Posts in Telehealth
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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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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New Reimbursement for Remote Therapeutic Monitoring in the Final 2022 Medicare Physician Fee Schedule

This article examines the new CPT codes for Remote Therapeutic Monitoring as finalized for reimbursement in the 2022 Medicare Physician Fee Schedule, discussing key takeaways and implications for digital health and remote patient monitoring companies.

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[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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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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Proposed 2022 MPFS: Expansion in Audio-Only Telehealth, Permanent Remote “Direct Supervision”, and Remaining Opportunities for New Permanent Telehealth Codes

CMS didn’t propose to add any permanent telehealth codes, but did incrementally expand patient access to telehealth in other ways.

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**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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2021 Trends and Opportunities for Healthcare Providers, Digital Health, and Life Sciences Innovators

2020 was the year that showed us all that you can’t truly predict what lays ahead. But, for all the surprises of the last year, the industry didn’t collapse, it accelerated along familiar trend lines. So, after a year like 2020, should we even attempt to predict what will happen in 2021? We say yes. And here’s why…

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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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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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Changes to the Anti-Kickback Regulations are Good News for Digital Health Innovation and the Shift to Value-Based Care

The Office of the Inspector General for HHS released a Final Rule aimed at reducing regulatory barriers and facilitating the move towards value-based care and giving healthcare providers and digital health companies more flexibility to enter into new business arrangements. This article is a high-level overview of the Rule and what it may mean for the future of healthcare.

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Reimbursement for Virtual Check-ins and e-Visits in the Proposed 2021 Medicare Physician Fee Schedule

On August 3, 2020, the Centers for Medicare & Medicaid Services (“CMS”) released it Proposed Medicare Physician Fee Schedule for CY 2021 (“Proposed MPFS”), seeking to expand reimbursement for Virtual Check-ins and e-Visits as a way of improving access to patient care. CMS proposes seven new HCPCS codes for these “Communication Technology-Based Services” that could be billed by practitioners who cannot bill Evaluation and Management (“E/M”) services independently.

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Carrie Nixon in mHealth Intelligence Discussing the Recent Telehealth Changes

Carrie Nixon, of the Nixon Law Group, said the order calls for “a strategy to improve rural health by improving the communications infrastructure in rural America,” though she notes such a strategy would have to be funded.

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Rebecca Gwilt in Home Health News Discussing the Latest Telehealth News

Nixon Law Group’s Partner, Rebecca Gwilt, was quoted in an article appearing in Home Health News discussing the new CMS proposed rules and how the supposed expansion of telehealth leaves out home health. Home health was largely ignored in the national conversation about supporting the expansion of telehealth

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The Future of Telehealth is Now in Sight: CMS’ Proposed Changes to the Medicare Physician Fee Schedule for CY 2021

On Monday, August 3, 2020, the Centers for Medicare & Medicaid Services (“CMS”) released the 2021 Medicare Physician Fee Schedule Proposed Rule (the “2021 Proposed Rule”). In the healthcare industry, the Medicare Physician Fee Schedule or “MPFS” is arguably the most prominent force shaping the industry on an ongoing basis. Each year, CMS releases a Proposed Rule mid-summer to give stakeholders a first look at what is potentially to come for the following year. Stakeholders have an opportunity to comment on those proposals, CMS reads the comments it receives, and then based on those comments CMS updates its proposals and releases a Final Rule.

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Remote Patient Monitoring in the 2021 Proposed Medicare Physician Fee Schedule

Last evening, the Centers for Medicare & Medicaid Services (“CMS”) issued its proposed Medicare Physician Fee Schedule for CY 2021 (the “MPFS”). In addition to a number of important changes relating to the provision and reimbursement of telehealth, the proposed MPFS includes long-awaited clarifications around use of the Remote Patient Monitoring (“RPM”) codes established over the past three years

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Op-ed by Carrie Nixon in The Hill: 5 Actions to Fuel the Digital Health Momentum

Nixon Law Group’s Managing Partner, Carrie Nixon, was quoted in an op-ed for The Hill discussing 5 actions to fuel the digital health momentum. "The COVID-19 public health emergency has forcefully opened the door for widespread adoption of telehealth, remote patient monitoring, and other digital health platforms by patients and providers alike."

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Carrie Nixon on Post-COVID-19 Telehealth Rules and Policies with mHealth Intelligence

Experts Weigh in on Post-COVID-19 Telehealth Rules and Policies. Nixon Law Group’s Managing Partner, Carrie Nixon, was quoted extensively in an article appearing in mHealth Intelligence regarding her views on post-COVID-19 telehealth rules and policies.

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