An Act Regarding MaineCare Coverage for Telehealth Services
Maine Legislature, Session 128, LD 1485
Committee Amendment CA_A_S205 (Senate)
Amends: 5 MRSA §12004, 22 MRSA §3173-H, 22 MRSA §3173-I, 22 MRSA §3173

COMMITTEE AMENDMENT "A" to S.P. 515, L.D. 1485, Bill, "An Act 
Regarding MaineCare Coverage for Telehealth Services" 
Amend the bill by striking out eve1ything after the enacting clause and before the 
summary and inserting the following: 
'Sec. 1. 5 MRSA §12004-1, sub-§38-A is enacted to read: 
38-A. 
Human Services 
Maine Telehealth and 
Not Authorized 
Telemonitoring 
Advismy Group 
Sec. 2. 22 MRSA §3173-H is enacted to read: 
§3173-H. Services delivered through telehealth 
MRSA §3173-I 
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 between a patient and a health 
professional through a system with the ability to store digital infonnation, 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 patient's provider. 
B. "Store and forward transfers" means transmission of a patient's recorded health 
histmy through a secure electronic system to a provider. 
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 providers. 
COMMITTEE AMENDMENT 
COMMITTEE AMENDMENT "A" to S.P. 515, L.D. 1485 
D. "Telehealth," as it pertains to the delivery of health care services, means the use 
of interactive real-time visual and audio or other electronic media for the purpose of 
consultation and education concerning and diagnosis, treatment, care management 
and self-management of a patient's physical and mental health and includes real-time 
interaction between the patient and the telehealth provider, synchronous encounters, 
asynchronous encounters, store and forward transfers and remote patient monitoring. 
"Telehealth" includes telephonic services when interactive telehealth services are 
unavailable or when a telephonic service is medically appropriate for the underlying 
covered service. 
E. "Telemonitoring," as it pe1iains to the delive1y of health care services, means the 
use of information technology to remotely monitor a patient's health status via 
electronic means through the use of clinical data while the patient remains in a 
residential setting, allowing the provider to track the patient's health data over time. 
Telemonitoring may or may not take place in real time. 
2. Grants. The department may solicit, apply for and receive grants that support the 
development of the technology infrastructure necessary to suppoti the delivery of health 
care services through telehealth and that suppoti access to equipment, technical suppoti 
and education related to telehealth for health care providers. 
3. 
Annual repoi1. 
Beginning January 1, 2018 and annually thereafter, the 
depatiment 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 oftelehealth and telemonitoring providers, the 
number of patients served by telehealth and telemonitoring services and a summmy of 
grants applied for and received related to telehealth and telemonitoring. 
4. Education. The department shall conduct educational outreach to providers and 
MaineCare members on telehealth and telemonitoring services. 
5. Rules. The department shall adopt routine technical rules as defined by Title 5, 
chapter 375, subchapter 2-A to cany out the provisions of this section. Rules adopted by 
the depmiment: 
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; 
B. 
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; 
C. 
Must provide that group therapy for behavioral health or addiction services 
covered by the MaineCare program may be delivered through telehealth; and 
D. 
Must include requirements for individual providers and the facility or 
organization in which the provider works for providing telehealth and telemonitoring 
services. 
Sec. 3. 22 MRSA §3173-1 is enacted to read: 
COMMITTEE AMENDMENT 
COMMITTEE AMENDMENT "A "to S.P. 515, L.D. 1485 
§3173-1. Maine Telehealth and Telemonitoring Advisory Group 
The Maine Telehealth and Telemonitoring Advis01y Group, as established by Title 5, 
section 12004-I, subsection 38-A and refen-ed to in this section as "the advis01y group," is 
created within the department. 
1. 
Membership. 
The advisory group consists of the commissioner or the 
commissioner's designee and 9 other members appointed by the commissioner as follows: 
A. A representative of an organization in this State that has a mission to increase 
access to telehealth services in rural areas; 
B. A representative from a home health agency in this State; 
C. A representative from a nonprofit advocacy organization that represents hospitals 
in this State; 
D. A representative from each of 2 separate health care providers of integrated 
medical services in this State; 
E. A representative from a behavioral health organization in this State; 
F. 
A representative from an entity in this State with experience in the field of 
pharmacy;and 
G. Two medical practitioners in this State who use telehealth or telemonitoring as 
part of their regular practice. 
2. Meetings. The adviso1y group shall hold at least one regular meeting and no 
more than 4 meetings each year. 
3. Duties. The advis01y group shall: 
A. Evaluate technical difficulties related to telehealth and telemonitoring services; 
and 
B. 
Make recommendations to the depaiiment to improve telehealth and 
te1emonitoring services statewide. 
For the purposes of this section, "telehealth" and "telemonitoring" have the same 
meaning as in section 3173-H, subsection 1, paragraphs D and E. 
Sec. 4. Appropriations and allocations. 
The following appropriations and 
allocations are made. 
HEALTH AND HUMAN SERVICES, DEPARTMENT OF (FORMERLY DHS) 
Medical Care - Payments to Providers 0147 
Initiative: Provides appropriations and allocations for additional telehealth per-visit site 
facility fees and per-month telemonitoring fees. 
GENERAL FUND 
All Other 
2017-18 
$2,869 
COMMITTEE AMENDMENT 
2018-19 
$5,739 
COMMITTEE AMENDMENT "A" to S.P. 515, L.D. 1485 
GENERAL FUND TOTAL 
FEDERAL EXPENDITURES FUND 
All Other 
FEDERAL EXPENDITURES FUND TOTAL 
SUMMARY 
$2,869 
2017-18 
$5,178 
$5,178 
$5,739 
2018-19 
$10,355 
$10,355 
This amendment establishes an advisory group within the Depatiment of Health and 
Human Services to study telehealth and telemonitoring. It changes the guidance for 
rulemaking by the department. It changes the date of the required annual repoti from the 
depatiment to the Legislature. It also adds an appropriations and allocations section. 
FISCAL NOTE REQUIRED 
(See attached) 
COMMITTEE AMENDMENT 
Approved: 05/25/17 feac 
LD 1485 
LR 2196(02) 
An Act Regarding MaineCare Coverage for Telehealth Services 
Fiscal Note for Bill as Amended by Committee Amendment ''A,' (,S -;)..oi;j 
Committee: Health and Human Services 
Net Cost (Savings) 
General Fund 
Appropriations/ Allocations 
General Fund 
Federal Expenditures Fund 
Revenue 
Federal Expenditures Fund 
Fiscal Detail and Notes 
Fiscal Note Required: Yes 
Fiscal Note 
FY 2017-18 
$2,869 
$2,869 
$5,178 
$5,178 
FY 2018-19 
$5,739 
$5,739 
$10,355 
$10,355 
Projections 
FY 2019-20 
$5,739 
$5,739 
$10,355 
$10,355 
Projections 
FY 2020-21 
$5,739 
$5,739 
$10,355 
$10,355 
The bill includes General Fund appropriations to the Depaiiment of Health and Human Services of $2,869 in fiscal 
year 2017-18 and $5, 739 in fiscal year 2018-19 for additional telehealth per-visit site facility fees and per-month 
telemonitoring fees incurred by expanded eligiblity. Federal Expenditures Fund allocations will also be required for 
the FMAP match. 
LR2196(02) - Fiscal Note - Page 1 of I