What you’ll get out of this episode

First, thank you for making Decoding Healthcare Innovation #2 on Apple’s list of Healthcare Business News Podcasts after just 5 episodes!

In this episode, host Rebecca Gwilt talks with one of the nation’s brightest innovation attorneys, Kaitlyn O’Connor, who leads the Remote Patient Monitoring Team at Nixon Gwilt Law. Kaitlyn is slightly famous among digital health clients for her ability to give them plain English business insights within 24 hours of CMS releasing the Medicare Physician Fee Schedule (MPFS) Proposed Rule every summer. 

Does she sleep? We’re not sure.

In this episode you’ll discover:

• What the MPFS is, and why this annual Proposed Rule is so important for digital health companies (plus a little history on CPT code 99091 and how it launched RPM reimbursement);
• Why the agency in charge of these reimbursement rules (CMS) doesn’t always get it right;
• How ‘Notice and Comment Rulemaking’ helps stakeholders influence regulations;
• What to do when Congress doesn’t get it right;
• Why you should pencil this time period into your calendar every year to examine the Proposed Rule to advocate on behalf of your company and industry.

Because we work with hundreds of digital health companies, we’re deep into this topic every day and know what an impact even minor changes can make to a company’s bottom line. So make sure you do your homework!

Quotables

“This totally accessible, high impact process for influencing public policy is a black box for innovators. I love shining light in black boxes” Ep6 of @DecodingHealth1 w/ @NixonGwiltLaw https://sliceofhealthcare.com/category/decoding-healthcare-innovation/ 

“CMS does not always get things right in this fee schedule” Ep6 @DecodingHealth1 @NixonGwiltLaw https://sliceofhealthcare.com/category/decoding-healthcare-innovation/ #mpfs2022  

“It’s hard for an agency that doesn’t have a lot of opportunity to experience how things are happening in real life to draft practical rules.” Ep6 of @DecodingHealth1 @NixonGwiltLaw https://sliceofhealthcare.com/category/decoding-healthcare-innovation/ 

Recommended Resources

• Need help drafting compelling stakeholder comments to CMS? NGL has a fixed-fee service for that—but you need to book before August 23. Click here for details
• Follow RPM expert Kaitlyn O’Connor on Linkedin 
• From the Nixon Gwilt Blog: Everything you need to know about the 2022 MPFS Proposed Rule
• Contact representatives and advocacy groups directly:
  • Senate HELP Committee
  • House Ways and Means, Subcommittee of Health
  • Alliance for Connected Care
  • American Telemedicine Association
  • Connected Health Initiative (The App Association)

Health Information and Management Systems Society (HIMSS)

Join the Conversation

Does your perspective match up with ours? Tell us how you think healthcare innovation ties into Nation