An Act To Improve and Modernize Home-based Care
Maine Legislature, Session 130, LD 1543
Committee: Health and Human Services
Sponsors: MEYER, EVANS, FAY, HYMANSON, STOVER
Amends: 22 MRSA §3173-H, 22 MRSA §3173-I

Legislative Document
No. 1543
H.P. 1148
House of Representatives, April 22, 2021
An Act To Improve and Modernize Home-based Care
Received by the Clerk of the House on April 20, 2021.  Referred to the Committee on 
Health and Human Services pursuant to Joint Rule 308.2 and ordered printed pursuant to Joint 
Rule 401.
ROBERT B. HUNT
Clerk
Presented by Representative MEYER of Eliot.
Cosponsored by Representatives: EVANS of Dover-Foxcroft, FAY of Raymond, 
HYMANSON of York, STOVER of Boothbay.
Be it enacted by the People of the State of Maine as follows:
Sec. 1.  22 MRSA §3173-H, sub-§5, ¶D, as amended by PL 2019, c. 649, §1, is 
further amended to read:
D.  Must include requirements for providers providing telehealth and telemonitoring 
services; and
Sec. 2.  22 MRSA §3173-H, sub-§5, ¶E, as enacted by PL 2019, c. 649, §1, is 
amended to read:
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.; and
Sec. 3.  22 MRSA §3173-H, sub-§5, ¶F is enacted to read:
F.  Must require that the department provide reimbursement for telehealth and 
telemonitoring for MaineCare members receiving private duty nursing, home health 
services and personal care services and services provided to MaineCare members under 
a waiver granted by the federal Department of Health and Human Services, Centers for 
Medicare and Medicaid Services for home-based and community-based services or 
state-funded home-based and community-based support services.  The services to be 
reimbursed pursuant to this paragraph must include the following:
(1)  Services that support a person's ability to remain in the person's home, 
including, but not limited to, telehealth and telemonitoring services that support a 
person's safety, mobility or medication compliance, or that support virtual home 
visits and clinical consultation; and
(2)  Services of a pharmacist licensed under Title 32, chapter 117 to provide 
medication evaluation or consultation, including using telehealth services or by a 
home visit when telehealth is not the most effective mode of consultation.
Sec. 4.  22 MRSA §3173-I, sub-§3, as enacted by PL 2017, c. 307, §3, is amended 
to read:
3.  Duties.  The advisory group shall:
A.  Evaluate technical difficulties related to telehealth and telemonitoring services; and
B.  Make recommendations to the department to improve telehealth and telemonitoring 
services statewide.; and
C.  Make recommendations to the department on best practices and the use of 
technologies that can be used in a home.
Sec. 5.  Department of Health and Human Services to amend rules.  The 
Department of Health and Human Services shall amend its rules for services provided 
under rule Chapter 101:  MaineCare Benefits Manual, Chapters II and III, Sections 19 and 
and rule Chapter 5: Office of Aging and Disability Services Policy Manual, Section 63 
so that reimbursement is provided for a pharmacist licensed under the Maine Revised 
Statutes, Title 32, chapter 117 to provide medication evaluation or consultation to a 
member in a home visit when technology is not the most effective mode of consultation.
Sec. 6.  Department of Health and Human Services to amend rules.  The 
Department of Health and Human Services shall amend its rules for services provided 
under rule Chapter 101: MaineCare Benefits Manual, Chapters II and III, Section 40 so that 
reimbursement is provided for a pharmacist licensed under the Maine Revised Statutes, 
Title 32, chapter 117 to provide medication evaluation or consultation to a member in a 
home visit when technology is not the most effective mode of consultation.
Sec. 7.  Department of Health and Human Services to review and report on 
its supervision requirements.  The Department of Health and Human Services shall 
review the current requirement for in-person supervision as required under rule Chapter 
101: MaineCare Benefits Manual, Chapter II, Sections 19, 40 and 96 and rule Chapter 5: 
Office of Aging and Disability Services Policy Manual, Section 63.  In its review, the 
department shall determine whether this requirement is clinically necessary or the best use 
of financial resources given the availability of technology for interactive, real-time 
communication and in light of the federal 21st Century Cures Act, Public Law 114-255, 
Section 12006(a).  In its review, the department shall consider the use of technology in 
meeting compliance requirements and making supervision requirements consistent for all 
providers.  By December 15, 2021, the department shall submit a report to the Joint 
Standing Committee on Health and Human Services on the department's review and 
recommendations regarding in-person supervision requirements under rule Chapter 101: 
MaineCare Benefits Manual, Chapter II, Sections 19, 40 and 96 and rule Chapter 5: Office 
of Aging and Disability Services Policy Manual, Section 63 for all providers and regarding 
meeting compliance requirements.  The joint standing committee may report out a bill 
concerning the report to the Second Regular Session of the 130th Legislature.
