Code Section

Health and Safety Code - HSC

DIVISION 2. LICENSING PROVISIONS [1200 - 1796.70]

  ( Division 2 enacted by Stats. 1939, Ch. 60. )
  

CHAPTER 2.2. Health Care Service Plans [1340 - 1399.874]

  ( Chapter 2.2 added by Stats. 1975, Ch. 941. )
  

ARTICLE 5. Standards [1367 - 1374.195]
  ( Article 5 added by Stats. 1975, Ch. 941. )

  
1374.13.  

(a) For the purposes of this section, the definitions in subdivision (a) of Section 2290.5 of the Business and Professions Code 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) A health care service plan shall not 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, and pursuant to Section 1374.14.

(d) A health care service plan shall not 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, and pursuant to Section 1374.14.

(e) This section shall also apply to health care service plan contracts 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 law, this section does not authorize a health care service plan to require the use of telehealth if the health care provider has determined that it is not appropriate.

(Amended by Stats. 2019, Ch. 867, Sec. 2. (AB 744) Effective January 1, 2020.)