Category Archives: Telemedicine & Digital Health

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New Massachusetts Bills Propose Telehealth Insurance Coverage, Practice Standards

MassHealth
Momentum and support continues to build for telehealth commercial coverage laws across the United States, designed to ensure that covered members of health insurance plans can enjoy the full scope of their medical benefits – whether in-person or virtually.  Last summer, the Massachusetts Legislature considered a sweeping telehealth bill that would have instituted certain requirements … Continue reading this entry

Medicare Remote Patient Monitoring: CMS Allows “Incident to” Billing

medicaid
CMS just announced a clarification that remote patient monitoring under CPT code 99457 may be furnished by auxiliary personnel, “incident to” the billing practitioner’s professional services.  An “incident to” service is one that is performed under the supervision of a physician (broadly defined), and billed to Medicare in the name of the physician, subject to … Continue reading this entry

The Good and the Bad of the New MassHealth Telemedicine Rule

MassHealth
The Massachusetts Medicaid Program (known locally as MassHealth) issued a new All Provider Bulletin in January, setting forth new policies for certain behavioral health services delivered to MassHealth covered patients.  The guidance received mixed responses from the telehealth industry.… Continue reading this entry

Ambulance Suppliers: CMS Launches ET3 - A New Triage Model for EMS

On February 27, 2019, CMS will hold its first webinar to provide an overview on its new Emergency Triage, Treat, and Transport (ET3) Model for suppliers of emergency medicine services (EMS) and ambulance suppliers. On February 14, 2019, CMS’ Innovation Center announced ET3’s upcoming availability, which emphasizes the need for EMS suppliers to partner with … Continue reading this entry

Virginia Lawmakers Pass Bill Requiring Insurance Coverage for Remote Patient Monitoring

remote monitoring
Virginia lawmakers have taken new steps to expand the use of remote patient monitoring among the State’s residents, with both the House and Senate unanimously passing bipartisan legislation ensuring that commercial health plans will cover remote patient monitoring services. The bill now heads to the office of Governor Ralph Northam for signature.… Continue reading this entry

OIG Greenlights Digital Health Program Offering Free Smartphones to Patients

Last week, the federal HHS Office of Inspector General (OIG) gave the greenlight to allow a virtual care company and pharmaceutical manufacturer to loan patients free smartphones, so the patients (which include Medicare beneficiaries) could use the smartphones to track their drug therapy adherence via a mobile digital health app. The OIG’s recent Advisory Opinion … Continue reading this entry

Biometric Privacy: Illinois Supreme Court Decision Allows Claims to Proceed Without Showing of Actual Harm

On January 25, 2019, the Illinois Supreme Court handed down a key ruling that will make it significantly easier for consumers and workers to sue and recover damages for mere non-compliance with the requirements of the state’s Biometric Information Privacy Act, 740 ILCS 14/1 et seq. (BIPA or Act). In its highly anticipated decision in … Continue reading this entry

American Telemedicine Association Letter Offers Recommendations on DEA Special Registration for Telemedicine Prescribing of Controlled Substances

pharmacy
On January 9, 2019, the American Telemedicine Association (ATA) issued a policy comment letter to the U.S. Drug Enforcement Administration (DEA), advocating for provider-friendly changes to federal controlled substance prescribing rules. Note: the firm’s Telemedicine & Digital Health Industry Team participated in the ATA’s special workgroup to develop the recommendations.… Continue reading this entry

Understanding Medicare’s New Remote Evaluation of Pre-Recorded Patient Information (Asynchronous Telemedicine)

medicaid
Starting January 1, 2019, the Medicare program will cover certain medical services delivered via asynchronous telemedicine technologies. The Centers for Medicare and Medicaid Services (CMS) just published the final rule for the 2019 Physician Fee Schedule, introducing a new code, officially titled “Remote Evaluation of Pre-Recorded Patient Information” (HCPCS code G2010). This article provides the … Continue reading this entry

Top 10 FAQs on Medicare’s Virtual Check-In Codes: The New Brief Communication Technology-Based Service

medicaid
Telemedicine providers rejoice: Medicare will cover new virtual care services starting January 1, 2019.  The Centers for Medicare and Medicaid Services (CMS) just published the final rule for the 2019 Physician Fee Schedule, introducing a new code: Virtual Check-Ins, officially titled “Brief Communication Technology-Based Service” (HCPCS code G2012).  This article discusses the new code and … Continue reading this entry

Medicare Remote Patient Monitoring Reimbursement FAQs:   Everything You Need to Know About Chronic Care Remote Physiologic Monitoring Codes 

monitoring
Remote Patient Monitoring (RPM) is the next big thing in medical care; patients just don’t know it yet.  And, it seems, neither do many physicians.  On Thursday, CMS published the final rule on its new RPM codes, officially titled “Chronic Care Remote Physiologic Monitoring.”  There are three new RPM codes, all of which will go live starting January 1, 2019.  These codes … Continue reading this entry

President Signs New Law Allowing Telemedicine Prescribing of Controlled Substances: DEA Special Registration to Go Live

Public Affairs
President Trump just signed into law the “Special Registration for Telemedicine Act of 2018” (the Act), requiring the Drug Enforcement Administration (DEA) to activate a special registration allowing physicians and nurse practitioners to prescribe controlled substances via telemedicine without an in-person exam. The DEA has no more than one year to complete the task.… Continue reading this entry

