Nathaniel Lacktman on Centers for Medicare & Medicaid Services (CMS)

Remote Patient Monitoring: Medicare Proposes Two Major Expansions

Last week, CMS proposed two significant changes to remote patient monitoring (RPM) services reimbursed under the Medicare program. The changes, part of the proposed 2020 Physician Fee Schedule, have been hotly anticipated by...more

8/7/2019 / Centers for Medicare & Medicaid Services (CMS) , Digital Health , Health Care Providers , Health Information Technologies , Medicare , Physician Fee Schedule , Proposed Amendments , Telehealth , Telemedicine

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

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...more

3/19/2019 / Centers for Medicare & Medicaid Services (CMS) , Medical Monitoring , Medicare , Physician Fee Schedule

Virginia Lawmakers Pass Bill Requiring Insurance Coverage for Remote Patient 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...more

2/12/2019 / Centers for Medicare & Medicaid Services (CMS) , Digital Health , Governor Northam , Health Care Providers , Home Health Care , Medical Monitoring , Medicare , Telehealth , Telemedicine

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

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...more

11/7/2018 / Anti-Kickback Statute , Centers for Medicare & Medicaid Services (CMS) , HCPCS , Health Care Providers , Medicare , Physicians , Telemedicine

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

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,...more

11/6/2018 / Anti-Kickback Statute , Centers for Medicare & Medicaid Services (CMS) , Final Rules , HCPCS , Health Care Providers , Medicare , Physician Fee Schedule , Physicians , Telemedicine

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

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...more

11/6/2018 / Centers for Medicare & Medicaid Services (CMS) , Chronic Care Managment (CCM) , Entrepreneurs , Final Rules , Health Care Providers , Healthcare , Medicare , Physician Medicare Reimbursements , Physicians , Telehealth

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....more

8/10/2018 / Bipartisan Budget Act , Centers for Medicare & Medicaid Services (CMS) , Comment Period , EMTALA , HCPCS , Health Care Providers , Hospitals , Medical Reimbursement , Medicare , Proposed Rules , Social Security Act , Telecommunications , Telehealth , Telemedicine

INSIGHT: CMS’s Virtual Care Codes Pave New Avenues for Telemedicine Services Delivery

The Centers for Medicare & Medicaid Services 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...more

7/27/2018 / Centers for Medicare & Medicaid Services (CMS) , Electronic Health Record Incentives , HCPCS , Health Care Providers , Health Information Technologies , Medicare , Physician Fee Schedule , Physicians , Proposed Rules , Public Comment , Regulatory Agenda , Telemedicine

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

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...more

7/18/2018 / Centers for Medicare & Medicaid Services (CMS) , Health Care Providers , Health Information Technologies , HRSA , Physician Fee Schedule , Physicians , Proposed Rules , Public Comment , Regulatory Agenda , Telemedicine

OIG Report: CMS Paid Practitioners for Telehealth Services That Did Not Meet Medicare Requirements

The Office of Inspector General (OIG) at the Department of Health & Human Services (HHS) just published a new report on OIG’s review of Medicare payments for telehealth services. The objective of the OIG review was to...more

4/16/2018 / Audits , Bi-Partison Balanced Budget Act (BBA) , Centers for Medicare & Medicaid Services (CMS) , Department of Health and Human Services (HHS) , Health Care Providers , Medicare , MedPAC , OIG , Telehealth

Telemedicine Credentialing by Proxy: What Hospitals and Telehealth Companies Need to Know

Hospital-based telemedicine services continue to rapidly expand across the country, allowing providers to deliver care to rural areas and better allocate the staffing and availability of specialist physicians such as...more

2/20/2018 / Centers for Medicare & Medicaid Services (CMS) , Conditions of Participation (CoP) , Credentialing , Health Care Providers , Hospitals , Medicare , Telemedicine , The Joint Commission

Top 5 Ways Telehealth Will Change Under the New Federal Funding Bill

The telemedicine industry has been abuzz upon learning that provider-friendly legislation was included in the new federal Bipartisan Budget Act of 2018, signed into law by the President on February 9, 2018. But telehealth...more

2/16/2018 / ACOs , Bi-Partison Balanced Budget Act (BBA) , Centers for Medicare & Medicaid Services (CMS) , Department of Health and Human Services (HHS) , Health Care Providers , Health Information Technologies , Medical Reimbursement , Medicare , New Legislation , Physicians , Reimbursements , Telehealth , Telemedicine

Medicare’s New Remote Patient Monitoring Reimbursement: What Providers Need to Know

The new year continues to offer big opportunities for telemedicine and digital health companies, and one of the most notable developments is CMS’ decision to reimburse providers for remote patient monitoring (RPM). Effective...more

2/14/2018 / Centers for Medicare & Medicaid Services (CMS) , Health Care Providers , Medicare , Physician Medicare Reimbursements , Physicians , Reimbursements , Telehealth , Telemedicine

Medicare Payments for Telehealth Increased 28% in 2016: What You Should Know

Telehealth providers can celebrate another successful year of growth, as CMS reported a 28% increase over total 2016 payments for telehealth services under the Medicare program. Providers continue to successfully integrate...more

9/2/2017 / Centers for Medicare & Medicaid Services (CMS) , Health Care Providers , Medicare , Provider Payments , Telehealth , Telemedicine

