§3173-H. Services delivered through telehealth
1. Definitions. As used in this section, unless the context otherwise indicates, the following terms have the following meanings.
A. "Asynchronous encounters" means the interaction or consultation between a patient and the patient's provider or between health professionals regarding the patient through a system with the ability to store digital information, including, but not limited to, still images, video, audio and text files, and other relevant data in one location and subsequently transmit such information for interpretation at a remote site by health professionals without requiring the simultaneous presence of the patient or the health professionals. [PL 2019, c. 649, §1 (AMD).]
A-1. "Health professional" means a provider or an individual, facility or organization with whom a provider consults in order to provide care to a patient. [PL 2019, c. 649, §1 (NEW).]
A-2. "Patient" means a MaineCare member. [PL 2019, c. 649, §1 (NEW).]
A-3. "Provider" means an individual, a facility or an organization that provides services under the MaineCare program. [PL 2019, c. 649, §1 (NEW).]
B. "Store and forward transfers" means transmission of a patient's recorded health history through a secure electronic system to a health professional. [PL 2019, c. 649, §1 (AMD).]
C. "Synchronous encounters" means a real-time interaction conducted with interactive audio or video connection between a patient and the patient's provider or between health professionals regarding the patient. [PL 2019, c. 649, §1 (AMD).]
D. "Telehealth," as it pertains to the delivery of MaineCare services, means the use of information technology and includes synchronous encounters, asynchronous encounters, store and forward transfers and telemonitoring. [PL 2021, c. 291, Pt. A, §1 (AMD).]
E. "Telemonitoring," as it pertains to the delivery of MaineCare services, means the use of information technology to remotely monitor a patient's health status via electronic means, allowing the provider to track the patient's health data over time. Telemonitoring may be synchronous or asynchronous. [PL 2021, c. 291, Pt. A, §2 (AMD).]
[PL 2021, c. 291, Pt. A, §§1, 2 (AMD).]
2. Grants. The department may solicit, apply for and receive grants that support the development of the technology infrastructure necessary to support the delivery of MaineCare services through telehealth and that support access to equipment, technical support and education related to telehealth for providers.
[PL 2019, c. 649, §1 (AMD).]
3. Annual report. Beginning January 1, 2018 and annually thereafter, the department shall report to the joint standing committee of the Legislature having jurisdiction over health and human services matters on the use of telehealth in the MaineCare program, including the number of providers providing telehealth and telemonitoring services, the number of patients served by telehealth and telemonitoring services and a summary of grants applied for and received related to telehealth and telemonitoring.
[PL 2019, c. 649, §1 (AMD).]
4. Education. The department shall conduct educational outreach to providers and MaineCare members on telehealth and telemonitoring services.
[PL 2017, c. 307, §2 (NEW).]
5. Rules. The department shall adopt routine technical rules as defined by Title 5, chapter 375, subchapter 2‑A to carry out the provisions of this section. Rules adopted by the department:
A. May not include any requirement that a patient have a certain number of emergency room visits or hospitalizations related to the patient's diagnosis in the criteria for a patient's eligibility for telemonitoring services; [PL 2017, c. 307, §2 (NEW).]
B. Except as provided in paragraph E, must include qualifying criteria for a patient's eligibility for telemonitoring services that include documentation in a patient's medical record that the patient is at risk of hospitalization or admission to an emergency room; [PL 2019, c. 649, §1 (AMD).]
C. Must provide that group therapy for behavioral health or addiction services covered by the MaineCare program may be delivered through telehealth; [PL 2019, c. 649, §1 (AMD).]
D. Must include requirements for providers providing telehealth and telemonitoring services; and [PL 2019, c. 649, §1 (AMD).]
E. Must allow at least some portion of case management services covered by the MaineCare program to be delivered through telehealth, without requiring qualifying criteria regarding a patient's risk of hospitalization or admission to an emergency room. [PL 2019, c. 649, §1 (NEW).]
[PL 2019, c. 649, §1 (AMD).]
6. Consent for telehealth and telemonitoring services. A patient may provide verbal, electronic or written consent for telehealth and telemonitoring services under this section.
[PL 2021, c. 291, Pt. A, §3 (NEW).]
SECTION HISTORY
PL 2017, c. 307, §2 (NEW). PL 2019, c. 649, §1 (AMD). PL 2021, c. 291, Pt. A, §§1-3 (AMD).
