OF DIGITAL INTEREST

Trending in Telehealth: September 19 – 25, 2023

By Patrick Zanayed and Jayda Greco on Sep 28, 2023
Posted In Telehealth

Trending in Telehealth highlights state legislative and regulatory 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 in the past week:

Interstate Compacts
Medicaid Coverage
Telehealth Practice Standards
Telehealth Access

A CLOSER LOOK

Finalized Legislation and Rulemaking

New Hampshire enacted HB 409, which enacts the Social Worker Licensure Compact.
Louisiana adopted rulemaking regarding Medicaid coverage for physician-directed treatment-in-place ambulatory services. The rule allows such services to be provided via telehealth when the provider meets certain requirements, such as enrollment and notification to the Department of Health.
Alaska adopted rulemaking that provides eligibility requirements and defines the scope of services for delivering psychological care through electronic means while physically separate from the recipient. The regulations require applicants for a courtesy license to be licensed in another jurisdiction where the licensing requirements are at least equivalent to those in Alaska.

Legislation and Rulemaking Activity in Proposal Phase

Highlights:

As mentioned in last week’s update, California progressed two bills that are now awaiting the governor’s signature.
- AB 1478 was presented to the governor on September 20, 2023. The bill would require the State Department of Public Health to maintain, on its website, a database of referral networks for community-based mental health providers and support services addressing postpartum depression and prenatal care, and information on mental health providers and support groups that allow patient-driven care access, including telehealth and virtual care.
- AB 48 also was presented to the governor on September 20. The bill would require the State Department of Public Health, in consultation with interested stakeholders, to develop a standardized informed consent form which would then need to be available to skilled nursing facilities and intermediate facilities by December 31, 2025. Additionally, the bill would permit prescribers to use remote technology, including telehealth, to examine patients and obtain the above mentioned informed written consent.
Ohio proposed rulemaking specifying the requirements for delivery of services by speech-language pathologists and audiologists via telehealth, such as licensure and encryption requirements and guidelines for assessing whether telehealth is appropriate based on the patient’s condition.

Why it matters:

Increased activity in California continues. California continues to move forward with legislation to address access to healthcare services via telehealth. While they increase access, these bills are addressed to specific sites of care, such as nursing facilities, reflecting an openness to telehealth under specific circumstances.
States are focused on Medicaid reimbursement for telehealth services. This week, we saw Louisiana adopt rulemaking regarding Medicaid coverage for physician-directed treatment-in-place ambulatory services.
Telehealth practice standards remain a focus. Alaska and Ohio’s enacted and proposed rulemaking, respectively, continue the trend of states expanding on telehealth practice standards for non-physician licensees.

Telehealth is an important development in care delivery, but the regulatory patchwork is complicated. The McDermott digital health team [...]

Continue Reading

Trending in Telehealth: September 5 – 18, 2023

By Amanda Enyeart and Jayda Greco on Sep 22, 2023
Posted In Telehealth

Trending in the past week:

Medicaid Coverage
Broadband Access
Behavioral Health and Substance Use Disorder Treatment
Practice Standards Across Licensee Types

A CLOSER LOOK

Finalized Legislation and Rulemaking

California enacted AB 1241, which was presented for signature last week. As noted in our prior updates, the bill will loosen certain requirements related to the virtual delivery of care within the Medi-Cal program.
Maryland made effective a host of non-substantive rulemaking updates related to professional standards for telehealth across a variety of licensee types, including optometrists, massage therapists, social workers, dietitians, chiropractors, audiologists, speech language pathologists, hearing aid dispensers, music therapists, physical therapists, occupational therapists and professional counselors. The final rules provide clarity by removing language regarding the physical location of a practitioner or patient when providing telehealth and by removing ambiguous and other language to be consistent with telehealth regulations adopted by other health occupations boards.

