Transformation

Panel Presentation

(T8-01) Negotiating & Advocating for Commercial Health Plan Payment Without a Coverage Law

Monday, April 24
2:45 PM - 3:45 PM
Location: W331 A

n connection with the Business & Finance SIG efforts, this panel presentation addresses the real world of how to negotiate telehealth coverage with commercial health plans when the provider's state lacks a telehealth coverage law. The panelists, each of whom has "in-the-trenches" experience with such negotiations and research across many states, will discuss how providers can approach health plans for coverage and reimbursement. The topic will be specifically tailored to address strategies for states with: 1) no telehealth coverage statute; or 2) weak telehealth coverage statutes and/or no payment parity law. Panelists will also include examples of actual health plan telehealth coverage policies, working through them as case studies. The session will also devote a portion of time to share ideas on how providers can advocate in their home state for passage of meaningful telehealth commercial coverage statutes, and "lock arms" in the interest of promoting true coverage and payment parity across the board. The session will conclude with an interactive Q&A discussion among panelists and attendees, led by the moderator. Note: this session is NOT a rehash/overview of the landscape of coverage/reimbursement rules. Rather, it is focused exclusively on commercial health plan coverage, and what providers can do to approach plans on a contract-by-contract basis, while simultaneously advocating for better laws in their state. This pressing issue is a hot topic that has not been covered in detail at prior ATA Annual Meetings, so attendees should find this new content compelling and engaging. Although many ATA attendees will appreciate the topic, this is an advanced session where the presenters will jump right into the thick of it.

Learning Objectives:

Nathaniel Lacktman

Partner, Head of Telemedicine and Virtual Care Practice
Foley & Lardner LLP

Nathaniel Lacktman is a healthcare lawyer and partner at Foley & Lardner. He is the Chair of the firm’s Telemedicine Industry Team and co-chair of the firm’s Digital Health Work Group. He advises health care providers and technology companies on business arrangements, compliance, and corporate matters, with particular attention to telehealth, digital health, and health innovation. His approach to practicing law emphasizes strategic counseling, creative business modeling, and fresh approaches to realize clients' ambitious and innovative goals. He serves on the Executive Committee of the American Telemedicine Association's Business & Finance SIG, Chairs the Telemedicine and eHealth Affinity Group of the American Health Lawyers Association, and is Chief Legal Counsel to the Telehealth Association of Florida. He speaks and writes frequently on issues at the forefront of telehealth and has provided comments and policy rulemaking input on telemedicine to lawmakers and state boards of medicine across several states. He is listed in 2013 - 2016 Chambers USA: America's Leading Business Lawyers, which notes his expertise in telehealth. Follow his telehealth law feed on Twitter @Lacktman.

Presentation(s):

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Kofi Jones

Vice President of Government Affairs
American Well

Kofi Jones is the Vice President of Government Affairs and Telehealth Evangelist for American Well - a national mobile and web based telehealth solution provider based in Boston. Jones focuses most of her efforts on collaborating with federal, state, and congressional leaders to ensure the proliferation of modernized and safe telehealth policies. Prior to joining American Well, Kofi spent 4.5 years working for the Deval Patrick Administration - first as a Public Affairs Director and spokeswoman for the Governor's Economic Development Secretary, and then as the Executive Director of the Commonwealth Marketing Office. She has also spent over 15 years as a communications and media expert, including
a decade in television news as a producer, reporter, and anchor.

Presentation(s):

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Lauren Lashbrook

Business Development Manager
Mend

Lauren Lashbrook is the Business Development Manager for Mend. Mend is a web-based platform that offers a simple telemedicine solution to the market. Mend enables practices to treat their patients through telemedicine. Mend is dedicated to delivering more than a software solution for their clients, Lauren's work with Mend involves partnering with providers to help them develop a successful telemedicine program-guiding them every step of the way including navigating the constantly evolving legislation and reimbursement landscape for telemedicine. She has extensive experience in discussing coverage rules directly with commercial health plans in states across the country, including directly negotiating telehealth coverage for providers.

Presentation(s):

Send Email for Lauren Lashbrook


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