The Maine Department of Health and Human Services recently adopted new MaineCare telehealth reimbursement rules, replacing the current telehealth rules effective April 17, 2016. Importantly, the new rules: (i) eliminate the approval process previously required for use of telehealth, including the requirement that providers submit documentation showing that a physical, social, or geographic limitation existed that prevented the provider from delivering service in a face-to-face encounter or otherwise justify the use of telehealth as more appropriate; (ii) allow interactive telehealth for all medically necessary services that can be delivered remotely at comparable quality; (iii) provide for an "originating site fee" to be paid to the site housing the patient (while the remote site bills for the services rendered); (iv) provide for real-time, interactive visual and audio telecommunications or, if not available, telephonic services; (v) require providers to use secure, HIPAA-compliant equipment; and (vi) require member choice, written informed consent, and member education. In addition, the rules provide for telemonitoring services to certain "eligible" members.
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