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Trending in Telehealth: January 9 – 16, 2023

by Amanda Enyeart and Abby Higgins | Jan 19, 2023 |

Trending in Telehealth is a new weekly series from the McDermott Digital Health team where we track telehealth regulatory and legislative activity. Each week we will highlight developments that impact the healthcare providers, telehealth and digital health companies, pharmacists, and technology companies that deliver and facilitate the delivery of virtual care.

Trending This Week:

Provider Licensing
Telehealth Definitions
Tele-behavioral health

A Closer Look:

Finalized: 2

Illinois enacted emergency changes to the Telehealth Act and other statutes that expand the ability of certain out-of-state providers to provide reproductive care via telehealth in the state.
Massachusetts’ Department of Medical Assistance finalized rules that amend definitions for diagnostic, case consult and treatment services (beginning on page 139), and establish requirements for licensed independent clinical social workers (LICSWs) to enroll as MassHealth providers and use of telehealth by LICSWs (beginning on page 309).
Oregon adopted a rule that clarifies that acupuncturists can provide telemedicine services.

Proposed: 6

Alaska proposed a rule that would amend the educational requirements for a professional counselor license, requiring that at least three of the hours are in telehealth. This is added alongside the existing professional ethics requirements and new additions of cultural competencies and suicidality.
Florida proposed updates to disciplinary rules for those licensed under the Florida Board of Osteopathic Medicine. The new rules include penalties for failing to identify to patients the type of license under which the practitioner is practicing, expanding the state’s existing rules imposing penalties related to care being provided through telehealth.
Texas proposed three rules relating to behavior analysts’ use of telehealth, as a result of a four-year rule review conducted by the Texas Department of Licensing & Regulation. These proposed rules establish requirements for behavior analysts’ use of telehealth in delivering care and align definitions with telehealth regulations for other providers. The public comment period for all three rules ends on February 5, 2023.
Wyoming proposed a rule that would modify standards of practice for occupational therapy. This includes clarification surrounding the requirement for occupational therapists and occupational therapist assistants to hold a Wyoming license to provide services to a patient in Wyoming, including treatment delivered through telehealth technologies, at the time of services. The public comment period ends March 5, 2023.

Highlights for the Industry:

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APTA Pushes Digital Health Companies to Use “Physical Therapy” in Marketing Materials Only When the Care is Directed by Licensed Physical Therapists

by Purnima Boominathan and Lisa Mazur | Dec 22, 2022 | Advertising & Marketing, New Blog Guidance

On December 2, 2022, the American Physical Therapy Association (APTA) published a statement concerning a recent decision from UnitedHealthcare and its contractor, Kaia Health, to stop marketing Kaia Health’s services as “physical therapy” given that Kaia Health’s program does not consistently involve licensed physical therapists. As a result, digital health companies that market themselves as providing physical therapy should evaluate their marketing and customer communications to determine whether any revisions are required pursuant to the APTA’s guidance.

BACKGROUND
The APTA and APTA North Carolina sent a letter to UnitedHealthcare, along with a complaint filed with the North Carolina Board of Physical Therapy Examiners, identifying that the services provided through Kaia Health’s application were not overseen by a licensed physical therapist. UnitedHealthcare subsequently acknowledged that Kaia Health and United Healthcare’s benefits manager, Optum, utilized the phrase “physical therapy” in its marketing materials and that all materials would be revised to remove reference to physical therapy.

WHY IT MATTERS
The APTA has consistently held that physical therapy, either in person or digitally, must be “performed or directed only by licensed physical therapists.” The APTA has requested that physical therapy providers sign a pledge, which in part acknowledges that the “physical therapist examination, evaluation, diagnosis, development of a management plan, and intervention shall be represented and reimbursed as ‘physical therapy’ only when performed by a physical therapist or when selected interventions are performed by a physical therapist assistant under the direction and supervision of a physical therapist.” Several digital healthcare companies have signed onto the APTA’s pledge.

The complaint filed with the North Carolina Board of Physical Therapy Examiners, along with the APTA’s letter to UnitedHealthcare, are strong indicators that state boards of physical therapy and industry groups are reviewing the marketing and the scope of services offered by virtual physical therapy companies, as well as companies who partner with virtual physical therapy companies.

