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TRANSCRIPT

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Clara Salvai:

Hello, good afternoon. Welcome to our telemedicine webinar. We are so thrilled that you are joining us today. My name is Clara Salvai, I’m the chief operating officer of Cohen Healthcare Law Group. And I’m here today with two of my attorneys, Mr. Matthew Stokke and Mr. Chris Esseltine.

We have crafted this webinar around a lot of questions, and we know that you are thrilled to get to know more about your telemedicine ventures, for many of you who are trying to start in this business, for some of you who are already into this business, and for the ones who are thinking about this. We pride ourselves into giving great legal advice and accompany many of our clients through their journey.

So please let me introduce you to my attorneys, Matthew Stokke and Chris Esseltine. And let’s give a start to this webinar. I hope you enjoy it as much as we enjoy putting it together. Thank you.

Chris, Matt, do you want to tell a little bit about yourselves and your careers before we start this webinar, please?

Matthew Stokke:

Sure. Thank you, Clara, for the introduction. My name is Matt Stokke. I am an associate here at Cohen Healthcare Law Group. Been practicing in the Orange County area here in California, in healthcare law, for almost 10 years now. So I look forward to hopefully giving you some useful information today and help direct your practices appropriately.

Clara Salvai:

Chris?

Chris Esseltine:

Thanks Clara. My name is Chris Esseltine. I’m a 16 year healthcare attorney, with an additional specialty in FDA and FTC law. I have represented the 36 largest pharmaceutical companies in the world, as well as large hospital chains and other healthcare entities, but also startup companies, small companies, individual practices. I’ve touched perhaps every aspect of healthcare law that there is.

So I’ve been with Cohen Healthcare Law for just a short time, but it’s a home to me now and a perfect fit. So happy to be here with you and happy to help guide you on this journey of discovering the various laws and regulations involved in telemedicine.

Clara Salvai:

Thank you, Chris. And thank you both, truly.

Clara Salvai:

So we have created this webinar to go over five or four of the main questions. And we designed this to try to convey a lot of advice into the main questions that we have received. After we go over this you’re going to have a brief opportunity to submit your own questions live, and we are going to select some of them in hopes to shed some light into the things that you want to know.

And of course, because time is a constraint, we may not be able to go over all your questions. But you are always welcome to contact our firm and get in touch with us. We are looking forward to help you in your particular matters and questions and establish, hopefully, a friendship.

So please let’s give a start to the questions. And the first question is: if I see a patient via telemedicine, do I have to see them in-person first, does this regulation differ from state to state? Chris?

Chris Esseltine:

Thanks, Clara. So the problem we have with telemedicine is each state governs its own telemedicine laws. Some states even call it telehealth officially, instead of telemedicine, but we’re talking about the same thing.

The purpose of telemedicine is to be able to see a patient remotely, and not in person, to facilitate their needs and keep costs down and a number of other beneficial things. So while there are some broad sweeping laws and trends and requirements, each state has its own requirements for various things.

The answer to this is generally no. The purpose of telemedicine is to be able to facilitate that visit without seeing a patient in person. And this is true in every state, there has to be, established, a provider-patient relationship. Just like if you go into somebody’s office, you would establish that relationship with the doctor, the nurse practitioner, whoever. And that’s essential for any proper relationship when you’re seeking healthcare. But in most cases, and in most states, the patient doesn’t have to establish that relationship by seeing someone in person first. And then, from then on, they can do a telemedicine visit.

There are exceptions to this. There are a few states that require in-person first. There are some states that require in-person only for certain visits or for certain purposes, for example prescribing any kind of medical cannabis or certain controlled substances like opioids and so forth. The state does require the patient to go in and see … if it’s not the telemedicine provider, at least a provider, and establish that relationship and establish the prescription or whatever it is.

And then from there, the telemedicine visit can occur, and, for example, these prescriptions of controlled substances can be renewed just through telemedicine. But the problem here is that we have 50 different states, plus the district of Columbia, with many different regulations. So, overall, there’s the general advice. But please keep in mind, every state differs about how a patient-provider relationship has to be established.

Clara Salvai:

Perfect. Matt, is there anything that you will want to add?

Matthew Stokke:

Yeah. And Chris is right. I would just add, we get a lot of questions from our clients, especially right now, during this public health emergency that we’re experiencing. And Chris was referring, in terms of the need to see a patient in-person when there are controlled substances involved. He was referring to the federal Ryan Haight Act, which some of you may have heard of.

