Chapter 96. Remote Patient Monitoring

“Certified nurse midwife” means an individual who meets the licensure and conditions of participation for certified nurse midwives set forth in COMAR 10.09.01.

“Certified nurse practitioner” means an individual who meets the licensure and conditions of participation for certified nurse practitioners set forth in COMAR 10.09.01.

“Department” means the Maryland Department of Health, which is the single State agency designated to administer the

“Episode” means the span of treatment during which remote patient monitoring services are rendered to eligible participants.

“Home” means the place of residence occupied by the participant, other than a hospital, nursing facility, or other medical or psychiatric institution.

“Home health agency" means a public or private agency or organization that meets the licensure requirements and conditions of participation of COMAR 10.09.04.

“Maryland Medical Assistance Program” means the program of comprehensive medical, behavioral, and other health-related care for indigent and medically indigent individuals, jointly financed by the federal and state governments and administered by states under Title XIX of the Social Security Act, 42 U.S.C. §1396 et seq., as amended.

“Medically necessary” means that the service or benefit is:

“Participant” means an individual who is certified as eligible for, and is receiving, Medical Assistance benefits.

“Physician” means an individual who meets the licensure requirements and conditions of participation of COMAR 10.09.02.

“Physician assistant” means an individual who meets the licensure requirements and conditions of participation set forth in COMAR 10.09.55.

“Program” means the Maryland Medical Assistance Program.

“Provider” means an individual or an organization who:

“Remote patient monitoring” means the use of synchronous or asynchronous digital technologies that collect or monitor medical, patient-reported, and other forms of health care data for Program participants at an originating site and electronically transmit that data to a distant site provider to enable the distant site provider to assess, diagnose, consult, treat, educate, provide care management, suggest self-management, or make recommendations regarding the Program participant’s health care.

Meet all license requirements as set forth in COMAR 10.09.36.02; and

Be licensed in the state in which the participant resides.

Licensed pursuant to Health-General Article, §§19-401—19-408, Annotated Code of Maryland;

Part of a hospital or related institution licensed pursuant to Health-General Article, §§19-301—19-359, Annotated Code of Maryland; or

Legally authorized to provide home health services in the jurisdiction in which the service is provided.

Hold a current license to practice registered nursing in Maryland, and be certified as a nurse practitioner by the Nursing Board; or

Meet the nurse practitioner regulatory requirements of the state in which the services are provided.

Be licensed to practice as a physician assistant in Maryland or in the state or jurisdiction in which the service is provided;

Be in compliance with requirements set forth in COMAR 10.32.03;

If practicing in Maryland, have a delegation agreement with a supervising physician that outlines the physician assistant’s duties within the medical practice or facility which has been filed with and approved by the Board of Physicians; and

If practicing in Maryland, have a delegation agreement with a supervising physician that documents the specialized training, education, and experience of the physician assistant for performing advanced duties.

Be enrolled with an active status as a Maryland Medical Assistance Program provider on the date the service is rendered;

Be a:

Meet the requirements for participation in the Medical Assistance Program as set forth in COMAR 10.09.36.03.

Maintain documentation using either electronic or paper medical records;

Retain remote patient monitoring records according to the provisions of Health-General Article, §4-403, Annotated Code of Maryland;

Submit the preauthorization on a form developed by the Department; and

Include the participant’s consent to participate in remote patient monitoring.

Installation;

Education for the participant in the use of the equipment; and

Daily monitoring of vital signs and other medical statistics.

Establishing criteria for reporting abnormal measurements;

Informing the participant of abnormal results; and

Monitoring results and improvements in patient’s ability to self-manage chronic conditions.

Have an order by a physician, physician assistant, certified nurse midwife, or certified nurse practitioner who has examined the patient and with whom the patient has an established, documented and ongoing relationship;

Report abnormal measurements to the participant and to the ordering provider; and

Send the ordering provider a weekly summary of monitoring results, including improvement in patient’s ability to self-manage chronic conditions.

Remote patient monitoring equipment;

Upgrades to remote patient monitoring equipment;

The internet connections necessary to transmit the results of remote patient monitoring services to the provider’s offices; or

More than:

Bill on a UB04; and

Be paid a monthly rate.

Bill using a CMS 1500 or an 837P; and

Be paid a monthly rate.

Provider’s customary charge unless the service is free to individuals not covered by Medicaid; or

The Department’s professional fee schedule as found in COMAR 10.09.02.07.