Maine Issues New MaineCare Telehealth Rules

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The Maine Department of Health and Human Services recently adopted new MaineCare telehealth reimbursement rules, replacing the current telehealth rules effective April 17, 2016.
United States Food, Drugs, Healthcare, Life Sciences

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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