So, we get a lot of questions right now. There’s been an explosion of practices that have converted to telehealth practices. So we get a lot of questions about if there is a relaxation of those federal requirements. During the public health emergency that is one of the exceptions, when the in-person exam isn’t necessarily required, subject to some very specific conditions.

So I just wanted to add that because that tends to be a big hot button question, especially right now. And all the attorneys out there are waiting to see what the federal government decides to do when they lift the public health emergency exception. And because telehealth has gotten so popular during the pandemic, what they’re going to do about it in the future, if they’re going to still continue to enforce these kinds of requirements and prohibitions going forward.

Clara Salvai:

That’s an interesting question that we are getting from a lot of clients lately. So it’s worth, definitely, that you mentioned. Thank you for sharing that.

So the next question is: what constitutes a good faith examination? Matt?

Matthew Stokke:

Thank you, Clara. Yes. And like Chris was saying, it’s kind of a patchwork of laws and regulations and interpretations about what exactly is a good faith exam. You’ve probably heard of some other terms out there as well, the initial exam, patient examination.

I’ll speak primarily here from the California perspective. When we talk about good faith examinations, we tend to do that mostly in the context of medical spas. And of course, what is required in these initial exams or good faith exams will differ depending on the type of treatment that is provided to the patient.

So, I can say, generally, that the good faith exam will normally consist of two parts: obtaining a patient’s medical history and performing an appropriate physical examination of the patient if needed. The medical history will touch on their general lifestyle, ongoing treatments they’re undergoing currently, and any allergies, things like that, especially if there’s going to be administration of any drugs or prescription drugs. The basic elements of those good faith exams will contain those two elements.

Of course, as I said, it will differ just depending on the local standard of care. I think that’s the magic word in all of this, is standard of care. What will other physicians in the local community, what kind of questions will they ask? And depending on the answer to one of those questions, what does the standard of care require them to do? Are they adhering to that standard of care?

And luckily there are some cases out there, publicly. And this is true with the California medical board, most likely with other medical boards in other states, where you can see exactly what the board took issue with. And there’s a lot of … well, there’s one in particular in the last few years, having to do with whether that patient exam was sufficient. They determined it wasn’t. So it’s going to be a very fact intensive kind of analysis there.

I don’t know if Chris has anything to add to this?

Clara Salvai:

By all means, Chris?

Chris Esseltine:

Yeah, no, Matt’s right. It’s an issue of standard of care. I mean, obviously, if you see a patient via telemedicine, it’s just over the phone and you ask a simple question because they have a simple issue. But if they’re having heart palpitations or something more serious, there’s only so much you can do over the phone, even sometimes there’s only so much you can do by video.

It’s not so much a legal standard as it is a medical standard. Each provider has gone through training, education, licensing, and should know what is required for a proper examination in a given circumstance. So something more serious, you may need to see the person one-on-one or refer them to an emergency room. Something simpler, it would be easy to do it by phone.

For example, I had a client who had a patient that called and said, “I think I have strep throat.” “I can’t really determine that,” the doctor said, “Just by the phone. Can we jump on a Zoom call and I can see by video?” And she shone a flashlight in her throat, and the doctor looked and said, “Yep, that’s strep.” And in that doctor’s opinion, to perform a good faith examination he needed to see some video about what was going on in the throat.

So it really is the independent medical judgment of the provider, based on his or her training and licensing and understanding of what would be standard of care.

Clara Salvai:

Perfect. That is super helpful, I believe.

So let’s go to the next question. The next question is: what constitutes a valid telemedicine visit? Do emails or phone calls count? And it’s very related to the previous one, right?

So Chris, do you want to take over this one?

Chris Esseltine:

Yes. Sure. So, each state, once again, has its own standards and regulations about what a valid telemedicine visit is. Most states will allow phone calls as well as video, either/or. There are some states that do not. Hawaii, for example, they don’t consider a valid telemedicine visit by phone or audio alone, they require video. So, there are a few, not many, but a few states that require more than a phone call.

There are four basic types of telemedicine visits. There’s audio only. There’s video … and obviously audio comes with the video … There’s something called a store and forward, in other words information is taken, either a patient history or a questionnaire or something, and then sent to the provider. Not in real time, but the provider opens up that particular file, looks at it, makes a recommendation, maybe calls in a prescription or maybe calls the patient back and says, “Okay, I need a little more information.” And then there is remote patient monitoring. So that’s just a technology whereby the patient can strap on some kind of device monitor, a heart monitor, or some other bodily function, and the provider can look at the reading in real time or review that test later on.

