Posts in Telemedicine
How to Integrate Direct-to-Consumer (DTC) Lab Testing into Your Telemedicine Model
How to Integrate Direct-to-Consumer (DTC) Lab Testing into Your Telemedicine Model

There are two primary structures in use in the DTC space: (1) Outsourcing and (2) Insourcing.

In this article, you’ll gain an overview of each structure, discover the limitations regarding billing and revenue model, and walk away with key operational considerations.

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Virtual Care Management, Telemedicine, Digital HealthRebecca Gwilt, Esq. and Bethany Corbin, Esq.direct-to-consumer lab testing, dtc lab testing
The 2023 Medicare Physician Fee Schedule Proposed Rule: Everything You Need to Know Now [video]
The 2023 Medicare Physician Fee Schedule Proposed Rule: Everything You Need to Know Now [video]

Whether you are building a business aimed at facilitating RTM for healthcare providers or growing a direct-to-consumer RTM practice, you know that reimbursement requirements significantly impact several of your most important business decisions.

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Behavioral Health, Digital Health, Medical Practice, Medicare, Physician Fee Schedule, Physicians, Provider, Reimbursement, Remote Monitoring, Remote Patient Monitoring, Regulations, Telehealth, Telemedicine, Virtual Care Management, WebinarNixon Gwilt Law2023 MPFS, reimbursement, behavioral health, chronic pain management, RTM, telehealth
Digital Health Companies: How to choose a business model to bring your consumer-centric care to the market
Digital Health Companies: How to choose a business model to bring your consumer-centric care to the market
Digital Health, Life Sciences, Medical Practice, MSO, Physicians, Regulations, Reimbursement, Remote Monitoring, Remote Patient Monitoring, Telehealth, Telemedicine, Virtual Care ManagementRebecca GwiltDigital Health, regulation, Virtual care, business, market, Telehealth, Virtual care management, virtual care compliance, direct to consumer, friendly PC, friendly physician MSO, provider, healthcare provider, telehealth network, MSO, pharmacy, telepharmacy, mobile medical applications
2022 Trends and Opportunities for Healthcare and Life Sciences Businesses and Investors
2022 Trends and Opportunities for Healthcare and Life Sciences Businesses and Investors

Find out what Healthcare and Life Sciences businesses and investors anticipate for the healthcare industry in 2022.

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Digital Health, FDA, Legislation, Life Sciences, Medicare, OIG, Pharmacy, Remote Patient Monitoring, Telehealth, TelemedicineNixon Gwilt Lawtelepharmacy, contracts, RTM, SaMD, FDA, wearables, FTC, hospital at home, tele-phlebotomy, tele-radiology, data analytics, femtech, hipaa, DEA
Pharmacy Innovation Series: the DEA Steps into Telepharmacy Regulation
Pharmacy Innovation Series: the DEA Steps into Telepharmacy Regulation

For the first time, the Drug Enforcement Agency (“DEA”) is becoming directly involved in the telepharmacy space, an industry that the DEA has not previously regulated aside from the loose application of its existing regulations governing online pharmacies. Find out what this means for your business and how you can submit comments to the DEA directly in this post.

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Life Sciences, Pharmacy, Telehealth, TelemedicineReema Tanejatelepharmacy, DEA, ANPRM, csa, controlled substances act, pharmacist, pharmacy, regulation
3 Practical Steps to Better Protect Your Healthcare Business (and Reputation) from Data Breaches
3 Practical Steps to Better Protect Your Healthcare Business (and Reputation) from Data Breaches

Data is rapidly becoming one of the most valuable assets in the healthcare market, putting digital health companies that collect and process large amounts of personal data at higher risk than many other types of businesses. If you have a healthcare business, then you’ll want to keep reading…

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Digital Health, Electronic Records, Health IT, HIPAA, Privacy, Regulations, Remote Patient Monitoring, Startups, Telehealth, TelemedicineKathrin (Kat) Lozahprivacy and security, data privacy, HIPAA, data breach, GDPR, compliance
Telehealth in the 2022 Medicare Physician Fee Schedule: Audio-Only Telehealth for Mental Health Made Permanent, and CMS Punts on Remote Direct Supervision
Telehealth in the 2022 Medicare Physician Fee Schedule: Audio-Only Telehealth for Mental Health Made Permanent, and CMS Punts on Remote Direct Supervision

On November 2, 2021, the Centers for Medicare and Medicaid Services (“CMS”) finalized the Medicare Physician Fee Schedule for Calendar Year 2022 (the “Final 2022 MPFS” or the “Final Rule”). As we noted in our July article discussing the Proposed 2022 MPFS, CMS made some significant proposed changes to allow for audio-only telehealth in some limited circumstances. In addition, the agency also proposed to enable remote “direct supervision,” which would allow practitioners to supervise clinical staff billing incident to their services as long as they could be available by audio/video communication as necessary.

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Behavioral Health, CMS Programs, Healthcare Reform, Medicare, OIG, Physician Fee Schedule, Regulations, Reimbursement, Telehealth, TelemedicineRebecca GwiltTelemedicine, telementalhealth, 2022 Medicare Physician Fee Schedule, 2022, MPFS, Medicare, telemedicine, CMS, 99441, 99442, 99443, CPT, 93797, 93798, G0422, G0423, G2252
Additional Reimbursement for Chronic Care Management and Principal Care Management Finalized in the 2022 MPFS
Additional Reimbursement for Chronic Care Management and Principal Care Management Finalized in the 2022 MPFS

In the Final Medicare Physician Fee Schedule (“MPFS”) for 2022 (the “Final Rule”) issued on November 2, 2021, the Centers for Medicare and Medicaid Services (“CMS”) added five new CPT codes in the categories of Chronic Care Management (“CCM”) and Principal Care Management (“PCM”) and increased reimbursement for already existing codes in the same categories. Despite stakeholder feedback, CMS refrained from making any changes to the existing rules for obtaining beneficiary consent for CCM and PCM.

