Code of Maine Rules
10 - DEPARTMENT OF HEALTH AND HUMAN SERVICES
144 - DEPARTMENT OF HEALTH AND HUMAN SERVICES - GENERAL
Chapter 101 - MAINECARE BENEFITS MANUAL (FORMERLY MAINE MEDICAL ASSISTANCE MANUAL)
Chapter I - Specific Policies By Service
Sec2 144-101-I-4 - Telehealth Services
Subsection 144-101-I-4.01 - DEFINITIONS

4.01-1 Asynchronous Encounter

The interaction or consultation between a Member and the Member's Health Care Provider or between Health Care Providers regarding the Member through a system with the ability to store digital information, including, but not limited to, still images, video, audio and test files, and other relevant data in one location and subsequently transmit such information for interpretation at a remote site by Health Care Providers without requiring the simultaneous presence of the Member or the Health Care Provider. The term "Store-and-Forward Telehealth" is also used for the term "Asynchronous encounters" in this rule.

4.01-2 Consultative Physician

A physician who provides consultation services to another clinical provider who is actively investigating the health status of a Member.

4.01-3 Department

The Maine Department of Health and Human Services.

4.01-4 Health Care Provider

Individual or entity licensed or certified to provide medical, behavioral health, and related services to MaineCare Members. Health Care Providers must be enrolled as MaineCare Providers to receive reimbursement for services.

4.01-5 Home Health Agency (HHA)

A voluntary, public, or private organization or a part of such organization that is certified under Title XVIII of the Social Security Act for reimbursement for the delivery of home health services, pursuant to Chapter II, Section 40, Home Health Services, of the MaineCare Benefits Manual (MBM).

4.01-6 Interactive Telehealth Services

Real time, interactive visual and audio telecommunications whereby a Member and a Health Care Provider interact remotely through the use of technology.

4.01-7 MaineCare Covered Services

Services covered and reimbursed through MaineCare as provided in the MBM.

4.01-8 Member

Any person certified as eligible for services under the MaineCare program.

4.01-9 Originating Facility Fee

Fee paid to the Health Care Provider at the Originating (Member) Site for the service of coordinating Telehealth Services.

4.01-10 Originating (Member) Site

The site at which the Member is located at the time of Telehealth Service delivery. The site must be physically located in the United States.

4.01-11 Receiving (Provider) Site

The site at which the Health Care Provider delivering the service is located at the time of service delivery. The site must be physically located in the United States.

4.01-12 Synchronous Encounter

A real-time interaction conducted with interactive audio or video connection between a Member and the Member's Health Care Provider or between Health Care Providers regarding the Member.

4.01-13 Specialist

A medical professional highly trained in a particular medical field.

4.01-14 Telehealth Services

The use of information technology by a Health Care Provider to deliver clinical services at a distance for the purpose of diagnosis, disease monitoring, or treatment. Telehealth Services may be either Telephonic or Interactive and includes synchronous encounters, asynchronous encounters, store-and-forward transfers, and telemonitoring.

4.01-15 Telemonitoring Services

The use of information technology to remotely monitor a Member's health status via electronic means, allowing the provider to track the enrollee's health data over time. Telemonitoring may be synchronous or asynchronous.

4.01-16 Telephonic Services

The use of audio-only telephone communication by a Health Care Provider to deliver clinical services at a distance for the purpose of diagnosis, disease monitoring, or treatment.

4.01-17 Treating Provider

A medical professional who either is currently providing or has provided medical treatment, evaluation, or who has an ongoing treatment relationship with the Member.