Posts in Digital Health
How RPM Companies Can Leverage the New Remote Therapeutic Monitoring CPT Codes Expected in 2022
How RPM Companies Can Leverage the New Remote Therapeutic Monitoring CPT Codes Expected in 2022

With these new RTM codes set to go into effect January 1, 2022, RPM vendors already in the remote monitoring arena should start preparing now for how they can take advantage of this new reimbursement opportunity.

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Digital Health, Remote Patient Monitoring, Reimbursement, Physician Fee Schedule, FDAKaitlyn O'ConnorRTM, 2022 MPFS, CPT, Remote Patient Monitoring, RPM, Remote Therapeutic Monitoring, SaMD, software as a medical device
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
3 Key Challenges Facing Tele-dentistry Companies and How to Approach Them
3 Key Challenges Facing Tele-dentistry Companies and How to Approach Them

Dentistry is one of a number of clinical specialties that is taking a creative and innovative approach to delivering care using digital health tools. Most of us are now familiar with Byte, SmileDirectClub, and Candid—these companies are pioneers in the space. However, tele-dentistry has far more potential applications than retail clear aligner services. Tele-dentistry entrepreneurs are building solutions for remote examination of sore or swollen teeth and gums, screening for certain oral diseases and cancers, mobile dental hygiene, dental hygiene education, and more.

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Telehealth, Tele-dentistry, Provider, Digital Health, ReimbursementKathrin (Kat) Lozahdentistry, teledentistry, CPOD, Corporate practice of Dentistry
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
New Reimbursement for Remote Therapeutic Monitoring in the Final 2022 Medicare Physician Fee Schedule
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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Digital Health, Medicare, Physician Fee Schedule, Regulations, Reimbursement, Remote Patient Monitoring, TelehealthCarrie NixonRemote Therapeutic Monitoring, Remote Monitoring, Remote Patient Monitoring, Reimbursement, MPFS, 2022 Medicare Physician Fee Schedule, CPT Code 98975, CPT Code 98976, CPT code 98977, CPT code 98980, CPT code 98981, RPM, RTM, CPT
[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
Proposed 2022 MPFS: Expansion in Audio-Only Telehealth, Permanent Remote “Direct Supervision”, and Remaining Opportunities for New Permanent Telehealth Codes
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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Telehealth, Remote Patient Monitoring, Reimbursement, Physician Fee Schedule, Digital Health, ProviderRebecca Gwiltproposed rule, telementalhealth, audio-only reimbursement, chronic pain management, rural health clinics, FQHCs, Opioid treatment programs, telebehavioral health, remote supervision, chronic pain
New Remote Therapeutic Monitoring CPT codes introduced in Proposed 2022 Medicare Physician Fee Schedule
New Remote Therapeutic Monitoring CPT codes introduced in Proposed 2022 Medicare Physician Fee Schedule

On July 13th, the Centers for Medicare and Medicaid Services (“CMS”) released its proposed Medicare Physician Fee Schedule for Calendar Year 2022 (the “2022 Proposed MPFS” or the “Proposed Rule”). In doing so, it recognized five new CPT codes for Remote Therapeutic Monitoring (“RTM”) of “non-physiologic” patient data such as “musculoskeletal system status, respiratory system status, therapy (medication) adherence, and therapy (medication) response” as well as pain. While this new code set is welcomed by advocates for virtual care, the 2022 Proposed MPFS that discusses RTM may raise just as many questions as it answers.

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Digital Health, Physician Fee Schedule, Medicare, Reimbursement, Remote Patient MonitoringCarrie Nixon and Kaitlyn O'Connorremote patient monitoring, RPM, Remote Therapeutic Monitoring, RTM, 2022 Medicare Physician Fee Schedule
[VIDEO] How we think about Healthcare Innovation and what we're seeing in the market right now
[VIDEO] How we think about Healthcare Innovation and what we're seeing in the market right now

We’re inviting you back for a bit of our weekly Partner meeting. This time we’re talking about Healthcare Innovation—what it is, the kind of innovative companies we’re seeing in the market, and what they’re doing that you should know about.

