►
Description
House Insurance Committee- February 22, 2022- House Hearing Room 1
A
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C
A
Thank
you,
mr
clerk.
Do
we
have
any
personal
orders?
A
I
would
just
like
to
wish
chairman
kumar
and
his
wife
linda
a
speedy
recovery
this
morning
and
that
we're
thinking
about
them.
So,
let's
see
members
today
we
have
two
bills.
On
the
calendar
item
number
one
is
house
bill,
2655.
D
You,
madam
chair
and
members,
we
do
have
an
amendment
white
house
bill.
2655
is
going
to
do.
It
basically
removes
the
sunset
provision
from
our
telehealth
that
has
worked
well
during
the
pandemic
time
and
we'll
continue
that
allowable
system
we've
got
an
amendment
coded
zero
one,
four:
zero,
zero
one.
That
will
thank
you
and
what
the
amendment
does
it.
D
It
provides
the
proverbial
belt
and
suspenders
to
ensure
that
that,
if
there's
a
declared
emergency
tornado
happen
somewhere
that
it's
not
declared
across
the
state
and
and
just
to
kind
of
give
clarity
to
to
the
whole
system,
but
essentially
what
the
amendment
does.
It
continues
the
the
efforts
of
telehealth
and
removes
the
sunset.
So
that's
the
amendment
and
the
bill
itself.
Madam
chair
and
members.
A
Thank
you,
chairman
hawk
members.
Do
we
have
any
questions
on
the
amendment.
A
Seeing
no
no
further
questions
are
we
ready
to
vote
on
adopting
amendment
zero
one,
four:
zero,
zero.
One,
there's
no
objections!
All
in
in
favor
of
adopting
amendment
zero,
one,
four
zero
one,
please
signify
by
saying
aye
anyone
opposed
the
eyes
have
it.
A
A
Seeing
no
further
questions
we're
ready
to
vote.
Are
we
ready
to
vote?
No,
no
questions.
Is
there
any
objection?
All
those
in
favor
of
sending
house
bill
2655
to
calendar
and
rules
signify
by
saying
aye
aye
for
those
opposed?
No
the
eyes.
Have
it
house
bill
2655
moves
on
to
calendar
and
rules?
Thank.
E
C
E
C
Well,
it's
it's
saying
that
it
it's
it's
just
it's
kind
of
a
simply
worded
bill,
but
I
think
does
it
and
I'm
asking
questions
I
don't
know,
I'm
getting
conflicting
information
when
I
ask
questions
of
people
over
the
past
few
days
by
changing
this
audio
like
right
now
telehealth
we
we
passed
telehealth
last
year,
where
telehealth
has
paid
the
same
rate
as
an
in-office
visit.
Would
this
bring
this
audio
back
up
to
be
paid
the
same
rate
as
telehealth
by
changing
the
code?
E
E
C
I
guess,
and
and
it's
already
I
guess
is
it:
is
it
already
legal
right
now
and-
and
these
are
questions
I
don't
know,
no
one's
answers.
Why
I'm
asking
are
these
are
audio
conversation
now
is?
Is
it
legal
now,
of
course,
this
is
a
very
narrow,
defined
part
of
the
practice,
but
is
it
legal
now
for
doctors
to
talk
and
prescribe
to
their
patients
or
renew
prescriptions,
or
are
they
limited
in
this
category?
Right
now,.
E
E
You
would
have
to
be
an
established
patient
and
you
will
have
not
have
been
been
in
their
office
within
the
last
seven
days
and
then
whatever
comes
up
based
off
your
conversation,
if
you
meet
the
criteria
between,
I
think
99
441
is
at
least
a
five
minute
conversation
with
them.
E
Where
you
do
an
evaluation,
and
then
you
do
your
medical
management
at
that
point
in
time,
and
you
meet
those
criteria
document
that
criteria
so
from
a
diabetic
standpoint,
you're
an
established
patient
with
your
physician
and
say
you
step
on
something
and
you
get
a
cut
in
your
foot
and
you
call
your
physician.
You
have
a
conversation
with
them.
You
have
directed
it.
E
E
If
you
don't
go
back
to
their
office
within
the
next
immediate
short
period
of
time,
it
says
leading
to
an
e
m
service
or
procedure
within
the
next
24
hours
or
soonest
available
appointment.
So
if
that
doesn't
happen
and
you're
not
you
don't
have
to
have
a
procedure,
anything
that
for
the
diabetic
foot,
then
you
could
bill
them.