CMS Proposes New Medicare Telehealth Coding Rules

The Centers for Medicare and Medicaid Services (CMS) issued its proposed Medicare Physician Fee Schedule (PFS) for CY 2017 on July 7, 2016. In it, CMS would require practitioners to use a new place of service (POS) code to...more

8/2/2016 / Centers for Medicare & Medicaid Services (CMS) , Medicare , MPFS , Physician Fee Schedule , Public Comment , Telehealth , Telemedicine

Hospital Text Messaging Rules Placed on Hold by Joint Commission

The Joint Commission, which accredits hospitals and other health care organizations, hit pause on its prior May 2016 announcement to allow secure text messaging in hospitals and other health care organizations. The use of...more

7/29/2016 / Centers for Medicare & Medicaid Services (CMS) , Conditions of Participation (CoP) , Data Security , Health Care Providers , Health Information Technologies , Health Insurance Portability and Accountability Act (HIPAA) , Hospitals , Physicians , Telehealth , Text Messages

The State of Telehealth - Policy and Reimbursement Q&A

Foley Partner Nathaniel Lacktman, head of the firm’s telemedicine and virtual care practice, participated in a comprehensive Q&A discussing the challenges and opportunities facing the telehealth market with Healthcare...more

7/11/2016 / Centers for Medicare & Medicaid Services (CMS) , Health Care Providers , Health Insurance , Hospitals , Medical License , Physicians , Reimbursements , Standard of Care , Telehealth , Telemedicine

Medicare Payments for Telehealth Increased 25% in 2015: What You Need to Know

More good news on the telehealth reimbursement front: CMS reported its total 2015 payments for telehealth services under the Medicare program and it was a 25% increase over last year. This reflects how providers are...more

3/4/2016 / Centers for Medicare & Medicaid Services (CMS) , Fee-for-Service , Health Care Providers , Medicare , Physician Medicare Reimbursements , Proposed Legislation , Telehealth , Telemedicine

Will New Hampshire Offer Medicaid Telehealth Coverage?

A lonely sentence at the end of New Hampshire’s new telemedicine law could mean the Granite State will join 48 other states in offering Medicaid FFS coverage of telehealth services. Interestingly, the very end of the Act...more

12/22/2015 / Centers for Medicare & Medicaid Services (CMS) , Fee-for-Service , Health Care Providers , Medicaid , New Legislation , Telehealth , Telemedicine

2016 Will Be the Year of Telemedicine and ACOs

If 2015 was the year that brought telemedicine directly to consumers, 2016 will be the year of telemedicine and Accountable Care Organizations (ACOs). ACOs are expected to increase the use of telemedicine technologies as a...more

12/16/2015 / ACOs , Alternative Payment Models (APM) , Centers for Medicare & Medicaid Services (CMS) , Medicare , Medicare Shared Savings Program , OIG , Telemedicine

Payers Embracing Telemedicine Cost Savings, Ramping Up Reimbursement in 2016

Often considered the primary obstacle to telemedicine implementation, reimbursement changes are now better viewed as one of the most prominent drivers of telemedicine expansion. Payers are finally beginning to realize what...more

11/24/2015 / Aetna , Anthem Insurance , Centers for Medicare & Medicaid Services (CMS) , CIGNA , Health Care Providers , Healthcare Costs , Humana , Reimbursements , Telemedicine , UnitedHealth

Five Telemedicine Trends Transforming Health Care in 2016

Telemedicine is a key component in the health care industry shift to value-based care as a way to generate additional revenue, cut costs and enhance patient satisfaction. One of the biggest changes to health care in the last...more

11/16/2015 / ACOs , American Telemedicine Association , Centers for Medicare & Medicaid Services (CMS) , Telemedicine , Value-Based Purchasing

Top Three Reasons ACOs Should Use Telehealth and Telemedicine

Accountable Care Organizations (ACOs) can share costs of telehealth and remote patient monitoring services among their hospitals, providers/suppliers, and other ACO participants, according to federal regulations under the...more

11/3/2015 / ACOs , Alternative Payment Models (APM) , Centers for Medicare & Medicaid Services (CMS) , Fee-for-Service , Fraud and Abuse , Health Care Providers , Health Information Technologies , Healthcare , Healthcare Reform , Hospitals , Medicare , Medicare Shared Savings Program , OIG , Suppliers , Telehealth , Telemedicine , Value-Based Purchasing , Waivers

Medicare Telehealth Services in Puerto Rico

As U.S. health care providers continue to use telehealth, telemedicine, and virtual care services to expand their services and geographic footprint overseas, they are beginning to ask whether or not Medicare will cover...more

9/14/2015 / Centers for Medicare & Medicaid Services (CMS) , Healthcare , Medicare , Medicare Advantage , Physicians , Puerto Rico , Telehealth , Telemedicine

Telehealth Commercial Coverage and Parity Laws: Trends, Challenges and Opportunities

There will always be differences among state laws on telehealth coverage, but what is remarkable is the rapidly increasing pace at which states have been adopting coverage statutes in the last few years, with currently 29...more

9/1/2015 / Amended Legislation , Centers for Medicare & Medicaid Services (CMS) , Commercial Insurance Policies , Health Care Providers , Health Information Technologies , Health Insurance , Health Plan Sponsors , Healthcare , Medicaid , Medical Devices , Medical Reimbursement , Medicare , New Legislation , Pending Legislation , Physicians , Reimbursements , Software Developers , Telehealth , Telemedicine

Nathaniel Lacktman

Foley & Lardner LLP

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