H721 - Increase Access to Telehealth Services

• Defines "telehealth" for Medicaid and NC Health Choice to include real-time audio/video encounters, store-and-forward services, and asynchronous communications where providers have access to patient medical history, while excluding services delivered solely through email, text chat, or audio unless additional clinical information is shared or services are behavioral health services.

• Prohibits Medicaid and NC Health Choice from requiring physical presence of providers, prior authorization that would not apply to in-person care, network membership, or technology restrictions as conditions of telehealth coverage; requires reimbursement rates and cost-sharing to be equivalent to in-person services.

• Mandates that health benefit plans must cover telehealth services and cannot exclude covered services based solely on delivery method being telehealth rather than in-person, though deductibles and copayments may not exceed amounts required for in-person services.

• Requires the Department of Health and Human Services to submit a report by September 1, 2020 on telehealth changes, costs, savings, and outcomes to the Joint Legislative Medicaid and NC Health Choice Oversight Committee and Fiscal Research Division.

• Becomes effective October 1, 2019, with health benefit plan requirements applying to contracts issued, renewed, or amended on or after that date.