C
I
guess
that
that's
the
main
thing
I
it's
our
it's
already
they're
already
able
to
to
talk
to
their
patients
and
do
that.
I
don't
really
understand
quite
what
the
bill
is
doing,
except
from
the
way
I
understand
code
it
would.
It
would
fully
compensate
it
would
fully
compensate
audio
to
a
physician
force,
the
insurance
companies
to
pay-
and
I
have
not
talked
to
insurance
companies.
C
So
that's
why
I'm
asking
questions
it
would
force
to
pay,
reimburse
doctors
at
the
same
rate
for
talking
to
a
patient
over
the
phone
as
they
would
coming
into
their
office
for
a
for
an
exam
or
through
telemedicine,
and
I
I
was
concerned
about
that.
That's
the
only
question
I
really
had.
If
the
code
changed,
where
compensation
has
been
changed.
E
I
think
that's
what,
based
on
this
code,
we
may
have
somebody
that
could
if
we,
if
we
need
to
go
out
out
of
session,
we
may
have
somebody
that
can
answer
that
question
for
us.
A
F
Julie,
griffin,
tennessee
medical
association-
thank
you
all
for
having
me
today,
madam
chairman
and
members
of
the
committee,
I'm
gonna
answer
your
question.
First,
the
rate
would
be
tied
to
what
the
e
m
code
is
for
that
you
are
correct.
It
would
tie
it
to
that
e
m
code,
which
is
what
the
patient,
what
the
payers
would
have
to
pay
based
on
that
negotiated
rate
for
the
in-person
visit.
F
F
It's
we
had
a
testimony
in
subcommittee
from
one
of
our
cancer
specialists
here
in
nashville,
who
sees
a
lot
of
patients
two
and
three
hours
from
here,
because
there's
not
a
lot
of
cancer
specialists.
F
He
says
less
than
five
percent
of
his
telemedicine
visits
would
even
qualify
for
one
of
these
visits,
so
we're
talking
very
rarely
or
we
would
this
be
happening
where
you
would
have
to
be
able
to
provide
the
same
standard
of
care
as
what
that
visit
would
require.
It
also
requires
significant
documentation
to
prove
that
that
visit
was
medically
necessary
and
if
that
documentation
is
not
there,
if
say,
the
payers
thought
that
there
was
an
individual
physician
who
was
misusing
the
statute.
F
There
is
utilization
review.
Therefore
they
if
they
do
not
find
that
the
documentation
that
that
provider
is
putting
in
the
record
meets
the
definition
of
medical
necessity.
They
can
either
recoup
the
money
or
not
pay
that
claim
so
they
have.
They
have
a
lot
more
power
to
to
look
at
what
that
doctor
is
doing
right
now
during
the
pandemic.
F
Most
the
payers
were
paying
for
for
this
at
the
at
the
same
rate,
because
people
couldn't
get
there.
What
we
found
were
particularly
cancer
patients.
I
know
the
disability
coalition
is
very
interested
in
this
piece
of
legislation:
the
heart
association,
the
cancer
society.
We
are
all
supporting
this
bill
because
those
are
people
are
having
to
travel
great
distances
from
very
rural
communities
that
may
not
have
one
the
access
or
the
means
to
be
able
to
do
the
video
component,
and
so
yes,
it
is.
F
C
Yeah
to
agree,
I
guess
the
main
thing
is
what
we
were
talking
about
is
granting
the
way
the
way
the
the
way
it's
it's
written,
it's
a
very
simple
bill
and
it
changes
code,
but
it
doesn't
say
what
the
code
does
and
that's
what
I
was
wanting.
We
doctors
can
already
treat
their
patients.
C
F
Questions
about
when
we,
when
we
discussed
this
bill
with
chairman
terry,
we
were
trying
to
to
keep
it
in
line
with
what
you
all
passed
last
year
for
behavioral
health,
so
that
it
was
exactly
as
you
all
had
already
approved
the
language
for
behavioral
health.
We're
really
talking
about
three,
maybe
a
few
more
codes,
but
three
primary
codes
that
would
be
allowed
for
audio
only
other
than
what
you
all
have
already
approved.
F
And
those
are
I'm
not
going
to
give
you
the
numbers,
because
I
know
y'all,
don't
care
about
the
numbers,
but
but
those
three
codes
are
the
evaluation
and
management
codes
that
don't
necessarily
require
you
to
have
your
hands
on
that
patient,
but
preferably
our
doctors
would
like
to
always
have
hands
on
the
patient
that
just
that's
the
way
they
prefer
to
do
business
if
they
can't
do
that
in
this
day
and
age
of
technology,
tele
telehealth
has
turned
into
a
viable
option.
