CMS Finalizes APCM Codes for 2025: What it Means for Primary Care and Digital Health Companies

CMS has finalized the APCM codes for 2025. See what this means for primary care and digital health companies.

Medicare Physician Fee ScheduleCarrie NixonNovember 14, 2024remote patient monitoring, Telehealth, Medicare, Teleheath, Digital Health, behavioral health integration, mpfs, medicare physician fee schedule, remote therapeutic monitoring, digital health, mental health, telemental health, DMHT, APCM, CMS, MPFS, codes

New Reimbursement Opportunities for Digital Mental Health Treatment in 2025: CMS’ Final Rule

See what the final Medicare Physician Fee Schedule for 2025 has to say about Digital Mental Health Treatment

Remote Monitoring, Medicare Physician Fee ScheduleCarrie NixonNovember 8, 2024remote patient monitoring, Remote Therapeutic Monitoring, Remote Monitoring, remote care, Telehealth, Medicare, Teleheath, Digital Health, behavioral health integration, mpfs, medicare physician fee schedule, remote therapeutic monitoring, digital health, mental health, telemental health, DMHT

OIG’s Call for Increased Oversight of Remote Patient Monitoring Misses the Mark

Learn about the Office of Inspector General’s new report around remote patient monitoring and the key areas where it misses the mark.

Remote MonitoringCarrie NixonOctober 17, 2024OIG, remote patient monitoring, Remote Therapeutic Monitoring, Remote Monitoring, remote care, Telehealth, Medicare, Teleheath, software as a medical device, Digital Health, compliance, compliance assessment, Healthcare compliance, Chronic Care Management, Principal Care Management, behavioral health integration

Fundraising at Every Stage: Top Tips for Digital Health Startups

Learn how to make the fundraising process go as smoothly – and as quickly – as possible as a digital health startup — whether you're raising for the first time or you're a Series C company preparing for exit.

FundraisingCarrie Nixon and Kevin JoyceSeptember 5, 2024fundraising, compliance, healthcare compliance, entity formation, corporate law, startup fundraising, digital health, seed startups, series a startups, series b startups, series c startups, cap table creation, fundraising tips

Point Solution Fatigue, Meet M&A: How Strategic Transactions Can Transform Digital Health

Explore how strategic mergers and acquisitions (M&A) can reduce or even eliminate point solution fatigue by creating more comprehensive and integrated platforms that will improve patient care and reduce administrative burden.

Corporate Healthcare LawKevin Joyce, Carrie Nixon, Sam PinsonAugust 16, 2024M&A, Digital Health, Remote Patient Monitoring, Remote Monitoring, AI, reimbursement, fee for service, privacy and security

Navigating Reimbursement Strategies in the Food as Medicine Space

One of the key factors in FaM’s growth is reimbursement policy across various payors and providers. This post introduces reimbursement frameworks and strategies that support the FaM space, including medical nutrition therapy (MNT), medically tailored meals (MTM), the Supplemental Nutrition Assistance Program (SNAP), and employer-sponsored benefits programs.

Food As MedicineMichael Pappas and Samuel PinsonJuly 26, 2024food as medicine, Healthcare innovation, reimbursement, medicaid, Medicare, Commercial payers

New Reimbursement for Digital Mental Health Treatment in the 2025 Medicare Physician Fee Schedule Proposed Rule

In the recently released 2025 Medicare Physician Fee Schedule Proposed Rule (the “Proposed Rule”), the Centers for Medicare & Medicaid Services (CMS) created a new reimbursement pathway for “Digital Mental Health Treatment” (DMHT) devices and services.

Behavioral HealthCarrie NixonJuly 23, 2024mpfs, reimbursement

CMS Proposes New Reimbursement for Advanced Primary Care Management Services

Under the Proposed Rule, physicians and non-physician practitioners – for example, nurse practitioners (NPs) and physician assistants (PAs) – can order and bill for APCM services. Here’s what digital healthcare innovators need to know.