So those are the four types of telemedicine visits. And each state has its own laws about what is permissible, what is considered a valid telemedicine visit. Some only allow video and audio. Some allow only video. Some allow store and forward and audio, but they don’t allow remote patient monitoring. So, you really have to consult one of us to look into that particular state’s telemedicine laws to see what is and is not a valid telemedicine visit.

As well, be aware that the states may have laws saying that this is a valid telemedicine visit, but then insurers, like Medicare for example, have very specific requirements about what is a valid telemedicine visit or what kind of telemedicine visit they will pay for and not pay for. So, it really is an issue of trying to figure out which state you’re talking about and what the particular requirements … not only for state law, but for the payers. And that makes it a little more difficult, but that, unfortunately, is the lay of the land when it comes to telemedicine law and what constitutes a valid visit.

Clara Salvai:

Thank you, Chris.

Matt, is there anything that you want to add?

Matthew Stokke:

No, I think that’s a great point, Chris, that when there’s insurance involved you have to be aware of the billing manuals that that insurer … the current ones that they’re using. So back to the good faith exam, and Clara already said it, it is related, there are specific requirements. And I’m not a billing expert, but for an initial exam you need to be sure you’re meeting specific requirements as set forth in that insurance company’s billing manual. So, you may be complying with state law, or vice versa, but may not be complying with the insurer’s policies there. So, I think that’s a great point.

And the last thing I would add is that, just as a general rule of thumb, I think … and it goes back to standard of care, again … you want to try to replicate, as closely as possible, what you’d be doing in an in-person visit. In-person doesn’t necessarily mean that it adheres to the standard of care. But that’s the general rule of thumb, that if you’re in a medical spa for example, a practitioner there, and you don’t see the patient’s skin for example, whether a photo or a video, or it’s a very low resolution photo or video, then that’s to your professional discretion, that maybe you should see a higher resolution or actually see them in-person in that scenario. So very fact intensive, again.

Clara Salvai:

Thank you. Yeah. It feels like healthcare is always very fact intense. That’s what we do for a living. And that’s why all of you should always consult with an attorney.

Let’s go to the next question. And the next question is: can someone other than a physician conduct a telehealth visit? Matt?

Matthew Stokke:

Yeah, that’s a good question. And we sound like a broken record at this point, but it will have to do with the state law, the particular law. In California, for those of you are here, healthcare provider in the context of telehealth is defined, under the code here, to mean anyone who is licensed under the division where a physician is licensed. So that would include a nurse, other types of allied health professionals, marriage and family therapists, behavioral health. So, it is fairly broad here, in California.

Now, there could be some individual rules under each of those different boards for the health profession that will apply to that particular type of licensee. But again, it’s going to have to do with the patchwork of state laws out there. A thing to always remember is that, in the example of the nurse, here in California, there still is that physician supervision and oversight that is required. So even though they are allowed to see patients via telehealth, that supervision requirement is still there, just like it is in an in-person context. So, you always want to be aware of that. It doesn’t change the scope of any licensee’s practice.

Clara Salvai:

Perfect. Chris, is there anything that you may want to add to this question?

Chris Esseltine:

No, Matt hit it right on the head.

Clara Salvai:

Perfect.

Matthew Stokke:

Thank you, Chris.

Clara Salvai:

So we have created, actually, a little … let’s call it checklist, that opens up for some information that you guys in the other side of the screen also were interested in getting. So, guys, do you mind walking us through this?

Matthew Stokke:

Sure. This is a good starting point for analyzing and for spotting different potential issues that you’ll need to be aware of in your telehealth practice. And we’ve spoken about, here, the basic requirements. The first one, of course, being establishing the clinician-patient relationship. And that’s going to be related to each state’s laws and regulations about how to conduct a valid telehealth visit.

Prescribing, of course, is the next issue. If that’s going to be involved, there’s going to be a variation and possibly additional requirements and prohibitions under certain cases, depending on whether there’s controlled substances involved.

I know Chris was mentioning the insurance issues, so maybe you can just summarize that for us, Chris?

Chris Esseltine:

Sure. I mean, obviously we’ve got CashPay down here for med spas and so forth. There’s a lot of CashPay. So, for things like that we don’t need to worry about whether insurance is going to reimburse for a particular telemedicine visit. And luckily … for all of our attendees on this webinar, don’t start breathing into a paper bag. Don’t start thinking, “Oh my gosh, how many states? And then how many insurance payers in each state? And everybody’s got their own laws and regulations.” Don’t overthink this or get panicked about it. … most of the private insurance payers have similar laws.