F
They
would
rather
see
that
patient
if
they
can,
but
there
are
just
some
instances.
I
think
dr
terry
gave
you
one
as
a
diabetic
patient,
who
may
have
to
travel
two
hours
in
order
to
see
him
or
or
not
him,
but
the
physician,
and
they
could
evaluate
what's
happening
with
that.
Diabetic
patient
make
adjustments
over
the
phone
because
that
diabetic
patient's
able
to
keep
their
blood
sugar
levels
at
you
know
you
keep
that
yourself.
G
Thank
you,
madam
chairman,
and
so
you
said
earlier
this
this
would
only
be
used
as
a
last
resort,
and
my
only
question
would
be
where,
where
does
this
state?
Where
is
it
defined?
By
last
resort?
I
mean
you
know
what
would
keep
a
bad
actor
from
making
going
to
you
know
their
local
pub
and
making
20
calls
and
collecting
a
copay.
F
There
are
things
that
are
tied
to
this
statute
that
we're
amending
that
would
prohibit
that
from
happening
happening.
First
of
all,
the
physician
has
to
have
access
to
the
complete
medical
record
in
order
for
this
visit
to
take
place,
so
they
don't
have
access
to
the
complete
medical
record
in
a
pub.
I
can
guarantee
you,
so
it's
not
going
to
happen
in
pub.
I've
heard
on
the
golf
course:
doctors
picking
up
the
phone
and
just
calling
patients
it
has
to
be
a
patient-initiated
visit
in
order
for
it
to
qualify.
F
F
Well,
first
of
all,
it's
in
this
is
just
adding
language
into
the
current
statute,
so
the
statute,
that's
that
it's
being
added
to
has
all
those
safeguards
in
it.
So
it's
just
tying
that
back
to
the
same
statute
that
requires
the
patient
initiated
and
to
have
access
to
the
medical
records.
So
that's
what's
required
now
for
a
video
visit
and
that's
what
this
would
be
tied
to
and
the
behavioral
health
is
the
same
way.
F
In
addition,
there
is
utilization
review
and
if
the
documentation
and
and
trust
me
doctors
have
to
document-
or
they
will
get
recouped
if
they
can't
prove
the
medical
necessity
of
that
encounter,
then
they
are
going
to
be
recouped
by
the
insurance
company
for
the
for
that
visit
and
they
won't
get
any
payment.
F
So
there
I
mean
there
are
already
safeguards
in
the
statute
to
try
to
defer.
Could
there
be
a
bad
actor?
There
could
be
a
bad.
I
mean
people
find
ways
around
statutes
all
the
time.
That's
why
you
all
are
are
here,
but
I
think
we've
got
the
safeguards
in
place
to
discourage
that,
and
so
that's
what
that's.
F
I
just
think
the
safeguards
are
there
to
make
sure
that
you
don't
have
somebody
on
the
the
golf
course,
because
they're
not
going
to
be
able
to
provide
they're
not
going
to
have
access
to
the
complete
medical
record
and
just
to
keep
in
mind.
There
is
a
lot
of
telemedicine
out
there
that
is
or
telehealth,
I
should
say,
telehealth
out
there.
That
is
audio
only
but
has
no
continuity
of
care.
F
The
teledocs
of
the
world,
which
I
I
know
many
of
the
the
payers
promote
to
their
to
their
their
participants.
That's
that's
the
kind
of
audio.
Only
except
the
difference
is
they
don't
have
to
have
access
to
a
complete
medical
record.
They
don't
have
to
be
subject
to
the
same
utilization
review
unless
it's
in
their
contract-
and
I
don't
know
if
it's
in
their
contract
or
not,
but
they
don't
they're,
not
subject
to
the
same
statutes
as
necessarily
what
we're
talking
about
here.
F
Because
we're
also
mandating
that
these
doctors
still
have
to
maintain
the
bricks
and
mortar
of
an
office.
They
can't
do
this
because
part
of
what,
in
order
to
qualify
for
telehealth,
you
have
to
have
seen
that
patient
in
person
within
the
last
16
months,
so
we're
making
sure
that
these
are
folks
that
are
having
the
bricks
and
mortar
they're,
maintaining
the
medical
record
so
that
you
have
full
access
to
all
the
information
about
that
patient.
F
Because
one
of
the
things
that
I
know
our
folks
really
get
concerned
with
with
the
teledocs
of
the
world
is
that
you
may
have
someone
who
calls
a
teledoc,
because
they've
had
a
major
sinus
infection.
