20-841.09. Telemedicine; coverage of health care services; definitions
A. All contracts issued, delivered or renewed on or after January 1, 2015 must provide coverage for health care services that are provided through telemedicine if the health care service would be covered were it provided through in-person consultation between the subscriber and a health care provider and provided to a subscriber receiving the service in a rural region of this state. The contract may limit the coverage to those health care providers who are members of the corporation's provider network.
B. This section does not prevent a corporation from imposing deductibles, copayment or coinsurance requirements for a health care service provided through telemedicine if the deductible, copayment or coinsurance does not exceed the deductible, copayment or coinsurance applicable to an in-person consultation for the same health care service.
C. Services provided through telemedicine or resulting from a telemedicine consultation shall comply with Arizona licensure requirements, accreditation standards and any practice guidelines of a national association of medical professionals promoting access to medical care for consumers via telecommunications technology or other qualified medical professional societies to ensure quality of care.
D. This section does not apply to limited benefit coverage as defined in section 20-1137.
E. For the purposes of this section:
1. " Health care services" means services provided for the following conditions or in the following settings:
(a) Trauma.
(b) Burn.
(c) Cardiology.
(d) Infectious diseases.
(e) Mental health disorders.
(f) Neurologic diseases including strokes.
(g) Dermatology.
2. " Rural region" means either:
(a) An area that is located in a county with a population of less than nine hundred thousand persons.
(b) A city or town that is located in a county with a population of nine hundred thousand persons or more and whose nearest boundary is more than thirty miles from the boundary of a city that has a population of five hundred thousand persons or more.
3. " Telemedicine" :
(a) Means the interactive use of audio, video or other electronic media for the purpose of diagnosis, consultation or treatment.
(b) Does not include the sole use of an audio-only telephone, a video-only system, a facsimile machine, instant messages or electronic mail.
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