Legislation and Rulemaking Activity in Proposal Phase

Highlights:

California progressed several bills to the engrossing and enrolling stage and to the governor for signature.
- AB 965 moved from the second committee to the governor for signature. The bill is an amendment to the Permit Streamlining Act that would require local agencies that process applications for the construction of broadband projects to simultaneously process multiple broadband permit applications for substantially similar projects under a single permit (so-called batch broadband permit processing), with the goal of ensuring a more efficient broadband approval process.
- AB 1369 also progressed from the second committee to the governor for signature. This legislation provides that a person licensed as a physician and surgeon in another state would be authorized to deliver healthcare via telehealth to a patient who, among other requirements, has a disease or condition in which there is a reasonable likelihood of death within a matter of months.
- AB 1478 was enrolled on September 14, 2023. The bill would require the State Department of Public Health to maintain, on its website, a database of referral networks of community-based mental health providers and support services addressing postpartum depression and prenatal care, information on mental health providers and support groups that allow patient-driven care access, including telehealth and virtual care.
- AB 912 was enrolled on September 16, 2023. The bill would authorize school-based health centers to provide primary medical care, behavioral health services or dental care services on site or through mobile health or telehealth.
- AB 48 was sent to engrossing and enrolling on September 13, 2023. The bill would add nursing [...]
  
  Continue Reading

Key Takeaways | What the Money Thinks: Investing in Innovative Care Delivery

By McDermott Will & Emery on Sep 19, 2023
Posted In Uncategorized

During this session, digital health investors and finance experts discussed the trends they are watching in today’s market. The group also shared ideas on how companies can stand out from their competitors in the bid for limited investor dollars, and the role of venture capital and venture capital-backed companies in solving today’s healthcare challenges.

Session panelists:

Bill Evans, Founder and General Partner, Rock Health
Anna Fagin, Principal, Town Hall Ventures
Adam Heller, Managing Director, Healthcare Investment Banking, Ziegler Healthcare Investment Banking
Fazeela Abdul Rashid, Partner, Revolution Growth
Moderator: Dale Van Demark, Partner, McDermott Will & Emery

Top takeaways included:

The COVID-19 pandemic accelerated the adoption of digital health, and while digital healthcare delivery is here to stay, some correction in the market is expected. While the healthcare system was moving towards digital health due to technological advances, the COVID-19 pandemic accelerated patients’ and providers’ wiliness to utilize technology. This increased utilization has provided tangible evidence that digital health solutions have real efficacy, clinical quality, and can help lower costs and bring better, more efficient outcomes. At the same time, the COVID-19 pandemic distorted the market, as providers had no choice but to supply care virtually, and there was abundant capital for startups. As the pandemic unwinds and the market tightens, the panelists expect to see correction in the market.
In this constrained capital market, successful digital health companies are those that can demonstrate they are self-sustaining, able to be a long-term solution and can add value. Investment funds have been funneled towards operating and managing portfolio companies, with fewer new investments as a result. With this in mind, new entrepreneurs in the digital health ecosystem need to demonstrate that they can make a core, clear difference, adding true efficiency to the healthcare system and demonstrating where their value resides.
Digital health tools can address inequities in the health care system—but not every solution addressing inequity is venture-backable. There is a tremendous opportunity for digital health tools to address inequity if founders and investors are willing to ask hard questions and commit to addressing inequity as part of their goals. Returns can be equipped by mission, rather than acting in conflict with the mission. However, not every business that can affect outcomes is designed for scale and is venture-backable. The panelists agreed that it is okay that not everything is venture-backable—there are many ways to fund a business and many issues in the healthcare system that require different stakeholders.
For ventures that are looking for capital right now, focus on finding the right partners and demonstrating value. The panelists recognized that it is a difficult time for ventures that are looking for funding, but urged companies not to give up if they have something unique and visionary. Even in this market, the panelists agreed that finding the right partner is key—the relationship must work in both directions and align with the venture’s vision. The panelists also advised that successful ventures that will be those that can achieve early, [...]

Continue Reading

Key Takeaways | Hospital and Health System Digital Health Spotlight: It’s all About the Patient!

By McDermott Will & Emery on Sep 14, 2023
Posted In Uncategorized

During this session, leaders from health systems and digital health technology companies explored how they are leveraging their prowess to develop cutting-edge strategies to deliver accessible, easy to use and secure digital health solutions that work together seamlessly across the healthcare ecosystem and patient journey.

