#6: One Way Digital Health Companies Can Influence National Healthcare—without Expensive Lobbyists or PR Firms

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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

Health Information and Management Systems Society (HIMSS)

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Carrie Rebecca

About Your Hosts

Carrie Nixon and Rebecca Gwilt are partners at Nixon Gwilt Law, a healthcare innovation law firm exclusively serving Providers, Digital Health Companies, and Life Science Businesses seeking to transform the way we receive and experience healthcare. Find out more at NixonGwiltLaw.com.

This podcast is produced by Slice of Healthcare LLC.

14 episodes