Executive committee backs exemptions for remote-monitoring provider Cadence, recommends full board approval

The State Board of Medical Licensure executive committee voted to recommend that the full board approve exemptions to the board's 20/80 rule and 75-mile rule for Dr. Theodore Feldman and Dr. Randall Kernow, allow the addition of nurse practitioners submitted with the request, permit referrals outside the Merit Health system, and authorize supervising up to eight advanced practice providers.

The recommendation came after a Zoom appearance by Dr. Theodore Feldman, who described Cadence, the remote patient monitoring company he represents, and asked that Dr. Kernow be added under the same exemptions previously granted to Feldman in May 2023. "We have now been operating as an RPM company which has nurse practitioner care delivery, a tech platform, and the remote monitoring capabilities of blood pressure cuffs, scales, and glucose monitors to manage diabetes, hypertension, congestive heart failure," Dr. Theodore Feldman said.

The request, presented by Feldman and by counsel Brian Higgins, asked the board to broaden prior exemptions so that Cadence may add an additional nurse practitioner, name Dr. Kernow as medical director, accept referrals from physicians outside Merit Health, and permit supervising up to eight APPs. "We do not supplant Mississippi‑based and licensed physicians," Brian Higgins told the committee, saying Cadence operates only when a Mississippi‑licensed physician orders its services.

Committee members questioned scope and oversight. Dr. Owens, serving as presiding officer for the meeting, explained why he preferred hearing from licensees first: "This board is really focused on protection of the public, but we do that through regulation of licensees," he said. Dr. Randall Kernow told the committee he is a board‑certified internist who serves as Cadence's medical director and that he currently provides clinical support and quality oversight rather than maintaining a full‑time private patient panel.

Cadence representatives provided usage and outcome data. The company reported monitoring 1,672 Mississippi patients at four Merit Health sites referred by 37 Mississippi‑licensed physicians; they said Cadence has served more than 40,000 patients nationally and operates in about 25 states. Feldman and Kernow cited published results they said show reduced hospital admissions and improved chronic disease control, including a company‑reported 27 percent reduction in hospital admissions across more than 6,000 patients and blood‑pressure control meeting national guidelines for roughly 70 percent of hypertensive patients in their reported sample.

After a motion by Dr. Joiner and a second from Dr. Ken Lippincott, the committee voted by voice to recommend approval. The committee's action is advisory to the full board; committee members said the recommendation will be transmitted to the full board for final action.

Clarifying details recorded at the meeting include: Cadence's Mississippi patient count of 1,672 across four Merit Health sites referred by 37 providers; company claim of serving more than 40,000 patients nationwide; reported average patient age of 74; and prior exemptions granted to Dr. Feldman in May 2023. The paperwork before the committee did not include the full, written submission for multiple APRNs, and committee members asked that written details be provided to the full board.

The full board will receive the committee's recommendation at a subsequent meeting, where members will vote on the exemptions and supervisory limits.