You
know
three
months
in
a
row
but
three
months
in
a
row
if
that
doctor
had
seen
that
might
be
able
to
determine
that.
Maybe
there
was
something
else
going
on
with
that
patient.
G
Yeah
in
any
concept,
I
want
you
to
want
to
tell
you.
I
think
this
is
a
great
idea.
I
guess
I
just
I
just
don't
see
the
safeguards
and-
and
I
worry
that
we've
we've
seen
what
a
few
bad
actors
could
do
with
the
the
opiate
epidemic,
and
so
I
I
just
worry
that
the
safeguards
aren't
there
and
that
you
could
just
have
a
guy
making
a
bunch
of
phone
calls
to
get
some
co-pays
when,
when
he's
on
vacation,
get
some
extra
money.
F
The
patient
for
the
patient-
and
I
am
fully
if
that
needed,
to
be
clarified
that
it
was
the
patient
didn't,
have
access.
We
just
wrote
or
chairman
terry
wrote
the
bill
to
make
it
clean
as
you
all,
because
last
year
you
all
approved
this
very
language
for
the
behavioral
health
side.
H
Thank
you,
madam
chairman,
and
one
of
the
things
I
just
want
to
read
from
the
current
code
and
the
current
code
says
in
56-7-103.
H
Section,
a
c
or
6-c,
notwithstanding
any
other
subdivisions,
this
hipaa
compliance
audio
only
conversation
for
the
provision
of
behavioral
health
services
when
the
means
described
in
subdivision
above
are
unavailable,
meaning
the
the
the
visual
component.
So
so,
essentially,
what
this
is
saying
already
in
code
is
that
audio
only
is
not
the
first.
You
know
the
the
patient.
H
As
said
in
in
the
code,
the
patient
doesn't
have
access
to
a
virtual
mechanism
if
they're
in
hancock
county
or,
if
they're,
in
even
parts
of
hamilton
county,
sometimes
you
don't
have
cellular
coverage,
and
so
the
I
think
what's
confusing,
is
and
and
there's
a
little
bit
of
hyperbole
here.
We
all
know
insurance
companies
deny
claims,
and
so
there's
nothing
that
mandates
coverage
it.
H
Just
I
mean
there
can
be
a
denial
of
claim
in
my
okay,
and
so
what
I
understand
this
bill
to
do
is
in
the
case
that
the
virtual,
the
the
the
synchronous
exchange
of
information
by
video
is
not
available.
H
Then
this
would
be
a
fallback
and
that
that,
if,
if
the
care
that
can
be
delivered
over
the
phone,
clearly,
you
can't
bill
for
a
blood
pressure
check,
because
you
can't
take
someone's
blood
pressure
unless
they
already
have
remote
patient
monitoring.
You
can't
take
a
blood
sugar
sampling
unless
they
are
doing
it
themselves.
So
this
is,
there
are
very.
The
guidelines.
Are
the
existing
codes.
Is
that
correct?
A
I
There
was
a
statement
made
about
quality.
How
chairman
terry,
how
does
the
doctor
maintain
the
quality
in
an
audio
on
an
audio,
only
phone
call
versus
a
video
audio
call
versus
in
person
seeing
the
patient?
How
do
you
maintain
the
same
quality
in
all
three
of
those
situations.
E
Thank
you
great
question.
Right
now
for
an
in-person
visit.
There
are
different
codes
that
line
up
with
different
actions
that
the
the
provider
would
take.
Some
of
the
lesser
codes
that
are
out
there
do
not
require
a
examination
on
the
patient.
E
They
require
your
evaluation,
which
would
be
getting
your
history
of
the
present
illness
knowing
their
their
background
and
then
you
making
a
so
that's
your
evaluation
and
then
you
making
a
medical
decision,
and
so
you
can
make
an
evaluation
and
a
medical
decision
without
actually
doing
the
video
component,
and
I
will
I'll
give
you
an
example.
So,
in
medicine,
we're
taught
oftentimes
when
you
go
see
a
patient,
these
are
established
patients.
E
You
often
will
do
what's
called
a
soap
note,
that's
subjective
and
that's
where
you're
listening
to
what
the
patient
says.
The
o
is
the
objective
and
that's
where
you,
whatever
objective
signs,
you
do
from
a
physical
exam,
a's
the
assessment
and
and
pees
the
plan.
You
don't
always
have
to
do
the
o.