But again, you have to just determine if you have an outlier, you have a particular payer that won’t reimburse for telemedicine or will only reimburse under certain circumstances. And usually their customer service line or the contract that you sign with them will tell you if there’s anything out of the ordinary.

Medicare is fairly good, fairly straightforward. They’re usually the easiest, actually. And if you’re doing the telemedicine visit according to state law, and you’re doing it according to medical standards, then there aren’t additional requirements that Medicare has.

Medicaid, however, state by state. Even though it’s a federal program, it’s managed state by state. So, Medicaid does have specific requirements for each state about what they will reimburse and what they will not. So again, we can help you with that. If you let us know what states you’re thinking of or maybe going to be practicing in then we can guide you the right way.

Clara Salvai:

Perfect. So, I think that, with this, we have covered everything that we were requested by you guys in the other side. And we are officially opening our Q&A section, so please place your questions using the Q&A button. We will give you some minutes. I know that some of you already started. I’m seeing your questions. The attorneys are going to open, also, their Q&As, so that we can see what questions you have submitted. And we are going to be selecting a few.

And for those of you who haven’t placed a question yet, this is your chance, so please do so. And we are looking forward to answer some of these live.

Chris Esseltine:

So the first question I see, Clara, is a question about out-of-state practice. And I wanted to bring that up anyway, so it’s perfect that it’s the first thing that comes up.

Clara Salvai:

Perfect. All right.

Chris Esseltine:

So the question is, “How do telemedicine visits work, in terms of prescribing for a patient out-of-state?” In this particular case, the participant is asking about non-narcotics, but let me just address the out-of-state issue.

As with practicing medicine in general, in-person, every state requires a particular provider to be licensed in that state. So, if I want to move to New York and open up a medical practice, I have to be licensed in the state to do that. That’s just cut and dry. That’s no surprise to anyone.

So, similar issue … oh, well actually almost exactly the same issue with telemedicine. If you live in a particular state, as the provider, and you are seeing a patient in another state, you must be licensed in that state to practice medicine.

Now, it doesn’t mean you have to live in that state. So, for example, if I live in Tennessee and I am seeing a patient by telephone in New York, I just have to be licensed in New York. I can live in Tennessee. I can be in my home in Tennessee, having that patient visit. But I just have to be licensed in New York, or in other words licensed in the state where I’m seeing a patient. So that includes prescribing. So if I’m calling in a prescription to a pharmacy there in Manhattan, I can be in Tennessee, that’s just fine. So long as I am licensed in the state of New York or wherever I’m seeing the patient and prescribing, then it’s completely fine.

Let me just talk, for a second, about the pandemic. To facilitate patient visits, a lot of patients weren’t able to get out and see their doctors or the doctors, their offices were closed. A lot of people, especially for mental health, were having difficulty getting the proper care they needed. So, most of the states in this country, they relaxed those requirements and restrictions on state licensing so that you could, as a provider, offer medical services to someone in a state where you weren’t necessarily licensed.

The pandemic is over, in terms of these requirements, in every state in the union. So, states have now gone back to allowing only licensed providers to treat their patients. The only exception to this is the state of Florida. You don’t actually necessarily need to be licensed in the state of Florida, but you do have to be registered. There’s a form you fill out, and the state approves your ability to treat Florida patients if you live in another state without being licensed in Florida. You just have to be registered with the Florida board. But all the other states require you to be licensed to see a patient, number one, and then certainly to prescribe anything for them.

Clara Salvai:

Perfect. Thank you so much.

Matt, do you want to select any questions?

Matthew Stokke:

Okay. So yeah, there’s some questions here. Some of them are related to telehealth indirectly, but they’re important questions. And the rules are going to be the same, whether the practice is telehealth or an in-person practice. There’s a question here, asking, “Does an MD have to be an owner or a partial owner of the telemedicine business?”

Again, it’s a state-by-state question. The general answer here is yes, if it is a medical practice, providing medical services, an MD does have to be an owner. Certain states will offer a way for an MD and another type of licensed person to co-own the practice, subject to different rules about who can have more ownership. That’s usually the MD that has to have more ownership. So that was just a general question there.

