Federal Audits of Telehealth Are Coming

The COVID-19 pandemic brought about a swift surge in telehealth services as an essential means of delivering care to patients who would otherwise have lost critical healthcare access due to restrictions or caution relating to in-person care. Federal and state requirements relating to telehealth were amended (in some cases temporarily and in some cases permanently) in order to remove barriers and facilitate this transition to needed remote care. In the fall of 2020, however, Justice Department and HHS Office of Inspector General (OIG) announcements of a $4.5 billion healthcare fraud “takedown” of telemarketers and telemedicine companies had a somewhat chilling effect on the view of telehealth. Importantly, these fraudulent schemes did not involve fraudulent telehealth services; rather, they used telemarketing to channel unsuspecting Medicare beneficiaries to telemedicine companies with providers willing to prescribe medically unnecessary durable medical equipment, genetic tests, and compound drugs in exchange for kickbacks. Providers and industry watchdogs are looking forward to the results of OIG audits of Medicare Part B telehealth services announced as part of the OIG’s 2021 Work Plan to get a more accurate view of the actual incidence of telehealth services fraud, to guide corrective measures and legislation, and to defuse the concerns that have sprung from the 2020 takedown. Additional information can be found here.