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As Introduced
136th
General Assembly
Regular
Session
H. B. No. 709
2025-2026
Representatives Brownlee, Craig
Cosponsors: Representatives
Abdullahi, Brennan, McNally, Piccolantonio, Robb Blasdel, Robinson,
Salvo, Sigrist, Synenberg
To
amend section 3902.30 of the Revised Code
to
require private insurers to cover telehealth services for mental
health services the same as for in-person mental health services.
BE
IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF OHIO:
Section
1.
That
section 3902.30 of the Revised Code be amended to read as follows:
Sec.
3902.30.
(A)
As used in this section:
(1)
"Cost sharing" means the cost to a covered individual under
a health benefit plan according to any coverage limit, copayment,
coinsurance, deductible, or other out-of-pocket expense requirements
imposed by the plan.
(2)
"Health benefit plan," "health care services,"
and "health plan issuer" have the same meanings as in
section 3922.01 of the Revised Code.
(3)
"Health care professional" has the same meaning as in
section 4743.09 of the Revised Code.
(4)
"In-person health care services" means health care services
delivered by a health care professional through the use of any
communication method where the professional and patient are
simultaneously present in the same geographic location.
(5)
"Telehealth services" has the same meaning as in section
4743.09 of the Revised Code.
(B)(1)
A health benefit plan shall provide coverage for telehealth services
on the same basis and to the same extent that the plan provides
coverage for the provision of in-person health care services.
This
includes both of the following:
(a)
Outpatient mental health services, including preventative,
diagnostic, therapeutic, rehabilitative, and palliative interventions
rendered to an individual or group setting by a mental health
professional in accordance with a treatment plan appropriately
established, monitored, and reviewed;
(b)
Mental health services as defined in section 5119.01 of the Revised
Code.
(2)
A health benefit plan shall not exclude coverage for a service solely
because it is provided as a telehealth service.
(3)
A health plan issuer shall reimburse a health care professional for a
telehealth service that is covered under a patient's health benefit
plan. Division (B)(3) of this section shall not be construed to
require a specific reimbursement amount.
(C)
A health benefit plan shall not impose any annual or lifetime benefit
maximum in relation to telehealth services other than such a benefit
maximum imposed on all benefits offered under the plan.
(D)(1)
A health benefit plan shall not impose a cost-sharing requirement for
telehealth services that exceeds the cost-sharing requirement for
comparable in-person health care services.
(2)(a)
A health benefit plan shall not impose a cost-sharing requirement for
a communication when all of the following apply:
(i)
The communication was initiated by the health care professional.
(ii)
The patient consented to receive a telehealth service from that
provider on any prior occasion.
(iii)
The communication is conducted for the purposes of preventive health
care services only.
(b)
If a communication described in division (D)(2)(a) of this section is
coded based on time, then only the time the health care professional
spends engaged in the communication is billable.
(E)
This section shall not be construed as doing any of the following:
(1)
Requiring a health plan issuer to reimburse a health care
professional for any costs or fees associated with the provision of
telehealth services that would be in addition to or greater than the
standard reimbursement for comparable in-person health care services;
(2)
Requiring a health plan issuer to reimburse a telehealth provider for
telehealth services at the same rate as in-person services;
(3)
Requiring a health plan issuer to provide coverage for asynchronous
communication that differs from the coverage described in the
applicable health benefit plan.
(F)
The superintendent of insurance may adopt rules in accordance with
Chapter 119. of the Revised Code as necessary to carry out the
requirements of this section. Any such rules adopted by the
superintendent are not subject to the requirements of division (F) of
section 121.95 of the Revised Code.
Section
2.
That
existing section 3902.30 of the Revised Code is hereby repealed.