You
don't
have
to
do
the
objective
portion
of
that.
Sometimes
the
the
the
the
term
that
we
use
is
called
s
bar
and
it's
what's
the
situation
that
the
patient's
currently
in.
E
I
E
E
Thank
you.
That
would
be,
I
think
the
code
says
immediately
available
and
that
would
probably
I'd
have
legal
answer,
how
they
would
know,
and
you
couldn't
tell
if
patient
was
lying.
J
Zach
brown,
legal
services,
chairman
terry,
you
said
that
it
you
were
saying
that
that
the
code
refers
to
to
the
services
being
immediately
unavailable,
searching
right
now,
I'm
unable
to
find
a
unable
to
find
the
word
immediately
in
the
code.
Section
567
1003,
however
subdivision
a6
c
says
again
that
the
let
me
just
read
it
here:
compliant
audio,
only
conversation
for
the
provision
of
behavioral
health
services
when
the
means
described
in
subdivision
a6a
are
unavailable,
so
just
unavailable.
I
J
Chairman
spicy,
based
on
section
567
1003,
that
would
be
correct.
Thank
you.
A
K
Thank
you,
chairman,
and,
and
so
I
remember
this,
this
debate
from
last
year
when
we
were
talking
about
behavioral
health
services,
and
we
talked
quite
a
bit
about
how
to
comply
with
hipaa
requirements
and
having
seen
it
firsthand,
I
can
speak
to
the
the
great
success
that
that
specific
piece
of
the
code
has
been
within
behavioral
health
specifically
and-
and
I
think
expanding
to
to
all
services
is
a
is
a
good
idea,
and
I
keep
hearing
people
talk
about
the
the
cost
and
could
someone
be
you
know
at
home,
or
something
and-
and
I
think
we're
maybe
missing
it-
we're
not
we're
not
necessarily
talking
cost
of
what
it
costs
to
provide
the
service,
we're
talking,
opportunity
costs
of
of
a
of
a
provider
and
as
a
as
a
as
a
user
of
of
health
care.
K
You
know
we
don't
reimburse
based
on
on
cost
on
what
a
doctor
makes
and
what
they
don't
make.
We
don't
get
a
discount
if
we
get
a
cheaper
doctor
or
a
doctor
that
that
doesn't
negotiate
for
the
the
right
pay,
and
so
I
I
think
that
maybe
we're
missing
some
of
the
the
argument,
maybe
not,
but
I
support
this
bill.
I
think
it's
a
it's
a
great
idea.
K
There
are
several
people
that
don't
need
the
visual
aspect
of
of
the
of
the
telehealth
people
that
are
they're,
you
know
sight,
disabled
and
and
on
and
on
that
need
the
bit
the
ability
to
pick
up
the
phone
and
call,
and
so
anyway,
I
just
support
this
bill
and
wanted
to
say
those
few
words.
Thank
you.
L
Thank
you,
madam
chair,
and
to
the
to
the
sponsor.
I
just
wanted
to
check.
You
mentioned
the
the
codes
a
while
ago
that
are
currently
using
this
in
cms
they're
doing
it
medicare
medicaid
both
and
those
are
not
those
are
not
in
there
permanently.
Are
there
aren't,
were
they
wasn't
this
particular
provision
put
in
our
temporarily
through
the
to
the
pandemic
and
and
if,
if
so,
are
they
going
to
adopt
them
permanently,
or
is
there
any
expiration
date
on
that.
E
Thank
you
great
question.
This
was
brought
up
in
the
subcommittee
and
it's
my
understanding
that
they
are
working
to
make
this
a
permanent
code
and
in
the
event
that
it
does
not
go
permanent,
then
these
codes
would
go
away
and-
and
so
what
we're
basically
doing
is
would
be
putting
this
in
statute
for
these
codes
and
then,
if
it
goes
away,
then
then
they
would
not
be
able
to
bill
off
these
codes.
Oh.
A
A
Saying
no
father,
yes,
yes,
chairman
hawk.
D
Thank
you
very
much
and
forgive
me
he
had
to
leave
the
room,
but
in
case
you
get
sick
or
injured.
Today,
the
doctor
of
the
day
is
dr
howard,
harrell
he's
from
my
district.
So
don't
give
him
a
lot
of
work,
but
if
something
happens
he's
here
for
you,
so
dr
harold,
if
you're
outside
you've,
been
recognized.
Thank
you
very
much,
madam
chair.
A
Thank
you
chairman,
seeing
no
further
business
without
objection.
We
stand
adjourned.