Structure Maine Revised Statutes
Subtitle 3: INCOME SUPPLEMENTATION
Chapter 855: AID TO NEEDY PERSONS
22 §3172-A. Mental Health and Mental Retardation Improvement Fund (REPEALED)
22 §3172-B. Moneys received; credit to General Fund; unencumbered balance (REPEALED)
22 §3173. Powers and duties of department
22 §3173-A. Reimbursement for therapy; intermediate care facilities and skilled nursing facilities
22 §3173-B. Medically needy program; certain individuals in intermediate care facilities
22 §3173-D. Reimbursement for substance use disorder treatment
22 §3173-E. Treatment of joint bank accounts in Medicaid eligibility determinations
22 §3173-F. Charging or increasing premiums
22 §3173-G. Medicaid coverage for reproductive health care and family planning services
22 §3173-H. Services delivered through telehealth
22 §3173-I. Maine Telehealth and Telemonitoring Advisory Group
22 §3174-A. Medical coverage program for certain boarding home residents
22 §3174-C. Coverage for inpatient hospital mental disease treatment services
22 §3174-E. Interim assistance agreement
22 §3174-F. Coverage for adult dental services
22 §3174-H. Availability of income between married couples in determination of eligibility
22 §3174-I. Medicaid eligibility determinations for applicants to nursing homes
22 §3174-J. Medicaid drug formulary (REPEALED)
22 §3174-K. Counseling for certain children
22 §3174-L. Parity among counselors
22 §3174-M. Medicaid drug formulary
22 §3174-N. Authorization to pursue federal waivers to develop Medicaid managed-care program
22 §3174-P. Prescription processing service fee (REPEALED)
22 §3174-Q. Medicaid stability
22 §3174-R. Medicaid drug rebate program
22 §3174-T. Cub Care program (REALLOCATED FROM TITLE 22, SECTION 3174-R)
22 §3174-U. Medicaid reimbursement for dental services
22 §3174-V. Federally qualified health center reimbursements
22 §3174-W. Procedure for home health care changes (REALLOCATED FROM TITLE 22, SECTION 3174-U)
22 §3174-X. Contracted ombudsman services
22 §3174-Y. Prior authorization in Medicaid program
22 §3174-Z. Private, nonmedical and board and care institutions
22 §3174-BB. Enrollment periods
22 §3174-CC. Medicaid eligibility during incarceration
22 §3174-DD. Dirigo health coverage
22 §3174-EE. Mail order drugs (REALLOCATED FROM TITLE 22, SECTION 3174-AA)
22 §3174-GG. Long-term Care Partnership Program
22 §3174-HH. Coordination of services
22 §3174-II. Relationship to federal Medicare program
22 §3174-KK. MaineCare Stabilization Fund (REALLOCATED FROM TITLE 22, SECTION 3174-II)
22 §3174-LL. Inpatient services reimbursement based on diagnosis-related groups
22 §3174-QQ. Care for children with life-threatening conditions
22 §3174-RR. Dental hygienist reimbursement (REALLOCATED FROM TITLE 22, SECTION 3174-QQ)
22 §3174-SS. Calculation of 24 months (REPEALED)
22 §3174-TT. Limitation on reimbursement for opioids (REPEALED)
22 §3174-UU. Reimbursement for opioid drugs for the treatment of pain
22 §3174-WW. Tobacco cessation
22 §3174-XX. Dental therapy reimbursement
22 §3174-YY. State educational Medicaid officer
22 §3174-ZZ. Reimbursement for hearing aids
22 §3174-CCC. Chiropractic services reimbursement (REALLOCATED FROM TITLE 22, SECTION 3174-AAA)
22 §3174-DDD. Coverage for conversion therapy (REALLOCATED FROM TITLE 22, SECTION 3174-BBB)
22 §3174-EEE. Prior authorization of treatment for opioid use disorder
22 §3174-FFF. State-funded medical program for noncitizens
22 §3174-GGG. Palliative care reimbursement (REALLOCATED FROM TITLE 22, SECTION 3174-FFF)
22 §3174-HHH. Ostomy equipment reimbursement (REALLOCATED FROM TITLE 22, SECTION 3174-FFF)
22 §3174-III. Reimbursement for donor breast milk
22 §3175. Acceptance of federal provisions
22 §3175-A. Delinquent nursing home taxes to be withheld from Medicaid payments
22 §3175-B. Delinquent residential treatment facility taxes to be withheld from Medicaid payments
22 §3175-C. Delinquent hospital taxes to be withheld from Medicaid payments
22 §3175-D. Nursing facility depreciation
22 §3176. Treasurer of State as agent
22 §3178. Payment to conservator or guardian
22 §3179. Change of circumstances
22 §3180. Inalienability of aid
22 §3182. Fraudulent representations; penalty
22 §3184. Recovery of illegal payments
22 §3185. Medical expenses for catastrophic illness
22 §3186. Medical and social services referral service
22 §3187. Principles of reimbursement; rules
22 §3188. Maine Managed Care Insurance Plan Demonstration for uninsured individuals
22 §3189. The Maine Health Program (REPEALED)
22 §3189-A. Advisory Board to Privatize the Maine Health Program (REPEALED)
22 §3190. Community Health Program grants (REPEALED)
22 §3192. Community Health Access Program
22 §3193. Affordable Health Care Fund (REALLOCATED FROM TITLE 22, SECTION 3192)
22 §3194. Report on cost of dispensing medication
22 §3195. Compensation for care provided to persons with intellectual disabilities or autism
22 §3196. Coverage for non-Medicaid services to MaineCare members