Telehealth services and providers have been in high demand as the world copes with the COVID-19 public health emergency. Federal and state agencies have amended, and often loosened, regulations in an attempt to facilitate and expand access to telehealth.
However, the honeymoon phase of relaxed oversight may be coming to an end as the world adjusts to a new-normal.
The Department of Health and Human Services Office of Inspector General, along with state and federal law enforcement partners, participated in a nationwide health care fraud takedown in September 2020.
The takedown focused on several schemes to include alleged telefraud, or scams that leverage aggressive marketing and so-called telehealth services to commit fraud.
This fraudulent activity resulted in charges for 345 defendants in 51 judicial districts, including telemedicine executives, the owners of durable medical equipment (DME) companies, genetic testing laboratories, pharmacies, and more than100 medical practitioners, for their alleged participation in health care fraud schemes involving more than $6 billion in alleged loss.
In the aftermath of this takedown, on January 26, 2021, the Department of Health and Human Services, Office of Inspector General (“OIG”) announced a new telehealth-related audit targeting the implementation of telehealth waivers by home health agencies during the public health emergency.
On the same day, OIG announced a second telehealth-related audit to investigate a broad swath of telehealth services, dubbed “Audits of Medicare Part B Telehealth Services During the COVID-19 Public Health Emergency.”
In the Announcement, the OIG reveals its plan to conduct a series of audits of Medicare Part B telehealth services. The audits will occur in two phases.
The first phase aims to make an early assessment of whether services “such as evaluation and management, opioid use order, end-stage renal disease, and psychotherapy” meet Medicare requirements.
The second phase will dive deeper into a broad range of Medicare Part B telehealth services and compliance issues, including “distant and originating site locations, virtual check-in services, electronic visits, remote patient monitoring, use of telehealth technology, and annual wellness visits.”