An Act Regarding Telehealth
Maine Legislature, Session 130, LD 0333
Committee: Health Coverage, Insurance and Financial Services
Sponsors: HYMANSON
Amends: 24 MRSA §2904, 24-A MRSA §4316

Legislative Document
No. 333
H.P. 237
House of Representatives, February 8, 2021
An Act Regarding Telehealth
Received by the Clerk of the House on February 4, 2021.  Referred to the Committee on 
Health Coverage, Insurance and Financial Services pursuant to Joint Rule 308.2 and ordered 
printed pursuant to Joint Rule 401.
ROBERT B. HUNT
Clerk
Presented by Representative HYMANSON of York.
Be it enacted by the People of the State of Maine as follows:
Sec. 1.  24 MRSA §2904, sub-§1, ¶A, as amended by PL 2019, c. 289, §1, is further 
amended to read:
A.  A licensed health care practitioner who voluntarily, without the expectation or 
receipt of monetary or other compensation either directly or indirectly, provides 
professional services, including services provided through telehealth as defined in Title 
24‑A, section 4316, subsection 1, paragraph E C, within the scope of that health care 
practitioner's licensure:
(1)  To a nonprofit organization;
(2)  To an agency of the State or any political subdivision of the State;
(3)  To members or recipients of services of a nonprofit organization or state or 
local agency;
(4)  To support the State's response to a public health threat as defined in Title 22, 
section 801, subsection 10;
(5)  To support the State's response to an extreme public health emergency as 
defined in Title 22, section 801, subsection 4‑A; or
(6)  To support the State's response to a disaster as defined in Title 37‑B, section 
703, subsection 2;
Sec. 2.  24-A MRSA §4316, sub-§1, ¶C, as enacted by PL 2019, c. 289, §2, is 
amended to read:
C.  "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 an enrollee's physical and mental health and includes real-time 
interaction between the enrollee and the telehealth provider, synchronous encounters, 
asynchronous encounters, store and forward transfers and telemonitoring.  "Telehealth" 
includes the use of audio-only telephone when no means of interactive real-time visual 
and audio or other electronic media are available to the enrollee due to lack of such 
electronic media or of adequate broadband access or when the use of other means of 
interactive real-time visual and audio or other electronic media is infeasible, 
impractical or otherwise not medically advisable, as determined by the provider 
providing telehealth services to the enrollee or as determined by another provider with 
an existing relationship with the enrollee.  "Telehealth" does not include the use of 
audio-only telephone, facsimile machine, e-mail or texting.
Sec. 3.  24-A MRSA §4316, sub-§1, ¶E, as enacted by PL 2019, c. 289, §2, is 
repealed.
Sec. 4.  24-A MRSA §4316, sub-§2, as corrected by RR 2019, c. 2, Pt. A, §28, is 
amended to read:
2.  Parity for telehealth services.  A carrier offering a health plan in this State may 
not deny coverage on the basis that the health care service is provided through telehealth if 
the health care service would be covered if it were provided through in-person consultation 
between an enrollee and a provider.  Coverage for health care services provided through 
telehealth must be determined in a manner consistent with coverage for health care services 
provided through in-person consultation.  A carrier shall reimburse a provider for the 
diagnosis, consultation with or treatment of an enrollee delivered through telehealth 
services on the same basis and at least at the rate of reimbursement at which the carrier 
reimburses a provider for the provision of the same, or substantially similar, service through 
in-person consultation.  If an enrollee is eligible for coverage and the delivery of the health 
care service through telehealth is medically appropriate, a carrier may not deny coverage 
for telehealth services.  A carrier may not offer a health plan under which any deductible 
applied to health care services delivered through telehealth accumulates separately from 
the deductible that applies in the aggregate to all services covered under the health plan.  A 
carrier may offer a health plan containing a provision for a deductible, copayment or 
coinsurance requirement for a health care service provided through telehealth as long as 
the deductible, copayment or coinsurance does not exceed the deductible, copayment or 
coinsurance applicable to a comparable service provided through in-person consultation.  
A carrier may not exclude a health care service from coverage solely because such health 
care service is provided only through a telehealth encounter, as long as telehealth is 
appropriate for the provision of such health care service.
Sec. 5.  24-A MRSA §4316, sub-§3, ¶G is enacted to read:
G.  The carrier may not place any restriction on the prescribing of medication through 
telehealth by a provider whose scope of practice includes prescribing medication that 
is more restrictive than any requirement in state and federal law for prescribing 
medication through in-person consultation.
Sec. 6.  24-A MRSA §4316, sub-§5, as enacted by PL 2019, c. 289, §2, is repealed.
Sec. 7.  24-A MRSA §4316, sub-§6, as enacted by PL 2019, c. 289, §2, is amended 
to read:
6.  Utilization review.  This section does not prohibit or limit a carrier from conducting 
a utilization review for telehealth services as long as the utilization review is conducted in 
the same manner, is applied no more stringently and uses the same clinical review criteria 
as a utilization review for an in-person consultation for the same service.
Sec. 8.  Application.  The requirements of this Act apply to health plans, as defined 
in the Maine Revised Statutes, Title 24-A, section 4301-A, subsection 7, executed, 
delivered, issued for delivery, continued or renewed in this State on or after January 1, 
2022.  For purposes of this Act, all health plan contracts are deemed to be renewed no later 
than the next yearly anniversary of the contract date.
SUMMARY
This bill makes changes to the provisions governing health insurance coverage of 
telehealth services.
1.  It authorizes the delivery of health care services through telehealth by audio-only 
telephone.
2.  It clarifies that reimbursement for telehealth services must be made on the same 
basis and at the same rate as if the services were delivered in person.
3.  It clarifies that a carrier may not establish separate deductible limits for telehealth 
services that are not applied in the aggregate with other services covered under a health 
plan.
4.  It prohibits a carrier from placing restrictions on prescribing medication through 
telehealth that are more restrictive than requirements of applicable state and federal law for 
prescribing medication in person.
The bill applies to health plans issued or renewed on or after January 1, 2022.