There was another one here, it’s a longer question about an MSO managing various telehealth practices, it looks like. An MSO, by the way, for those who don’t know, is a management services organization, a management company that manages medical practices and other types of practices. They’re wondering if it’s okay to deposit patient money into MSO’s bank account prior to posting those funds to each of those practices bank account that that MSO manages.

It’s a big question. We’re in the age of digital health, connected health, so there are a growing number of these digital MSOs out there, management companies managing other telehealth practices. Again, it’s going to be a state-by-state kind of analysis here. But the general advice there is that patient money is sacred, it’s considered professional fees. And someone like me, or someone who has no medical background or license, would not be able to accept those fees. That’s the cut and dry law there.

Of course, there are some business issues that come about with that, where it’s just more practical, in some cases, for an MSO to accept those fees and then post it to the practice’s account. It’s never going to be the recommended way to do it. There are ways to possibly mitigate any risk in that regard, from a medical board saying to the MSO that, “You are improperly accepting patient fees.” You can explore different types of trust accounts and things like that, that might be available, depending on the bank.

But as a general matter, all the laws that apply for normal brick and mortar practices, in this regard, will also apply to telehealth practices. So, you can contact us if you have specific questions about your specific scenario there.

Clara Salvai:

Thank you so much. And also, for those of you who are watching this webinar, and this is the first time that you are seeing us live, know that we did an MSO webinar a couple of months ago. If you want the recording of that webinar please reach out to our firm. We will happily share that with you. You can also find that recording on our YouTube channel. And we are having an upcoming MSO deep in the woods details webinar coming up after this one. So, stay tuned, for many of you who are interested in that kind of management organization services.

So, Chris, do you see any other question that you want to answer?

Chris Esseltine:

Yeah, sure. There’s a question here that says, “Is supervision through video acceptable these days?” I’m assuming this person’s talking about physician supervision of a lower level practitioner, like a nurse practitioner, PA, or nurse.

Yes. And it depends again on: what are the services and what’s the supervision? It’s important that supervision actually is supervision, not just lip service, not a lower level practitioner simply renting out a doctor’s license. But at the same time, most states have a little more relaxed definition of supervision, where so long as the physician knows what’s going on, will look over a certain number of patient charts after the fact, and is available if there’s ever an emergency or a question, during office hours that lower level practitioner can reach out to the physician and say, “Hey, I’ve got a question,” or, “I’ve got a little concern or a problem here.” As long as that doctor is available, then it’s perfectly fine.

Sometimes that can be done by phone. Every now and then there’s perhaps a video that needs to take place, the doctor joins in the visit via video or something. But yeah, especially with all the Zoom technology and so forth, that kind of video supervision is just fine. It’s perfectly acceptable.

Clara Salvai:

Perfect. Matt, do you want to select another question?

Matthew Stokke:

Sure. And this may have been something that I didn’t say clear enough in my last answer. Someone asked, “Are you saying that MDs who are employees cannot do telemedicine?” And I think that’s an important clarification.

Though MDs are required to own medical practices, MDs, whether or not they own the practice, they are allowed to conduct patient visits via telemedicine, subject to their state’s requirements. So, employees only, who are physicians, they can use telemedicine.

Clara Salvai:

Perfect. Chris, do you want to select another one?

Chris Esseltine:

Yes, I have a question. It’s a really good one. This particular doctor says, “I have a lot of patients who have multiple homes where they live. If their permanent residence is in California, is it okay to do telemedicine with them in another state?”

This is one of those strange gray areas that regulators and legislators didn’t think of. If they are a resident of the state of California let’s say, and you’re a practitioner in California, you’ve seen this patient, you have that relationship already, and let’s say they’re visiting in Washington or Oregon or somewhere else, and they need to see you, is that acceptable?

And the general answer is yes. We can’t always point to a law that says, “Yep, that’s totally fine.” I’ve never known of a state who had an issue with it. I’ve spoken to state regulators about this. Not every state, of course, but some state regulators about this issue. And the purpose is to make sure that they govern the practice of medicine so that it’s safe and the patients are served properly and protected. So, obviously, those requirements would be fulfilled in the scenario I just talked about.

So, if a regulator wanted to kick up a fuss and say, “You saw a patient while they were in Washington,” I just can’t see it going anywhere. But I can’t say that nobody would kick up a fuss. It’s, again, one of those gray areas that has not been really contemplated by the specific black letter law.

Matt, feel free to chime in on this.

