8 Updates + Revenue Model Resources for Digital Health Innovators

Revenue Models! If you’re a digital health innovator, you’ve got to understand how revenue models work. And who better to walk you through it than a law firm that does this work every single day with hundreds of digital health clients?

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Now, on to the updates.

ALASKA

Expands Allowable Use of Telehealth Services?

TLDR: An Alaska house bill recently amended the state’s telehealth laws. Health care providers licensed in Alaska may offer telehealth services without first conducting in-person visits. Under specific conditions, the law permits out-of-state providers to provide services to patients in Alaska. These conditions include visits regarding suspected life-threatening diseases or follow-up care relating to a patient’s previous health service with the out-of-state provider. If the out-of-state provider is offering follow-up care, there must be (i) an established patient-provider relationship, and (ii) the out-of-state provider must have previously conducted an in-person visit with the patient. If the out-of-state provider is offering telehealth services for a suspected life-threatening disease, the patient must (i) be referred to the out-of-state provider by a provider licensed in Alaska, and (ii) the service must involve a discussion with the patient about the diagnossis, treatment options, or analysis of tests results for the life-threatening disease. The out-of-state provider must document the referral. The amendment imposes disciplinary sanctions on unauthorized out-of-state telehealth providers practicing in Alaska. Telehealth services in Alaska are reimbursable under Medicaid in the same manner as in-person services.?

Key Takeaways:

• Health care providers licensed in Alaska may offer telehealth services without first conducting in-person visits.?
• Out-of-state providers must follow specific conditions to practice telehealth services in the State.?
• Unauthorized out-of-state practice of telehealth in Alaska may be subject to disciplinary sanction.?
• In Alaska, telehealth is reimbursable under Medicaid in the same manner as in-person services.?
• Check out full revisions here .?

ARKANSAS

Allows Telehealth and Telemedicine for Veterinary Care

TLDR: Arkansas’s Veterinary Medical Examining Board enacted a veterinary telehealth and telemedicine rule that allows veterinarians to use online platforms to administer veterinary care services. The law requires that any person delivering telemedicine services to a patient located in Arkansas must (i) be licensed to practice veterinary medicine in the State and (ii) must establish a veterinarian-client-patient-relationship (VCPR). Generally, a veterinarian may only establish VCPR? through in-person examinations of the animal or through medically appropriate and timely visits to the location where the animal is kept. However, if the veterinarian is providing tele-triage (emergency animal care) services and the patient is referred to an in-person service according to established protocols. The law does not require an in-person examination to establish the VCPR. Veterinarians must provide identifying information and financial responsibility details to the client before the virtual encounter and must collect a medical history to determine whether it is appropriate to provide services via telehealth.?

Key Takeaways:

• Veterinarians must have an Arkansas license to provide telemedicine to patients in Arkansas.
• In-person examinations are generally required to establish a VCPR, except where the veterinarian performs tele-triage (emergency animal care).
• The law requires that the veterinarian provide and collect specific information before providing telemedicine services.
• There are limited exceptions to the in-person requirement for establishing a VCPR.
• Check out full revisions here .?

CALIFORNIA?

Updates Psychologist Applicant Supervision to Include Telehealth

TLDR: California amended the California Business and Professional Code to allow supervision of psychology licensure applicants and registered psychological associates via telehealth. The amendment requires compliance with state and federal laws relating to patient health confidentiality while delivering online services.?

Key Takeaways:

• Licensed psychologists may supervise California psychologist licensure applicants and registered psychologist associates using synchronous telehealth.?
• Check out full revisions here .?

COLORADO

Revises Requirements Relating to Telepharmacy Outlets

TLDR: Colorado revised location and administrative requirements for telepharmacy outlets, also known as remote pharmacy sites or prescription drug outlets. The revisions removed the previous restriction on operating telepharmacy outlets within a 20-mile radius of the nearest pharmacy and, instead, now require telepharmacy outlets to be located in an “area of need.” Areas of need can be any licensed or certified health care facility or any location that the Colorado Board of Pharmacy approves as having a need for care. Telepharmacy outlets must follow all requirements for applications; structure and equipment; staffing and training; pharmacy manager visitation; inventory record-keeping and storage; policy and procedure establishments; and the number of telepharmacy outlets operated by a central pharmacy. In addition, telepharmacy outlets must remain under the direct charge and control of the pharmacist manager or licensed pharmacist delegate, who may provide remote supervision.?

