C.M.R. 10, 144, ch. 101, ch. I, § 144-101-I-4, subsec. 144-101-I-4.06

Current through 2024-51, December 18, 2024
Subsection 144-101-I-4.06 - POLICIES AND PROCEDURES
4.06-1Telehealth Equipment and Technology
A. Health Care Providers must ensure that the telecommunication technology and equipment used at the Receiving (Provider) Site and the Originating (Member) Site is sufficient to allow the Health Care Provider to appropriately provide the Member with services billed to MaineCare.
B.Security
1. Health Care Providers must comply with all federal, state, and local regulations that apply to its business including, but not limited to, the Electronic Communications Privacy Act of 1986. Any services that use networked services must comply with HIPAA requirements.
2. A Telehealth Service shall be performed on a secure telecommunications line or utilize a method of encryption adequate to protect the confidentiality and integrity of the Telehealth Service information in accordance with State and Federal laws, rules, and regulations.
3. Both the Originating (Member) Site and the Receiving (Provider) Site shall use authentication and identification to ensure the confidentiality of a Telehealth Service.
4. A Health Care Provider shall implement confidentiality protocols that include, but are not limited to:
a. Identifying personnel who have access to a telehealth transmission;
b. Usage of unique passwords or identifiers for each employee or person with access to a telehealth transmission; and
c. Preventing unauthorized access to a telehealth transmission.
5. A Health Care Provider's protocols and guidelines shall be available for inspection by the Department upon request.
C. Except as set forth herein, services may not be delivered through electronic mail.
D. The Department will not separately reimburse Health Care Providers for any charge related to the purchase, installation, or maintenance of telehealth equipment or technology, nor any transmission fees. Health Care Providers shall not bill Members for such costs or fees.
4.06-2Member Choice and Education
A. Before providing a Telehealth Service to a Member, a Health Care Provider shall ensure and document that the following information is provided to the Member or authorized representative in a format and manner that the Member is able to understand:
1. A description of the Telehealth Service and what to expect;
2. An explanation that use of Telehealth Services is voluntary. The Member shall have the option to refuse the Telehealth Services at any time without affecting the right to future care or treatment and without risking the loss or withdrawal of a MaineCare benefit to which the Member is entitled;
3. An explanation that MaineCare will pay for the Member's transportation to MaineCare Covered Services pursuant to Section 113, Non-Emergency Transportation Services, of the MBM;
4. An explanation that the Member shall have access to all information resulting from the Telehealth Service as provided by law;
5. The information contained in subparts C, D, and E of this subsection.;
B. Prior to the provision of any Telehealth Services, the Health Care Provider shall obtain the Member's written, electronic, or verbal informed consent to receive services via Telehealth Services, to Store-and-Forward Telehealth Services, Remote Consultation, Virtual Check-In, or Telephone Evaluation and Management.

A copy of the informed consent shall be retained in the Member's medical record and provided to the Member or the Member's legally-authorized representative upon request.

C. Health Care Providers shall comply with federal and Maine state laws and regulations regarding individual health care data confidentiality when disseminating, storing, or retaining an identifiable Member image or other information from a Telehealth Service;
D. At the onset of the Telehealth Service, the Health Care Provider shall inform the Member of the persons present at the Receiving (Provider) Site, and the Member shall have the right to exclude any person from either site during the service; and
E. The Member shall have the right to object to the audio and/or visual recording of a Telehealth Consultation.
4.06-3Required Documentation
A. Providers must maintain documentation at the Originating (Member) Site and the Receiving (Provider) Site to substantiate the services provided. This requirement does not apply when the Originating Site is the Member's residence.
B. Except as provided herein for Store-and-Forward Telehealth, Remote Consultation, Virtual Check-Ins, and Telephone Evaluation and Management, documentation must indicate the MaineCare Covered Services that were rendered via Telehealth Services, the location of the Originating (Member) Site, and the Receiving (Provider) Sites.

C.M.R. 10, 144, ch. 101, ch. I, § 144-101-I-4, subsec. 144-101-I-4.06