Businesses offering digital or virtual physical therapy or musculoskeletal services should review their service descriptions and marketing materials and assess whether any updating is required—a task our healthcare team can help with. For assistance or questions, please reach out to your regular McDermott lawyer or contact any of the authors of this article.

Final Episode | Markets Under Pressure Strategies for Restructuring and Risk Management

by McDermott Will & Emery | Aug 11, 2022 | Uncategorized

In this new video series, McDermott’s digital health team shares timely insights and strategies to help your organization stay ahead of the curve, addressing critical areas of workforce management, financing and the potential for restructuring.

Today’s market pressures increase the potential for broken financial covenants. In this episode, McDermott partners Dale Van Demark and Felicia Perlman discuss steps that digital health companies can take now to prepare for the possibility of restructuring and mitigate associated risks.

Explore the full series and their takeaways here.

Episode Two | Managing Capitalization Structures and Investor Relationships in Today’s Digital Health Market

by McDermott Will & Emery | Aug 11, 2022 | Uncategorized

In this new video series, McDermott’s digital health team shares timely insights and strategies to help your organization stay ahead of the curve, addressing critical areas of workforce management, financing and the potential for restructuring.

In episode two, McDermott partner and digital practice co-head Lisa Mazur joins fellow partner Brian Gordon to review important considerations for navigating today’s market realities.

Explore the full series and their takeaways here.

Episode One | Workforce Management Solutions in an Uncertain Economic Environment

by McDermott Will & Emery | Aug 11, 2022 | Uncategorized

In this new video series, McDermott’s digital health team shares timely insights and strategies to help your organization stay ahead of the curve, addressing critical areas of workforce management, financing and the potential for restructuring.

In episode one, Stephen Bernstein talks with McDermott partner Ellen Bronchetti about timely employment considerations for digital health companies.

Explore the full series and their takeaways here.

Navigating Volatile Markets in the Digital Health Ecosystem | Introduction – What to Consider

by McDermott Will & Emery | Aug 11, 2022 | Uncategorized

In this new video series, McDermott’s digital health team shares timely insights and strategies to help your organization stay ahead of the curve, addressing critical areas of workforce management, financing and the potential for restructuring.

Watch the introduction where Stephen Bernstein, Co-Head of the Digital Health Practice, kicks off the series discussing what companies should be considering as they navigate today’s complex digital health ecosystem.

Explore the full series and their takeaways here.

2021 Digital Health Year in Review

by McDermott Will & Emery | Feb 22, 2022 | Telehealth

The continuation of the COVID-19 public health emergency (PHE) and consumer demand for digitally delivered healthcare not only necessitated the shift from in-person to virtual care, but also continued to drive interest, adoption, investment and transactions in digital health in 2021. Digital health funding in 2021 far surpassed 2020’s totals, with no signs of slowing down in 2022, and the potential permanence of some regulatory flexibilities beyond the PHE are charting a course for continued digital health growth in 2022 and beyond.

Access the report.

Telemedicine Providers Take Note – The No Surprises Act Is Effective January 1, 2022

by Emily Jane Cook, Jamie Gelfman, Lisa Mazur and Drew Elizabeth McCormick | Dec 30, 2021 | Enforcement, Telehealth

On December 27, 2020, the No Surprises Act was signed into law as part of the Consolidated Appropriations Act, 2021. In July and October 2021, respectively, the Department of Health and Human Services, the Department of Labor, the Department of the Treasury and the Office of Personnel Management (the Departments) issued two Interim Final Rules implementing core aspects of the No Surprises Act, including (1) prohibiting non-participating providers from balance billing individuals who receive services in participating facilities unless prior notice and consent is provided and obtained (referred to as Part I);[1] and (2) requiring providers and facilities to provide good faith estimates (GFE) to uninsured (or self-pay) individuals of expected charges prior to their scheduled services (referred to as Part II, and together with Part I and the statute, the NSA).[2]

Effective as of January 1, 2022, to the extent that an out-of-network telemedicine provider furnishes services to a patient at an in-network facility, the disclosure notice requirements and balance billing prohibitions under Part I apply. Additionally, to the extent that a telemedicine provider furnishes services to an uninsured (or self-pay) patient, the transparency requirements under Part II, including the requirement to provide a GFE, may apply. Notably, the NSA provides for steep penalties, including imposition of civil monetary penalties of up to $10,000 per violation. Additional information regarding a telemedicine provider’s compliance obligations under the NSA are outlined below.