Key Takeaways:

• Telepharmacy outlets must be located within an “area of need”.
• Telepharmacy outlets must follow all administrative and clinical requirements enforced by the Colorado Board of Pharmacy.?
• Telepharmacy outlets must remain under the pharmacist manager's or licensed pharmacist delegate’s direct charge and control.?
• Check out full revisions here .?

NEW YORK

Extends Emergency Rule to Allow Telehealth Services under Medicaid

TLDR: The New York Department of Health extended an existing public health emergency rule through November 13, 2022. Under the rule extension, Medicaid will continue to reimburse providers for telehealth services delivered to beneficiaries so long as the telehealth services are appropriate to meet the patient’s health care needs and the services are consistent with the provider’s scope of practice. Audio-only technologies and telephone communications are also permissible under this emergency rule extension.?

Key Takeaways:

• New York public health emergency rule will remain effective till November 13, 2022.?
• Medicaid will continue to reimburse for telehealth, including through the use of audio-only technologies and telephone communications.
• Check out full revisions here .?

OHIO

Updates Occupational Therapy and Physical Therapy Telehealth Provisions

TLDR: Ohio amended telehealth provisions in the Ohio Administrative Code to clarify that both in-person and telehealth therapy services must meet the same standard of care requirements. License holders may use synchronous or asynchronous technology during initial patient meetings so long as the appropriate standard of care requirements are satisfied. License holders must verify the identity and physical location of the patient at the beginning of each telehealth visit. To provide physical therapy services to patients located in Ohio, physical therapists and physical therapy assistants must either be licensed in Ohio or have been granted certain privileges to practice in Ohio through a physical therapy compact. A license holder must comply with all state and federal law requirements regarding the protection of patient information. A license holder must ensure that any username or password information and any electronic communications between the professional and a patient are securely transmitted and stored.

Key Takeaways:

• Ohio requires the same standard of care for in-person and telehealth services.?
• License holders may use synchronous or asynchronous technology during initial patient meetings.??
• Patient location and identity must be verified at the beginning of each telehealth visit.?
• Ohio licensure is required to provide physical therapy services to patients in Ohio.?
• Physical therapy compacts may enable out-of-state physical therapy licensees to practice in Ohio.
• License holders must comply with all state and federal requirements regarding protecting patient information.
• Check out full revisions here .?

OKLAHOMA

Revises Provisions for General Provider Policies Under Medicaid and Home Health

TLDR: The Oklahoma Health Care Authority Board revised several general provider policy provisions in efforts to expand Medicaid eligibility and promote compliance with the federal Home Health final rule. Amongst some of the revisions, the recently added term “face-to-face encounter” is defined as a patient visit in which a practitioner completes a face-to-face assessment related to the primary reason the beneficiary requires durable medical equipment (DME). Importantly, face-to-face encounters may take place via telehealth. The face-to-face encounter must occur no more than six months before the start of services. The ordering physician must document the face-to-face encounter, including the practitioner who conducted the encounter and the date of the encounter.? Furthermore, the revisions strictly enforce documentation requirements for various types of DME, such as positive airway pressure devices, sleep study devices, and continuous glucose monitoring. These documentation requirements include, but are not limited to, stating clinical findings and demonstrating a medical need for patient care services in the medical records. Medicaid and Home Health providers should review these revisions to ensure compliance with this rule.

Key Takeaways:

• Face-to-face encounters are defined and included in the policy revisions.
• The face-to-face encounter must occur no more than six months before services start.
• Face-to-face encounters may take place via telehealth.?
• Documentation requirements must be carefully maintained to remain eligible for reimbursements.?
• Check out full revisions here .?

WASHINGTON

Expands Home Health and Hospice Supervision Provisions to Include Telemedicine?

TLDR: The Washington Administrative Code extended the effective date of its 2021 emergency rule allowing Home Health and hospice care to be supervised via telemedicine. The extension permits home health and hospice agencies to continue providing supervisoin services through on-site visits or telemedicine. Additionally, providers may continue to use interactive audio and video technology as an alternative to face-to-face visits as long as providers? comply with HIPAA regulations.?

Key Takeaways:

• Home Health and hospice agencies may perform supervision either on-site or via telehealth.?
• Check out full revisions here .?

And that brings another issue to a close.

As always, know that if you’re a client of Nixon Gwilt Law, then we’re keeping tabs on all of these law and policy changes for you.

You don’t have to worry about tracking all these updates on your own or making key business decisions without fully understanding the evolving landscape.

(And with 50 states and multiple federal agencies, something is always changing).

If you’re not yet a Nixon Gwilt Law client, you can explore how we help businesses like yours innovate by clicking here .

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