Care Management ServicesCarrie NixonJuly 18, 2024primary care, Care Management Services, CMS, Physicians, Nurse Practitioner

The Proposed 2025 Medicare Physician Fee Schedule Has Arrived! Key Takeaways for Digital Health Innovators

Below is an overview of the most important proposals and the opportunities for healthcare innovators and digital health companies from the 2025 Medicare Physician Fee Schedule Proposed Rule

Medicare Physician Fee ScheduleCarrie Nixon and Kaitlyn O'ConnorJuly 12, 2024Digital Health, Healthcare innovation, Medicare, Proposed fee schedule

Food as Medicine Summit 2024: 4 Challenges FaM Innovators Face

At the most recent Food as Medicine (FaM) Summit, leading experts, policymakers, and healthcare innovators in FaM gathered to discuss one important goal: revolutionizing how we improve population health through food and nutritional guidance.

Here’s what we believe every healthcare and FaM innovator should know.

Food As MedicineMichael PappasJune 27, 2024food as medicine, FaM innovators, Healthcare innovation, health equity, medicaid, medicare

Digital Therapeutics Alliance Summit 2024: 5 Takeaways for DTx Innovators

The Digital Therapeutics Alliance Summit 2024, held in Washington, D.C., brought together over 500 industry leaders (including NLG’s own Carrie Nixon and Michael Schellhous), innovators, and key stakeholders to discuss the current state and future of digital therapeutics (DTx).

Digital Therapeutics/SaMDMichael Schellhous and Carrie NixonJune 24, 2024DTx, Digital Health, Healthcare innovation, data privacy, healthcare provider, FDA, value-based care

FTC Finalizes Changes to Health Breach Notification Rule: What Digital Health Companies and App Developers Need to Know

The Federal Trade Commission (FTC) finalized changes to the Health Breach Notification Rule (HBNR), clarifying its applicability to health apps and similar technologies, including those that are not subject to HIPAA. In 2023, FTC began enforcing the HBNR in earnest, with an expanded interpretation of their authority under the HBNR. In the 2024 Final Rule (the 2024 Final Rule), the agency conforms the HBNR to this expanded interpretation, clarifying its breadth for industry and the public.

Corporate Healthcare LawRebecca Gwilt, Samuel Pinson, and Michael SchellhousJune 10, 2024FTC Breach Notification Rule, FTC, HBNR, Digital Health, developers, data breach

FDA Enforcement Discretion: A Strategic Path to Market for Digital Health and Digital Therapeutics Companies

Healthcare delivery is changing, and digital health is revolutionizing healthcare, creating a burgeoning market opportunity for software-as-a-medical-device (SaMD) and digital therapeutic (DTx) products.

FDAMichael SchellhousMay 29, 2024DTx, SaMD, FDA, medical device, reimbursement

Colorado’s New AI Law Sets “National Standard” for Healthcare AI: 5 Things Developers and Deployers Need to Know, Now

Last Friday, Colorado’s governor signed into law the Colorado AI Act (“CAIA”). For digital health companies building with artificial intelligence, CAIA sets the first comprehensive national benchmark for minimum rights and protections for users of healthcare AI, effective February 1, 2026.

Corporate Healthcare Law, Artificial IntelligenceRebecca GwiltMay 21, 2024AI, Healthcare innovation, hipaa

ATA Nexus 2024: 4 Game-Changing Takeaways for Healthcare Innovators

The ATA Nexus 2024 Conference, one of the largest gatherings of virtual healthcare experts and thought leaders, just took place in Phoenix last week. If you weren’t able to attend…what did you miss?

TelehealthCarrie Nixon, Rebecca Gwilt, and Kaitlyn O'ConnorMay 17, 2024AI, Remote Monitoring, Digital Health, digital medicine, fee for service, value-based care, virtual reality

How do Healthcare AI Developers (and Buyers) Stay Ahead of the Regulatory Curve?

No centralized framework for the regulation of artificial intelligence in the United States currently exists. That said, the flurry of regulatory policymaking and legislation, congressional hearings and inquiries, and industry stakeholder organization around the development and deployment of healthcare AI portends major developments in the coming years. Experienced entrepreneurs and executives know that the ability to peer into the future can pay dividends, and we agree.

Artificial IntelligenceRebecca Gwilt and Samuel PinsonApril 22, 2024artificial intelligence, AI, Digital Health