(1) As used in this section: (a) "Mental health condition" means a mental disorder or a substance-related disorder that falls under a diagnostic category listed in the Diagnostic and Statistical Manual, as periodically revised. (b) "Telemedicine services" means the same as that term is defined in Section 26B-4-704. (2) Notwithstanding the provisions of Section 31A-22-618.5, a health benefit plan offered in the individual market, the small group market, or the large group market shall: (a) provide coverage for: (i) telemedicine services that are covered by Medicare; and (ii) treatment of a mental health condition through telemedicine services if: (A) the health benefit plan provides coverage for the treatment of the mental health condition through in-person services; and (B) the health benefit plan determines treatment of the mental health condition through telemedicine services meets the appropriate standard of care; and (b) reimburse a network provider that provides the telemedicine services described in Subsection (2)(a) at a negotiated commercially reasonable rate. (3) (a) Notwithstanding Section 31A-45-303, a health benefit plan providing coverage under Subsection (2)(a) may not impose originating site restrictions, geographic restrictions, or distance-based restrictions. (b) A network provider that provides the telemedicine services described in Subsection (2)(a) may utilize any synchronous audiovisual technology for the telemedicine services that is compliant with the federal Health Insurance Portability and Accountability Act of 1996.
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