state under Subsection 49-20-201(1)(a).
(3) The program shall, at the provider’s request, reimburse a network provider for medically appropriate telemedicine services at a commercially reasonable rate.
(4) Before November 1, 2019, the program shall report to the Legislature’s Public Utilities, Energy, and Technology Interim Committee and Health Reform Task Force on:
(4)(a) the result of the reimbursement requirement described in Subsection (3);
(4)(b) existing and potential uses of telehealth and telemedicine services;
(4)(c) issues of reimbursement to a provider offering telehealth and telemedicine services;
(4)(d) potential rules or legislation related to:
(4)(d)(i) providers offering and insurers reimbursing for telehealth and telemedicine services; and
(4)(d)(ii) increasing access to health care, increasing the efficiency of health care, and decreasing the costs of health care; and
(4)(e) telemedicine services that the program declined to cover because the telemedicine services that were requested were not medically appropriate.