Session panelists:

Erica Davila, general counsel, Transcarent
Daniel Gottlieb, partner, McDermott Will & Emery
Nathan Leong, vice president, legal, Memora Health
Sudipto Srivastava, vice president, digital transformation, Hospital for Special Surgery
Paul Uhrig, senior vice president, chief legal officer and digital health officer, Basset Healthcare Network
Moderator: Bernadette Broccolo, partner, McDermott Will & Emery

Top takeaways included:

The patient relationship is the cornerstone of any patient engagement strategy. Most, if not all, of the panelists agreed with this statement, yet they also recognize that the consumer and patient engagement solutions flooding the digital health ecosystem have cast doubt as to where the primary patient relationship should reside. For health systems, there is no doubt—they are and must remain a central, trusted partner for delivery and coordination of care across a patient’s healthcare journey. In their quest to do so, health systems are aggressively pursuing strategies that combine digital and in person touchpoints to engage individuals, both as consumers and as patients, “where they are” so they can get them to the right healthcare, at the right place and at the right time. While many digital health technology solution companies pursued “direct-to-patient” offerings early on, some quickly recognized the complexities of that model and shifted their primary focus to becoming an “extension” of health systems and payors by providing the turnkey technology infrastructure and support services they need to remain the “front door” for healthcare for patients and consumers.
Patients, providers and self-funded health plans want a seamless, integrated and holistic digital engagement experience. Digital engagement solutions and the data strategies supporting them have been highly fragmented and lacking integration across the patient journey and healthcare ecosystem. This is due largely to their multiple points of entry into disconnected “point-to-point solutions,” which is particularly challenging for poly-chronic patients. Providers and their patients, and self funded health plans and their members, are frustrated and clamoring for single sign on platforms through which they can engage seamlessly, in a single encounter, with digital health applications and data sources. Health systems, in particular, are looking to “fill the white space” in functionality existing between inflexible electronic health record (EHR) systems that rely exclusively on traditional patient identifiers and less formal point to point digital health solutions. Individual providers want solutions that will alleviate the burden and stress of today’s technology tools. And everyone wants an approach that brings a holistic rather than an episodic experience.
It will “take a village” to achieve seamless, integrated and holistic digital health engagement. No single stakeholder in the digital health ecosystem has the solution for overcoming the frustrating fragmentation of digital health engagement solutions. There certainly is no “one-size-fits-all” approach. Health systems, payors and digital health turnkey solution providers are [...]

Continue Reading

Trending in Telehealth: August 29 – September 5, 2023

By Dale C. Van Demark and Jayda Greco on Sep 8, 2023
Posted In Telehealth

Trending in the past week:

Medicaid Reimbursement of Behavioral Health Services
Practice Standards for Counselors and Therapists
Technology and EHR access

A CLOSER LOOK

Finalized Legislation and Rulemaking

West Virginia enacted emergency rulemaking, effective October 12, 2023, that establishes the scope of practice for the provision of counseling services via telehealth technologies and the process for licensed professional counselors or licensed marriage and family therapists to obtain an interstate telehealth registration with the West Virginia Board of Examiners in Counseling. This rule ensures continuity of care while existing patients are either transitioning to become a resident of another jurisdiction or temporarily located in another jurisdiction.
Washington, DC, adopted an emergency rule, effective September 1, 2023, that reimburses the use of audiovisual telehealth visits in the Assertive Community Treatment (ACT) program within DC Medicaid.
Mississippi finalized rulemaking, effective October 1, 2023, regarding Medicaid coverage for continuous glucose monitoring services via telemedicine.
Oklahoma finalized rulemaking, effective September 11, 2023, that allows for onsite and mobile crisis intervention services to be provided in person or via telehealth.

Legislation and Rulemaking Activity in Proposal Phase

Highlights:

California’s state legislature presented AB 1241 to the governor on August 30, 2023. If signed, the bill will loosen certain requirements related to the virtual delivery of care within the Medi-Cal program. Existing law requires providers that furnish services through video synchronous interaction or audio-only synchronous interaction to also either offer those services in person or arrange for a referral to, and a facilitation of, in-person care. That requirement will go into effect by a date set by the State Department of Health Care Services, but no sooner than January 1, 2024. Under AB 1241, providers will instead be required, in the above-described circumstance, to maintain protocols for patient referral to appropriate in-person care when the standard of care cannot be met by video synchronous interaction or audio-only synchronous interaction.
California’s state legislature progressed AB 965.The bill is an amendment to the Permit Streamlining Act that would require local agencies that process applications for the construction of broadband projects to simultaneously process multiple broadband permit applications for substantially similar projects under a single permit (so-called “batch broadband permit processing”), with the goal of a more efficient broadband approval process.
California also progressed AB 1369 to the Second Committee. This legislation provides that a person licensed as a physician and surgeon in another state would be authorized to deliver healthcare via telehealth to a patient who, among other requirements, has a disease or condition in which there is a reasonable likelihood of death within a matter of months.
Alaska proposed rulemaking to [...]

Continue Reading