Telehealth: A Comprehensive Guide for Pharmacies with Arielle Miliambro

In this episode, our guest is Arielle Miliambro, a Partner specializing in regulatory and transactional law within the Healthcare & Life Sciences departments. She assists clients with legal issues related to telehealth, data privacy, value-based care, and fraud compliance. She offers counsel on regulations like the Anti-Kickback Statute and prepares requests for OIG Advisory Opinions.

Arielle also guides stakeholders in telehealth and digital health models on fraud, corporate practice, and virtual care requirements. Additionally, she advises clients on data security and privacy issues, including HIPAA compliance and data breach response. She works with providers to develop value-based care and alternative payment models.

Her expertise extends to pharmacy clients, whom she advises on remote prescription processing, compliance, and licensing board matters. She also assists practitioners with in-office dispensing and scope of practice concerns. Furthermore, Arielle supports clients with corporate transactional matters, drafting various legal agreements and documents.

Telehealth Topics for Podcast

1. What is the difference between telehealth and telepharmacy
2. Pharmacy role in bigger picture of telehealth models
   • Considerations for kickbacks/fee splitting in telehealth models depending on pharmacy’s reimbursement
   • Pharmacists duty to validate script prior to dispensing
     • Telehealth “red flags”
     • Where does the line get drawn as to pharmacist’s obligations with respect to the actual patient encounter between prescriber/patient
3. Covid changes
   • State
     • Licensing flexibility for prescribers
     • Scope of practice of pharmacists
   • Federal
     • Telehealth reimbursement
     • DEA prescribing
       1. History / status of new rules related to CDS prescribing

1. Telehealth vs Telepharmacy Differences
   • Brief overview distinguishing the definitions of each:
     • Telehealth: Remote provision of clinical care
     • Telepharmacy: Remote provision of pharmacy services (e.g., offsite pharmacist doing DUR, offering patient counseling)
2. Changes in Telehealth During Covid
   • Federal and State Waivers
     • DEA waivers (current through 2025)
     • Physician licensing waivers by state (expired)
     • Modality flexibilities (mostly expired; some extended/made permanent depending on payor)
3. Pharmacist Obligations in Validating Telehealth Prescriptions
   • Pharmacist obligations/duties
   • BOP audits/investigations originating from BME
4. Maintaining Out-of-State Licenses for Telehealth Patients
5. DEA Updates with Proposed/New Final Rules
   
   

Guest - Arielle Miliambro

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Host - Hillary Blackburn, PharmD, MBA

www.hillaryblackburn.com