Telemedicine Investors Roundtable Focuses on Progress, Barriers, and ROI

medicaid
As telemedicine continues to see significant traction, health care organizations are working to implement telemedicine programs and  create technology infrastructures all while working within the current legislative requirements. Foley & Lardner LLP and Ziegler recently had an opportunity to sit down with 15 leaders in telemedicine to discuss the progress, barriers, and return on investment … Continue reading this entry

Medicare Proposes (and Rejects) New Telehealth Services for 2019

The telemedicine industry was pleased to learn CMS recently proposed adding new services to its list of Medicare-covered telehealth services.  But what may be more interesting are the services CMS declined to add, and why.  This article summarizes the newly-proposed additions as well as the services CMS rejected, explores some reasons for CMS’ decisions, and … Continue reading this entry

Medicare’s New Chronic Care Remote Physiologic Monitoring Codes: Everything You Need to Know

remote monitoring
Earlier this year, in a first-of-its-kind move, CMS made remote patient monitoring (RPM) a separately-reimbursable service under Medicare.  Now, CMS has proposed three new codes for RPM services, retitled “Chronic Care Remote Physiologic Monitoring,” which do a far better job reflecting how providers can more effectively and efficiently use RPM technology to monitor and manage … Continue reading this entry

Massachusetts Telehealth Legislation Paves Way for Sweeping Changes

MassHealth
The Massachusetts House of Representatives has passed sweeping telehealth legislation, accompanying a companion bill passed by the Senate in November 2017.  While Massachusetts is often considered a leader in health care innovation, the Commonwealth has not enacted significant legislation in this area for several years, and is among the minority of states without a meaningful telehealth insurance coverage … Continue reading this entry

Medicare’s New Virtual Care Codes: A Monumental Change and Validation of Asynchronous Telemedicine

monitoring
The Centers for Medicare and Medicaid Services just issued a proposed rule introducing monumental changes to the physician fee schedule, paving the way for asynchronous telemedicine and new technologies through a new set of virtual care codes.  CMS explained the impetus for the bold changes, declaring: “We now recognize that advances in communication technology have … Continue reading this entry

Delaware’s New Telemedicine Rules: Top Four Changes to Know

Delaware
The Delaware Board of Medicine recently enacted new regulations pertaining to telemedicine and telehealth. As we previously reported, the new regulations are intended to clarify the language in Delaware’s Medical Practice Act, which imposes certain practice standards for what constitutes an appropriate patient diagnosis and treatment via telemedicine, including the allowable modalities and when an … Continue reading this entry

Disruption and Innovation on Display at the 2018 CEO/Innovators Roundtable

ambulatory
On June 19 and 20, 2018, more than 60 innovators and thought leaders came together for the 13th annual, invitation-only CEO/Innovators Roundtable (Roundtable), hosted by Foley & Lardner LLP and BDC Advisors, LLC. The overall theme of the Roundtable was “disruption and innovation” in health care, and the discussion was divided into panels on five … Continue reading this entry

New Connecticut Law Allows Telemedicine Prescribing of Controlled Substances

Connecticut
Connecticut has taken another step towards expanding the meaningful use of telemedicine in connection with treatment of mental health and substance use disorders.  SB 302, signed by Governor Dannel Malloy and effective July 1, 2018, allows providers to prescribe controlled substances via telemedicine for the treatment of psychiatric disabilities or substance use disorder, including medication … Continue reading this entry

Kentucky’s New Telehealth Law Expands Insurance Coverage and Reimbursement

Kentucky
Kentucky health care providers and patients will soon enjoy a revamped, and significantly improved, telehealth commercial insurance coverage law.  Kentucky Governor Matt Bevin signed SB 112 into law on April 26, 2018, imposing both telehealth coverage and payment parity requirements for Kentucky Medicaid, Medicaid managed care organizations, and commercial health plans in the Bluegrass State.  … Continue reading this entry

Telemedicine Prescribing of Controlled Substances: the Dark Side of the New Congressional Bill

FDA
Congress has taken another step forward to require the federal Drug Enforcement Administration (DEA) to activate a special registration allowing physicians and nurse practitioners to prescribe controlled substances via telemedicine without an in-person exam. The House Energy and Commerce Health subcommittee approved the Special Registration for Telemedicine Clarification Act of 2018, part of a larger … Continue reading this entry

Making a “Tele-Difference” by Using Telemedicine to Aid Medically Vulnerable Populations

medicaid
More than 74 million individuals are enrolled in Medicaid and the Children’s Health Insurance Program (CHIP). Another 28 million are currently uninsured. Due to the repeal of the individual mandate (the requirement under the Affordable Care Act to purchase insurance or face a financial penalty), the uninsured population is projected to increase to 32 million … Continue reading this entry

Iowa’s New Telehealth Law: What You Need to Know

Iowa
Iowa Governor Kim Reynolds recently signed a new bill into law requiring commercial health insurers in the Hawkeye State to cover health care services provided via telehealth to the same extent those services are covered via in-person care.  The law, passed under HF 2305, takes effect January 1, 2019 and applies to all policies delivered, … Continue reading this entry