Matthew Stokke:

Yeah. I agree with you, Chris. And I recall … I can’t remember which state it was, there could be some references in various state laws about different conditions where licensure in that state, it might not be required in that specific circumstance. The example I’m thinking of is where there’s peer-to-peer consultations from a doctor, let’s say, who’s licensed in New York, seeing a patient who is now in Georgia. If Georgia had that law, where there was peer-to-peer consultation allowed, that doctor would be able to … while that patient is in Georgia, consult with a doctor licensed in Georgia and offer their consult to that doctor.

So, there are … it really depends on the state … some unexpected situations that they’ll specifically mention in their laws. So yeah, just wanted to mention that, that I saw fairly recently.

Chris Esseltine:

Yeah.

Clara Salvai:

Perfect. Okay. So-

Chris Esseltine:

There’s another question, but it’s sort of a follow-up to what we just talked about. There’s a practitioner in the state of California that has a subspecialty practice, and there are people from other states and countries who fly in to California to see this practitioner. Now, the visit is broken up into two different segments. One is … it’s a 50 minute visit to acquire just the patient history. And then once the patient flies into California, then the actual examination and diagnosis and anything else occurs. So is that legal?

And I think it goes along with the same thing. All you’re doing is acquiring history, right? It’s not really a patient visit, per se. I mean, this could be done with some kind of a form that the patient fills out. You could have a call center call and collect this information. So, I wouldn’t consider that a true patient visit, certainly not to examine or diagnose or treat. It’s just to acquire history.

If they are planning on coming into the state of California to actually get the proper medical visit then I think it should be fine. Once again, is it a gray area? Yes. As far as risk mitigation, is there any state that would have a big issue with this? I don’t believe so.

Clara Salvai:

Perfect. And I actually am seeing one question, and this will be the last one. Kimberly is asking, “Should you get a healthcare lawyer in your state, where you work?” You guys, what’s your take on this?

Chris Esseltine:

Nope.

Clara Salvai:

Yes.

Chris Esseltine:

No, my take is you don’t need someone … maybe the question is: well, I’m in Iowa, do I need to find a healthcare lawyer in Iowa to consult me? And no, you don’t at all. What you want is the best person for the job. You want someone with deep experience. And even someone in a particular state doesn’t necessarily know all the laws pertaining to that state, they have to go research them as well. So, you want the best person, the best firm, the best representation. It really isn’t important what particular state you’re in, so long as those state laws are understood by the lawyer who’s counseling you.

Clara Salvai:

Yeah. And also I want to add, I don’t know if Kimberly, you were with us from the very beginning? We had a small video discussing why it’s so important to have a healthcare lawyer. Well, as Chris really well pointed, that any attorney who is a healthcare attorney and he has knowledge and feels like he can assist you, no matter what state you are located, it’s a good fit.

It’s really important to always remember that, within attorneys, you have specialties. And it’s really important that you try to find a healthcare lawyer which is on a specialty, who is going to be able to walk you through all your needs when it comes to healthcare law.

Matt, is there anything that you want to add?

Matthew Stokke:

Yeah. Only thing I’d add to that is I agree with Chris. In Orange County and California here, I used to represent and defend practices and providers against board disciplinary actions. And in those circumstances, if you’ve gotten into some hot water, you will want to retain a firm, a local firm, who is able to see the … in general and make arguments before the court like that. So that’s what I would add there.

Chris Esseltine:

Great point.

Clara Salvai:

So just as a recap, when it comes to litigation, when you feel like you need to go to litigation, in that case you will need an attorney who is able to litigate for you in a specific state court. But for any other matters you can always have any healthcare attorney helping you, no matter what state you are located.

So, I think that, with that, we kick off our Q&A section. And, with this, we are ending basically our telemedicine webinar. In name of the whole firm and everybody who has been with you, Chris, Matt and yours truly, thank you so much for your time. We are hoping that you learn, along with us.

And remember that you are always invited to reach out to our firm if you have any questions. If you need any assistance or help into your healthcare matters, we have a very capable team that is literally waiting to get to know you and your ventures. And we are available pretty much 24/7. So thank you so much. And we’ll see you hopefully soon, in our next webinar.

Matt, Chris, is there anything that you want to add?

Chris Esseltine:

Just happy to be here. Thanks so much for everybody who attended.

Matthew Stokke:

Thank you very much.

Clara Salvai:

Perfect. So please remember, you can always visit our webpage for more information on our attorneys. We have amazing blog posts and resources. We have a very wide YouTube channel. And we are always creating more content to make sure that we can reach you for any questions that you may need.

So, thank you so much for your time and we’ll see you soon. Bye.