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-4.02 - MEMBER ELIGIBILITY
Universal Citation: 10 ME Code Rules ยง 144-101-I-4.02
Current through 2024-38, September 18, 2024
4.02-1 Telehealth Services
If a Member is eligible for the underlying Covered Service to be delivered, and if delivery of the Covered Service via Telehealth Services is medically appropriate, as determined by the Health Care Provider, the Member is eligible for Telehealth Services.
4.02-2 Telemonitoring Services
In order to be eligible for Telemonitoring Services, a Member must:
A. Be eligible for Home
Health Services under Chapter II, Section
40, Home Health Services;
B. Have a current diagnosis of a health
condition requiring monitoring of clinical data at a minimum of five times per
week, for at least one week;
C.
Have documentation in the patient's medical record that the patient is at risk
of hospitalization or admission to an emergency room;
OR
Have continuously received Telemonitoring Services during the past calendar year and have a continuing need for such services, as documented by an annual note from a Health Care Provider;
D. Have Telemonitoring Services included in
the Member's Plan of Care. A notation from a Health Care Provider, dated prior
to the beginning of service delivery, must be included in the Member's Plan of
Care. MaineCare shall not reimburse for Telemonitoring Services if they began
prior to the date recorded in the Provider's note.
E. Reside in a setting suitable to support
telemonitoring equipment; and
F.
Have the physical and cognitive capacity to effectively utilize the
telemonitoring equipment or have a caregiver willing and able to assist with
the equipment.
Disclaimer: These regulations may not be the most recent version. Maine may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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