In Maine, Medicaid and private insurance companies pay the same amount for remote monitoring and other telehealth services as they do for health services delivered during face-to-face consultations in a medical office.
|Reimbursement for: Live video, remote patient monitoring, virtual transfer of health information, remote consultations between a treating provider and a specialist
|Reimbursement for: Telehealth services delivered via live audiovisual technology and some types of electronic media
|Insurers can’t refuse to cover telehealth services if the same services would be covered if they were delivered in person.
Medicaid covers several types of telehealth services in Maine. Coverage is available for health care services delivered via live video, remote patient monitoring, consultations between providers, and the virtual transfer of a patient’s health information. Providers are reimbursed at the same rate whether they deliver these services in-person or via approved technology, and private insurers aren’t allowed to deny coverage for telehealth services if the same services would be covered if delivered during a face-to-face appointment.
Maine is a member of the Interstate Medical Licensure Compact and the Nurse Licensure Compact, which means doctors and nurses who aren’t licensed in Maine may provide consultative services to Maine residents as long as they’re licensed in their home states. Their professional licenses must be in good standing, with no recent disciplinary actions. Additionally, out-of-state providers aren’t allowed to open their own offices in Maine.
Eligible Health Care Providers
Maine doesn’t prohibit any health care providers from offering telehealth services. All providers who are licensed by the appropriate licensing body and operating within their professional scope of practice are permitted to offer telehealth services to patients in Maine. Providers who want to receive reimbursement from Medicaid must also register with MaineCare. Eligible providers include, but aren’t limited to, the following:
Maine allows health care providers to issue online prescriptions for telehealth patients. Before issuing a prescription, the provider must take a complete history from the patient to identify any potential drug interactions or contraindications. In some cases, a provider must also conduct a physical examination to determine if the patient has a medical condition requiring treatment with a prescribed medication.
Maine is also one of the few states that require online prescribing for providers with authority to prescribe opioids for pain relief. According to the Maine Department of Health and Human Services, this online prescribing requirement helps providers comply with relevant regulations and helps prevent the misuse and abuse of opioid medications.
If your primary care physician offers telemedicine services, you may want to keep seeing the same provider for continuity of care. Should you need a new provider, however, it’s important to do your research to find a medical professional who understands your needs and helps you feel comfortable.
Telehealth laws are always changing to better meet the needs of patients and providers. Keep up with all the changes by visiting these websites.