Statewide Mental Health Telehealth Access

Summary#

A-11665 would amend New York’s Mental Hygiene Law by adding a new section on telehealth by approved Article 31 mental health providers. Its stated goal is to prevent county-based limits on where they may serve recipients. The bill was introduced and referred to the Assembly Committee on Mental Health; it is not law.

  • An Article 31 provider with written state approval to provide telehealth would be authorized to serve recipients anywhere in New York, regardless of the recipient’s county of residence or location.
  • The state mental health commissioner and regional offices could not impose county limits through letters, guidance, operating-certificate conditions, corrective plans, or other non-regulatory actions. Limits could still apply if required by state or federal law, or adopted through state rulemaking.
  • Providers following their approved telehealth plan and applicable law could not be penalized or have an operating certificate denied, conditioned, or delayed just because they serve someone outside the county of their main licensed site.
  • Within 180 days of the law taking effect, the commissioner would have to issue guidance to regional offices, including standard procedures for reviewing and approving telehealth service plans.
  • If a recipient cannot or will not attend a clinic and telehealth is clinically found not viable, a provider would be authorized to deliver services at the recipient’s home. The commissioner would have to set the Medicaid rate for that service at the standard office-visit rate.

What it means for you#

  • Recipients: The bill would not guarantee an appointment or require a provider to offer every service by telehealth. It would remove county as a basis for restricting an approved provider’s telehealth service, while leaving clinical needs and other applicable rules in place.
  • Recipients needing in-home care: In the stated circumstances, providers would be authorized—but not required—to provide services at home.
  • Providers: Approved providers could serve recipients across county lines. They would still have to follow their approved telehealth plan and applicable statutes and regulations.
  • State officials: The commissioner would have to issue the required guidance and set the Medicaid rate. Regional offices could not enforce county limits through informal or certificate-related actions, subject to the bill’s exceptions.
  • Current law: The bill’s findings say state regulations already broadly allow this telehealth delivery. The current Mental Hygiene Law and regulations were not supplied, so that description and the bill’s changes against current law could not be independently verified.

Money#

No publicly available information on the bill’s total cost. The bill says the in-home Medicaid rate would be set at the standard office-visit rate “so as to ensure no additional fiscal impact,” but provides no cost estimate or supporting analysis.

  • The state would have to establish that Medicaid reimbursement rate.
  • The commissioner and regional offices would have to do the work of issuing guidance and reviewing telehealth service plans; the bill gives no staffing or administrative cost estimate.

What is unclear#

  • The bill does not set out the process, criteria, or timeline for approving telehealth plans; it directs the commissioner to provide standard procedures.
  • It does not explain how “clinically determined” would be applied when deciding that telehealth is not viable.
  • It does not say whether providers would receive additional payment for in-home services beyond the standard office-visit rate, or what the total Medicaid cost would be.
  • The parent law and current regulations were not supplied, so the existing approval rules and how this bill would interact with them are unclear.
  • The bill would take effect 90 days after becoming law, but passage is uncertain.

Case for#

  • The bill appears intended to prevent a recipient’s county from blocking access to an approved provider who can serve them by telehealth.
  • A statewide rule could reduce inconsistent interpretations among regional offices, as the bill’s findings say is needed.
  • The home-service provision could offer another way to receive care when attending a clinic is not possible and telehealth is not clinically suitable.

Case against#

  • The bill does not guarantee that a recipient can find a provider willing or able to serve them; it mainly limits county-based restrictions on providers.
  • The required procedures for reviewing telehealth plans and deciding when home care is appropriate are left for later guidance, leaving important details unsettled.
  • The bill claims the in-home rate would avoid additional state cost, but supplies no estimate showing whether that would be true in practice.