Section 1374.13 Of Article 5. Standards From California Health And Safety Code >> Division 2. >> Chapter 2.2. >> Article 5.
1374.13
. (a) For the 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 health care provider.
(c) No health care service plan shall require that in-person
contact occur between a health care provider and a patient before
payment is made for the covered services appropriately provided
through telehealth, subject to the terms and conditions of the
contract entered into between the enrollee or subscriber and the
health care service plan, and between the health care service plan
and its participating providers or provider groups.
(d) No health care service plan shall limit the type of setting
where services are provided for the patient or by the health care
provider before payment is made for the covered services
appropriately provided through telehealth, subject to the terms and
conditions of the contract entered into between the enrollee or
subscriber and the health care service plan, and between the health
care service plan and its participating providers or provider groups.
(e) The requirements of this section shall also apply to health
care service plan and Medi-Cal managed care plan contracts with the
State Department of Health Care Services pursuant to Chapter 7
(commencing with Section 14000) or Chapter 8 (commencing with Section
14200) of Part 3 of Division 9 of the Welfare and Institutions Code.
(f) Notwithstanding any other provision, this section shall not be
interpreted to authorize a health care service plan to require the
use of telehealth when the health care provider has determined that
it is not appropriate.