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Staying Connected: An Update on Medicare Reimbursement for Telehealth Services After the PHE

by Amanda Enyeart, Dawn R. Helak, Marshall E. Jackson, Jr., Lisa Mazur, Dale C. Van Demark, Mara McDermott and Lauren Knizner | Dec 21, 2021 | Telehealth

In hopes that the COVID-19 public health emergency (PHE) will soon end, Congress and the administration are evaluating the telehealth expansions and flexibilities put in place to respond to the PHE. As a result, the future for telehealth stakeholders remains uncertain. This article outlines various changes in Medicare telehealth reimbursement policy in effect during the PHE and identifies what actions would be required to make these changes permanent.

Since the implementation of the PHE, there has been a significant uptick in the provision of telehealth services by Medicare, other public payers and commercial payers. In response to this increased utilization and outreach by stakeholders, Congress has actively explored ways to make some, or all, of the PHE flexibilities permanent.

During the PHE, telehealth providers have been able to receive reimbursement for a greater variety of telehealth services, leverage more types of healthcare providers, and treat patients in more locations than ever before. Telehealth providers have been energized by these changes and are voicing resistance to the prospect of losing these new reimbursement opportunities post-PHE.

The pathways to making telehealth flexibilities permanent, however, are neither simple nor clear. Reimbursement for telehealth services is governed by complex statutory, regulatory and subregulatory requirements at the state and federal level. At the federal level, the PHE-driven changes have come via both federal legislation and regulatory modifications. This article describes what steps would be necessary to make federal telehealth reimbursement policy changes permanent as the healthcare system recovers and rebuilds from the COVID-19 pandemic.

CLICK HERE TO ACCESS THE FULL REPORT.

McDermott Partners Recognized As Digital Health Power Players

by McDermott Will & Emery | Aug 13, 2021 | Telehealth

Washington (August 11, 2021) – McDermott Will & Emery partners Jennifer Geetter and Vernessa Pollard have been recognized within an Insider profile on the “9 behind-the-scenes players who can make or break your digital-health startup.” The pair discussed advising young companies on the regulatory hurdles they have to clear before tackling the healthcare market.

As part of the Firm’s industry-leading health practice, Jennifer advises digital health companies on the development, delivery and implementation of innovative healthcare solutions. Vernessa leads medical device and technology companies through US Food and Drug Administration (FDA) regulations to bring products to market.

Vernessa explored with Insider how more tech companies are spreading into healthcare. These companies need assistance discussing the FDA’s newest regulations, including machine learning oversights or health-data privacy rules. If businesses are not knowledgeable about their regulatory requirements, it can make or break their investments.

“We have a number of what we’d consider to be nontraditionally FDA regulated entities, such as the large tech companies and even hospitals and healthcare providers, that are entering this space because they’re developing new tools or technology that may trigger FDA requirements,” Vernessa noted.

Jennifer explained that it’s not always clear if decade old FDA laws apply, so she advises her clients to prioritize building trust with patients through an emphasis of privacy and cybersecurity protection.

“There’s something about the intimacy of the standard doctor-patient relationship when you’re sitting across the room from your doctor that breeds trust,” Jennifer said. “When you’re in a digital healthcare system with distance, you don’t necessarily have that.”

McDermott Will & Emery is the nation’s leading health law firm. The Health Industry Advisory group is the only health practice to receive top national rankings from U.S. News – Best Lawyers “Best Law Firms,” Chambers USA, The Legal 500 US and Law360. The practice was also recognized by Chambers as “Health Team of the Year” in 2010, 2013, 2017 and 2019. McDermott has also held the top spot in PitchBook’s League Tables as the most active firm for healthcare private equity since 2017.

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