An Act To Promote Telehealth
Maine Legislature, Session 129, LD 1974
Committee: Health and Human Services
Sponsors: GRATWICK, STOVER, BELLOWS, CHENETTE, CLAXTON, VITELLI, CRAVEN, GATTINE
Amends: 22 MRSA §3173-H, 24-A MRSA §4316

Legislative Document
No. 1974
S.P. 676
In Senate, January 8, 2020
An Act To Promote Telehealth
Approved for introduction by a majority of the Legislative Council pursuant to Joint Rule 
203.
Reference to the Committee on Health and Human Services suggested and ordered printed.
DAREK M. GRANT
Secretary of the Senate
Presented by Senator GRATWICK of Penobscot.
Cosponsored by Representative STOVER of Boothbay and
Senators: BELLOWS of Kennebec, CHENETTE of York, CLAXTON of Androscoggin, 
SANBORN, H. of Cumberland, SANBORN, L. of Cumberland, VITELLI of Sagadahoc, 
Representatives: CRAVEN of Lewiston, GATTINE of Westbrook.
Be it enacted by the People of the State of Maine as follows:
Sec. 1.  22 MRSA §3173-H, as enacted by PL 2017, c. 307, §2, is amended to 
read:
§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 a health professional 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 patient's provider health professionals.
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.
A-2.  "Patient" means a MaineCare member.
A-3.  "Provider" means an individual, a facility or an organization that provides 
services under the MaineCare program.
B.  "Store and forward transfers" means transmission of a patient's recorded health 
history through a secure electronic system to a provider health professional.
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 health professionals regarding the patient.
D.  "Telehealth," as it pertains to the delivery of health care MaineCare 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 patient's 
provider, electronic consultation between health professionals regarding the patient, 
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 pertains to the delivery of health care MaineCare 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 support the delivery of health 
care MaineCare services through telehealth and that support access to equipment, 
technical support and education related to telehealth for health care providers.
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 telehealth and telemonitoring 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.
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 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;
B.  Must 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;
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.; and
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.
Sec. 2.  24-A MRSA §4316, sub-§1, ¶A-1 is enacted to read:
A-1.  "Asynchronous encounters" means the interaction or consultation between an 
enrollee and a telehealth provider or between health professionals regarding the 
enrollee 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 enrollee or 
the health professionals.
Sec. 3.  24-A MRSA §4316, sub-§1, ¶B-1 is enacted to read:
B-1.  "Synchronous encounters" means a real-time interaction conducted with 
interactive audio or video connection between an enrollee and a telehealth provider or 
between health professionals regarding the enrollee.
Sec. 4.  Department of Health and Human Services to reimburse targeted 
case management services delivered through telehealth.  The Department of 
Health and Human Services shall, no later than September 30, 2020, amend its rule 
Chapter 101: MaineCare Benefits Manual, Chapter I, Section 4, Telehealth and Chapter 
101: MaineCare Benefits Manual, Chapter II, Section 13, Targeted Case Management 
Services to provide for reimbursement of case management services delivered through 
telehealth to targeted populations.
SUMMARY
This bill directs the Department of Health and Human Services to amend its rule 
Chapter 101: MaineCare Benefits Manual, Chapter I, Section 4, Telehealth and Chapter 
101: MaineCare Benefits Manual, Chapter II, Section 13, Targeted Case Management 
Services to provide for reimbursement of case management services delivered through 
telehealth to targeted populations.  The bill makes other changes necessary for the 
delivery of telehealth services to be expanded to include case management services.
The bill clarifies that telehealth services reimbursable under a health plan or the 
MaineCare program include consultation between health professionals regarding a 
patient, whether the consultation occurs in real time or asynchronously.