Maine Gov. Janet Mills has signed into law new telehealth suggestions that require payers to cover any offerings that they would cover an individual. The new law also opens the door to faraway patient tracking and permits doctors to apply phone-primarily based telehealth in positive conditions.
June 18, 2019 – Maine lawmakers have exceeded rules setting up insurance parity for telehealth by non-public payers.
LD 1263, signed into law on June 13 by way of Gov. Janet Mills, also opens the door to extra faraway patient monitoring packages – vital attention in a predominantly rural state with large areas of underserved citizens. And it lets in compensation for healthcare companies who use phone-primarily based telehealth “when scheduled telehealth offerings are technologically unavailable on the time of the scheduled telehealth provider for a current enrollee and the telephonic offerings are medically suitable for the corresponding blanketed fitness care offerings.”
Danielle Louder, program director for the Northeast Regional Telehealth Resource Center, presented praise for the brand new law when its passage became referred to for the duration of this week’s Northeast Regional Telehealth Conference in Portland. She noted the law might objectives gaps in care throughout the nation.
“I assume we’re going to peer those gaps (get) smaller,” she talked about.
Introduced with the aid of State Sen. Geoffrey Gatwick, the brand new law mandates that any fitness plans within the state cowl a service supplied via telehealth if that provider is offered in person. It also orders that any copayment, deductible or coinsurance now not exceed any similar fees for in-person care, and prevents payers from denying insurance for a carrier entirely as it’s provided thru connected health era.
To qualify for coverage, a telehealth service should meet six conditions:
The fitness care service is otherwise blanketed beneath an enrollee’s health plan.
The health care carrier delivered by telehealth is of similar quality to the health care carrier introduced through an in-person session.
Prior authorization is required for telehealth offerings most effective if earlier authorization is required for the corresponding covered fitness care carrier. An in-character consultation prior to the delivery of services via telehealth isn’t always required.
Coverage for telehealth offerings isn’t constrained in any way on the basis of geography, vicinity or distance for travel.
The carrier shall require that a medical evaluation is performed both in individual or thru telehealth earlier than a provider can also write a prescription that is blanketed.
The provider shall offer coverage for the treatment of or extra folks who’re enrolled in the provider’s fitness plan at the equal time through telehealth, including counseling for substance use problems regarding opioids.
In addition, the bill units pointers for telemonitoring, which is described as the “use of data generation to remotely display an enrollee’s fitness repute through electronic means thru using medical records while the enrollee remains in a residential setting, allowing the provider to track the enrollee’s health records through the years.” Also known as RPM, it may be introduced both in actual time or as an asynchronous (keep-and-ahead) provider.