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CMS Programs, Digital Health, Healthcare Reform, OIG, Medicare, Physician Fee Schedule, Reimbursement, Telemedicine, TelehealthKaitlyn O'Connor and Reema TanejaCCM, PCM, Chronic Care Management, Principal Care Management, MPFS, 2022, 2022 Medicare Physician Fee Schedule, medicare physician fee schedule, 99437
Under 2022 Medicare Physician Fee Schedule, Physician Assistants Will Be Paid Directly for Services
Under 2022 Medicare Physician Fee Schedule, Physician Assistants Will Be Paid Directly for Services

On November 2, 2021, the Centers for Medicare and Medicaid Services (“CMS”) released its Final Medicare Physician Fee Schedule for 2022 (the “Final 2022 MPFS”), revising certain payment policies for services provided to Medicare beneficiaries by healthcare practitioners. These policies take effect on January 1, 2022.

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Healthcare Reform, Legislation, Medicare, OIG, Physician Fee Schedule, Physicians, Reimbursement, Telehealth, TelemedicineCarrie Nixon and Casey Pappphysician coverage, MPFS, 2022, medicare physician fee schedule
[Webinar Replay] The Top 3 Privacy Concerns for Digital Health Innovators
[Webinar Replay] The Top 3 Privacy Concerns for Digital Health Innovators

Discover how Privacy compliance impacts Digital Health Startup founders and executives in terms of access to capital and securing key vendor agreements in this webinar replay. You may not have ever looked at Privacy this way before, and we encourage you to explore this perspective so you can close those critical deals without unnecessary delay.

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Digital Health, HIPAA, Privacy, Startups, Telehealth, Telemedicine, Vendor RelationsNixon Gwilt Lawwebinar, funding, fundraising, key relationships, privacy and security, privacy, Digital Health
Remote Therapeutic Monitoring in the 2022 MPFS: How CMS Can (and Should) Get it Right
Remote Therapeutic Monitoring in the 2022 MPFS: How CMS Can (and Should) Get it Right

This is our take on the approach CMS should follow in improving and finalizing the RTM codes and associated reimbursement that improve patient outcomes and lower the overall cost of care. It is based on our extensive work with remote patient monitoring and care management digital health companies along with the physician practices who use the existing care management codes – including Remote Patient Monitoring (“RPM”), Chronic Care Management, Principal Care Management, and Behavioral Health Integration.

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Digital Health, Healthcare Reform, Medicare, Physician Fee Schedule, Reimbursement, Remote Patient Monitoring, Regulations, Telehealth, TelemedicineCarrie Nixon2022 Medicare Physician Fee Schedule, Remote Therapeutic Monitoring, remote patient monitoring, Remote Monitoring, virtual care, RPM, RTM, MPFS, 2022, proposed rule, proposed medicare physician fee schedule, medicare physician fee schedule, CMS
**Video Post** The OIG is Watching: Why your telehealth or virtual care company should be focused on compliance right now.
**Video Post** The OIG is Watching: Why your telehealth or virtual care company should be focused on compliance right now.

We’ve hit the record button during our weekly Partner meeting to talk about the increased scrutiny of telemedicine and virtual care service by the Office of the Inspector General (OIG), as reflected in the latest OIG work Plan and ongoing audits and evaluations.

This conversation is especially relevant for those of you in the telehealth/digital health space, whether you’re a healthcare provider or platform/tech providers.

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Provider, Digital Health, OIG, Telehealth, Telemedicine, Remote Patient Monitoring, VlogNixon Gwilt LawOIG, Office of Inspector General, telehealth, telemedicine, virtual care, digital health, provider, RPM, remote monitoring, remote patient monitoring, compliance assessment
Discover how six important additions and amendments to the physician self-referral law ("Stark") could create opportunities to grow your healthcare business in 2021
Discover how six important additions and amendments to the physician self-referral law ("Stark") could create opportunities to grow your healthcare business in 2021

A Final Rule published by CMS makes several important changes to the Stark Law that will be a boon for physicians eager to more closely coordinate with other providers to (1) better manage patient care and (2) to participate in the shift to value-based reimbursement.

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Digital Health, Fraud and Abuse, Regulations, Remote Patient Monitoring, Telehealth, TelemedicineRebecca GwiltStark Law, Stark, Digital Health, telemedicine, data analytics, innovation, CMS, healthcare innovation, healthcare attorney, healthcare lawyer, fee for value, value-based care, RPM, fraud and abuse, AKS, Safe Harbor, Rebecca Gwilt
Remote Patient Monitoring in the 2021 Medicare Physician Fee Schedule: The good, the bad, and the ugly
Remote Patient Monitoring in the 2021 Medicare Physician Fee Schedule: The good, the bad, and the ugly

On December 1, 2020, the Centers for Medicare and Medicaid Services (“CMS”) released its Final Medicare Physician Fee Schedule for 2021 (the “Final 2021 MPFS”), revising payment policies for services provided to Medicare beneficiaries by medical practitioners. These policies will take effect on January 1, 2021. Read on for insights from Team NGL.

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CMS Programs, Digital Health, Healthcare Reform, Physician Fee Schedule, Regulations, Reimbursement, Remote Patient Monitoring, Telehealth, TelemedicineCarrie Nixon and Kaitlyn O'Connor2021 MPFS, Digital Health, Telehealth, Telemedicine, Remote Patient Monitoring, RPM, CMS, Medicare, regulations, 2021 Medicare Physician Fee Schedule, Carrie Nixon, Kaitlyn O'Connor