H1585B2166A02999 NES:MAC 11/14/23 #90 A02999
AMENDMENTS TO HOUSE BILL NO. 1585
Sponsor: REPRESENTATIVE FRANKEL
Printer's No. 2166
Amend Bill, page 1, line 16, by striking out "Program."" and
inserting
Program" or "CHIP."
Amend Bill, page 3, lines 14 and 15, by striking out "Medical
assistance as provided in subarticle (f) of" and inserting
The medical assistance program established under
Amend Bill, page 3, lines 17 through 25, by striking out all
of said lines and inserting
"Medical assistance or Children's Health Insurance Program
managed care plan" or "MA or CHIP managed care plan." A health
care plan that uses a gatekeeper to manage the utilization of
health care services by medical assistance or children's health
insurance program enrollees and integrates the financing and
delivery of health care services.
Amend Bill, page 3, lines 28 through 30; page 4, line 1; by
striking out "OR MEDICAL ASSISTANCE OR CHILDREN'S HEALTH
INSURANCE" in line 28, all of lines 29 and 30 on page 3 and "OR
CHILDREN'S HEALTH INSURANCE PROGRAM MANAGED CARE PLAN" in line 1
on page 4 and inserting
to participate in one or more designated networks of the
health insurer
Amend Bill, page 4, line 3, by striking out "OR AN AGREEMENT
WITH THE DEPARTMENT OF HUMAN SERVICES"
Amend Bill, page 8, line 18, by striking out "LEGAL"
Amend Bill, page 8, line 25, by striking out "LEGAL"
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Amend Bill, page 9, line 13, by striking out "LEGAL"
Amend Bill, page 11, line 20, by striking out "LEGAL"
Amend Bill, page 11, lines 22 through 30; page 12, lines 1
through 17; by striking out all of said lines on said pages and
inserting
Section 7. Medical assistance and Children's Health Insurance
Program coverage.
(a) General rule.--Medical assistance and CHIP payments
shall be made for medically necessary services if all of the
following apply:
(1) If the services through teledentistry would be
covered through an in-person encounter.
(2) A service through teledentistry is consistent with
Federal law, the laws of this Commonwealth and applicable
regulations and guidance.
(3) Federal approval, if necessary, has been received by
the Department of Human Services.
(b) Applicability.--
(1) Subsection (a) shall not apply if the teledentistry
technology fails to comply with applicable statute,
regulations and departmental guidance.
(2) Nothing in this bill shall require medical
assistance or CHIP to pay for a service utilizing store-and-
forward technology or remote patient monitoring.
(c) Construction.--This section may not be construed to:
(1) Prohibit a MA or CHIP managed care plan from making
payments on behalf of enrollees to other dental care
providers for a covered service provided.
(2) Require medical assistance or CHIP to pay for a
service under this act if the delivery of the service through
teledentistry would be inconsistent with the necessary
standard of care.
Amend Bill, page 12, line 18, by striking out "9" and
inserting
8
Amend Bill, page 12, line 23, by striking out "(2) Section 7
shall take effect in 90 days"
Amend Bill, page 12, line 24, by striking out "(3)" and
inserting
(2)
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