An Act Regarding
Maine Legislature, Session 132, LD 1583
Committee Amendment CA_A_H811 (House)
Amends: 22 MRSA §2145-A

COMMITTEE AMENDMENT "/f " to H.P. 1041, L.D. 1583, "An Act Regarding
Home Health Care and Hospice Services Ordered by a Health Care Provider Outside of
Maine"
Amend the bill by striking out the title and substituting the following:
'An Act Regarding Home Health Care Services Ordered by a Physician Licensed
Outside of IMaine'
Amend the bill by striking out everything after the enacting clause and inserting the
following:
'See. 1. 22 MRSA §2145-A is enacted to read;
§2145-A. Home health care services ordered by physician licensed in another state
1. Requirements; home health care provider. A home health care provider that is
licensed pursuant to this chapter and certified by the United States Department of Health
and Human Services, Centers for Medicare and Medicaid Services as_a home health agencv
may provide home health care services for UD to 90 days to a patient who resides in this
State based on an order from a uhysician who is licensed in another state as lone as the
followmg requirements are met;
A. The physician holds a license in good standine conferred by the appropriate medical
board in the nhysician's jurisdiction of practice, The home health care provider must
verify that the uhvsician's license is in eood standine. and the verification must be
mamtamed on file_fQr reyiew by_the depM.'tmetiti
B. The physician issued the order pursuant to an in-person physical examination of the
patient perfoiTned m the state where the uhvsiciaa is licensed, Home health care
seryjces ordered by the physician are lunited to the medical purpose and clmical scope
from the results of the in-person uhysical examination; and
C. The phvsician and home liealth care provider comply with standards established in
mles adopted bv the department pursuant to subsection 5 and comply with regulations
adopted by the United States Department of Health and Human Services. Centers for
COMMITTEE AMENDMENT
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COMMITTEE AMENDMENT "fT" to H.P, 1041, L.D. 1583
Medicare and Medicaid Services under conditions of participation for home health
agencies pursuant to 42 Code of Federal Regulations, Part 484.
2. Exemption from medical license in this State, A physician who is licensed in
another state and who issues an order for home health care services in accordance with this
section is exempt from thereguu'ementQflicensure by the Board ofLicensure in M'edicine
in Title 32. chapter 48 or the Board of Osteopathic Licensure in Title 32, chapter 36 solely
for the purpose of ordering home health care services for a patient, as long as the followmg
requirements are met:
A. The order for the provision of home health care_services is for up to 90 days;
B. The physician provides telehealth services only to the patient for which the order
has been issued;
C. The physician orders home health care services from a home health care provider
that is certified by the United States Denartment of Health and Human Services,
Centers for Medicare and Medicaid Services as a home health agency; and
D. The physician only orders home health care services while the patient is receiving
home health care services,
3. Violation. If, during the depai-tineut's home health care sei-vices licensing nrocess
or during the United States Department of Health and Human Services, Centers for
Medicare and Medicaid Services survey and certification process, a physician is found to
be acting hi violation of this section, the department shall, in consultation with the Board
ofLicensure in Medicine under Title 32, chanter 48 or the Board ofOsteopathic Licensure
under Title 32, chapter 36, determine if the physician may no longer be exempt from
licensure m this State under subsection 2.
4.^ Limitation onjihysician providine telehealth services or in-uerson medical
care. A phvsician acting undersubsection 2 is not authorized to provide telehealth services
or in-person medical care to _any Ratient in this State except as expressly outlined in this
section,
5. Rulemakine. The department may adopt rules to implement this section, Rules
adopted pursuant to this subsection are routine technical rules ^^a^^^^^^^^ Title 5, chapter
375. subchaoter 2-A.'
Amend the bill by relettering or renumbering any uoncousecutive Part letter or section
number to read consecutively.
SUMMARY
This amendment changes the title of and replaces the bill.
1. It removes hospice services from the bill, Physicians who are licensed out of state
issuing orders in this State are limited to home health care services,
2, It provides that home health care providers who provide services to patients that
8 have orders from a physician licensed in another state must be certified by the United States
Department of Health and Human Services, Centers for Medicare and Medicaid Services,
in addition to being licensed by the Departmeftt of Health and Human Services,
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COMMITTEE AMENDMENT "/-T" to H.P, 1041, L.D, 1583
3, It removes the requirement from the bill that, for a patient in this State that has a
primary care provider, the physician licensed m another state must contact that primary
care provider,
4. It provides that an order for home health care services from a physician licensed in
another state is limited to 90 days.
5, It clarifies that the physician licensed in another state may provide telehealth
services only to the patient for which the order has been issued.
6, It clarifies that the physician licensed in another state may order services only from
a home health care provider that is certified by the Centers for Medicare and Medicaid
Services and may only order services while the patient is receiving those services from
such a provider,
7. It clarifies that a physician licensed in another state is exempt from licensure by the
Maine Board ofLicensure in Medicine or the Maine Board of Osteopathic Licensure for
this limited purpose. A physician who violates this limited exemption may lose the
exemption.
COMMITTEE AMENDMENT