Sec. 8.  Department of Health and Human Services to review 
reimbursement for care provided outside the home.  The Department of Health 
and Human Services shall review its rules for services provided under rule Chapter 101: 
MaineCare Benefits Manual, Chapters II and III, Sections 19, 40 and 96 and rule Chapter 
5: Office of Aging and Disability Services Policy Manual, Section 63. In its review, the 
department shall determine whether it is providing adequate reimbursement for activities 
performed outside of the home by a registered nurse licensed under the Maine Revised 
Statutes, Title 32, chapter 31 that are directly related to a member's care and are part of the 
member's plan of care. By December 15, 2021, the department shall submit a report to the 
Joint Standing Committee on Health and Human Services on the department's review and 
recommendations regarding reimbursement for activities performed outside of the home 
by a registered nurse licensed under Title 32, chapter 31 for services provided under rule 
Chapter 101: MaineCare Benefits Manual, Chapters II and III, Sections 19, 40 and 96 and 
rule Chapter 5: Office of Aging and Disability Services Policy Manual, Section 63. The 
joint standing committee may report out a bill concerning the report to the Second Regular 
Session of the 130th Legislature.
SUMMARY
This bill:
1.  Provides for reimbursement for telehealth and telemonitoring for MaineCare 
members receiving private duty nursing, home health services and personal care services 
and services provided to MaineCare members under a waiver granted by the federal 
Department of Health and Human Services, Centers for Medicare and Medicaid Services 
for home-based and community-based services or state-funded home-based and 
community-based support services.  The services must include: 
A.  Services that support a person's ability to remain in the person's home, including, 
but not limited to, telehealth and telemonitoring services that support a person's safety, 
mobility or medication compliance, or that support virtual home visits and clinical 
consultation; and 
B.  Services of a pharmacist licensed under the Maine Revised Statutes, Title 32, 
chapter 117 to provide medication evaluation or consultation, including telehealth 
services or by a home visit when telehealth is not the most effective mode of 
consultation;
2.  Expands the duties of the Maine Telehealth and Telemonitoring Advisory Group to 
include making recommendations about home technology to the Department of Health and 
Human Services;
3.  Directs the Department of Health and Human Services to amend its rules for services 
provided under rule Chapter 101: MaineCare Benefits Manual, Chapters II and III, Sections 
and 96 and rule Chapter 5: Office of Aging and Disability Services Policy Manual, 
Section 63 so that reimbursement is provided for a pharmacist licensed under Title 32, 
chapter 117 to provide medication evaluation or consultation to a member in a home visit 
when technology is not the most effective mode of consultation;
4.  Directs the Department of Health and Human Services to amend its rules for services 
provided under rule Chapter 101: MaineCare Benefits Manual, Chapters II and III, Section 
so that reimbursement is provided for a pharmacist licensed under Title 32, chapter 117 
to provide medication evaluation or consultation to a member in a home visit when 
technology is not the most effective mode of consultation;
5.  Directs the Department of Health and Human Services to review its in-person 
supervision requirement for home-based and community-based care providers to determine 
whether the use of technology that provides interactive, real-time communication is 
feasible and practical and to report its recommendations to the Joint Standing Committee 
on Health and Human Services; and
6.  Directs the Department of Health and Human Services to review its rules for 
services provided under rule Chapter 101: MaineCare Benefits Manual, Chapters II and III, 
Sections 19, 40 and 96 and rule Chapter 5: Office of Aging and Disability Services Policy 
Manual, Section 63 to determine whether it is providing adequate reimbursement for 
activities performed outside of the home by a registered nurse licensed under Title 32, 
chapter 31 and to report its recommendations to the Joint Standing Committee on Health 
and Human Services.