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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Pharmacy Innovation Series: Exploring Integration of Primary Care Services, Telehealth, and Telepharmacy for Pharmacies of all Sizes

Get our legal breakdown of the Walgreens/VillageMD partnership and how it relates to integration of primary care services, telehealth, and telepharmacy for pharmacies of all sizes. Subscribe to get the entire series.

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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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Behavioral Health Integration Under the 2021 Medicare Physician Fee Schedule Proposed Rule

On Monday, August 3, 2020, the Centers for Medicare & Medicaid Services (“CMS”) released the 2021 Medicare Physician Fee Schedule Proposed Rule (the “Proposed Rule”). The 2021 Proposed Rule includes a new code under the Behavioral Health Integration (“BHI”) Collaborative Care Model (“CoCM”) that, if finalized, would offer reimbursement for a shorter increment of time than had previously been available under BHI.

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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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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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Nixon Law Group welcomes Reema Taneja, Esq.

"I am excited to welcome Reema to NLG," said Carrie Nixon, Esq., Managing Partner of Nixon Law Group. "She comes to the firm with a depth of experience in the healthcare industry from both a legal and policy perspective. Reema brings her experience advising hospitals, health systems, and pharmacies on regulatory compliance, innovative business arrangements, and leading-edge healthcare policy reforms.”

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Carrie Nixon in Modern Healthcare Discussing the Senate Hearing on Telehealth

Nixon Law Group’s Managing Partner, Carrie Nixon, was quoted in an article appearing in Modern Healthcare discussing the Senate HELP Committee hearing on telehealth that took place on June 17, 2020. The article notes general consensus among Committee members on two areas set forth as priorities by the Committee’s Chair, including 1) making permanent the elimination of the originating site and geographic restrictions for Medicare reimbursement of telehealth visits; and 2) maintaining and potentially expanding the list of services that may be provided by telehealth under Medicare, along with the list of types of healthcare providers eligible to provide these services to Medicare beneficiaries.

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Tommy Miller with Rocket Factory: 5 Tips from the Negotiation Table

With “Episode 3: 5 Tips from the Negotiation Table,” Tommy and I will dive into the following topics that should be relevant for every investor, founder, and CEO: Have a solid but flexible strategy/commercialization plan; Know and understand your competitive landscape, and how you will fit into/disrupt it.; Begin your company with the end in mind – preparing for exit; Be well-prepared in highly regulated industries (regulatory paths, documentation, marketing, information systems); What are your use cases and who is paying?

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Webinar and Discussion: Innovating in an Emergency: How COVID-19 is Impacting Drug Development now...and beyond


Join us as Tommy Miller, Sr. Counsel and Life Science Lead at Nixon Law Group, speaks with industry experts, John Lazo and Nikki Hastings, about how the global COVID-19 pandemic has impacted pharmaceutical drug development. The panel will discuss how innovators are responding to the pandemic through new tests, devices and therapeutics and how the drug development ecosystem can implement "lessons learned" to help us better prepare for the future of drug discovery.

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CMS clarifies use of Remote Patient Monitoring during COVID-19 and further expands Telehealth for Physical Therapists, Occupational Therapists, Speech Pathologists, other practitioners

The Center for Medicare and Medicaid Services (“CMS”) has issued a second Interim Final Rule (“IFR2”) that includes additional expansions and clarifications relating to the provision and reimbursement of telehealth, remote patient monitoring, and telephone services during the COVID-19 Public Health Emergency (“PHE”). While these expansions are another step forward for the adoption of digital technologies and services in healthcare, there are additional changes needed in the near-term, as detailed in the summary below.

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FQHCs and RHCs now paid for Telehealth and Virtual Communications Services during COVID-19

The Coronavirus Aid, Relief, and Economic Security Act (CARES Act) passed by Congress on March 27, 2020 opened the door for Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs) to increase healthcare access to patients in rural and underserved areas by reimbursing for telehealth services to Medicare beneficiaries during the public health emergency (PHE). In addition, CMS has issued non-legislative policy changes and flexibility to address the increased need for remote services for Medicare beneficiaries in rural areas of the country.

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