This conversation is especially relevant for those of you looking for emerging trends which may impact the market. (And hey, isn’t that everyone?)

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Digital Health, ProviderNixon Gwilt LawLife Sciences and Biotech, innovation, market analysis, vlog
**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
Carrie Nixon in mHealth Intelligence Discussing the 2021 MPFS Reimbursements for RPM
Carrie Nixon in mHealth Intelligence Discussing the 2021 MPFS Reimbursements for RPM

Nixon Gwilt Law’s Managing Partner, Carrie Nixon, was quoted in an article appearing in mHealth Intelligence discussing the January amendments by the Centers for Medicare & Medicaid Services to the 2021 Physician Fee Schedule to clarify reimbursement for remote patient monitoring programs.

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CMS Programs, Digital Health, Healthcare Reform, Medicare, Physician Fee Schedule, Regulations, Remote Patient Monitoring, ReimbursementCarrie NixonRPM, remote patient monitoring, 2021 MPFS, 2021 Medicare Physician Fee Schedule
Webinar Recording: Remote Patient Monitoring and Virtual Care: Trends, Changes and Clarifications under the 2021 MPFS
Webinar Recording: Remote Patient Monitoring and Virtual Care: Trends, Changes and Clarifications under the 2021 MPFS

Join Nixon Gwilt Law’s Carrie Nixon and Kaitlyn O’Connor for a presentation and discussion about Remote Patient Monitoring and other virtual care services, with a particular focus on how these services are addressed in the 2021 Medicare Physician Fee Schedule and what that may mean for business and reimbursement models going forward.

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Digital Health, Healthcare Reform, Physician Fee Schedule, Reimbursement, Remote Patient MonitoringNixon Gwilt Lawremote patient monitoring, RPM, MPFS, 2021 Medicare Physician Fee Schedule, 2021 MPFS
What is a Value-Based Enterprise? New Opportunities for Digital Health and Healthcare Innovation
What is a Value-Based Enterprise? New Opportunities for Digital Health and Healthcare Innovation

Dramatic changes to the Anti-Kickback Statute and the Stark Physician Self-Referral Law regulations present an unprecedented opportunity for healthcare providers and digital health companies to create new business arrangements that align incentives around care coordination and patient engagement. Such arrangements are the foundation of the Value-Based Enterprise.

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Digital Health, Fraud and Abuse, Medicare, OIG, Provider, Regulations, Remote Patient Monitoring, ReimbursementCarrie NixonDigital Health, fraud and abuse, AKS, AKS Safe Harbor, Anti-Kickback Statue, Stark Law, Stark, CMS, regulations, remote patient monitoring, OIG
2021 Trends and Opportunities for Healthcare Providers, Digital Health, and Life Sciences Innovators
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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Cannabis Law, CMS Programs, Digital Health, Firm News, Healthcare Reform, Legislation, Physician Fee Schedule, Regulations, Reimbursement, TelehealthCarrie Nixon, Rebecca Gwilt, Kaitlyn O'Connor, Tommy MillerLife Sciences and Biotech, 2021 Medicare Physician Fee Schedule, 2021 predictions, health reform
Carrie Nixon in mHealth Intelligence Discussing the 2021 Medicare Physician Fee Schedule
Carrie Nixon in mHealth Intelligence Discussing the 2021 Medicare Physician Fee Schedule

Nixon Gwilt Law’s Managing Partner, Carrie Nixon, was quoted in an article appearing in mHealth Intelligence discussing the recent changes to Telehealth and Remote Patient Monitoring with the new 2021 Medicare Physician Fee Schedule (learn about our take here and here).

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CMS Programs, Digital Health, Healthcare Reform, Medicare, Physician Fee ScheduleCarrie Nixontelehealth, remote patient monitoring, 2021 MPFS, 2021 Medicare Physician Fee Schedule, rpm, RPM, Carrie Nixon