Focused On Health Care Law

The rise of telehealth is followed by a rise in oversight and audits

| Mar 25, 2021 | Medicare overpayment |

One of the many changes the pandemic has compelled society to make is telehealth. The rapid rise of telehealth in the year-plus of the pandemic has made healthcare services more accessible, helped preserve personal protective equipment, reduced demand on healthcare facilities and helped to keep both patients and providers free of the virus.

‘A matter of safety’

Earlier this year, the Deputy Director for the Health and Human Services Office of Inspector General said telehealth isn’t just a matter of convenience for Medicare beneficiaries, it’s also “a matter of safety for many beneficiaries.”

Because many healthcare providers are saying they expect that telehealth will continue after the pandemic – and could even expand – the OIG Deputy Director announced plans to conduct “significant oversight” of telehealth to ensure its benefits aren’t compromised by abuse, misuse or fraud.

Audits are underway

In fact, the OIG is already in the process of conducting several audits involving telehealth services. While the OIG’s work plan (a work plan is a list of “audits, evaluations, and inspections that are underway or planned”) indicates the focus will be on healthcare industry trends that emerged in the course of the pandemic, audits could also identify providers it believes received Medicare overpayments.

For instance, the OIG is conducting audits on the “Use of Telehealth to Provide Behavioral Health Services in Medicaid Managed Care,” “Home Health Services Provided as Telehealth During the COVID-19 Public Health Emergency” and “Medicare Part B Telehealth Services During the COVID-19 Public Health Emergency.”

A closer look at one audit

According to a recent article about the audits, the first half of the OIG’s Part B audits will review whether billing for certain services by telehealth met Medicare requirements. Healthcare service items in the audits include evaluation and management, psychotherapy and opioid use orders.

The second half of the Part B audits will include virtual check-ins, electronic visits and remote patient monitoring.

It’s clear that the rapid rise of telehealth has resulted in a need for oversight. The OIG is going to look closely at how telehealth is used to deliver services and how Medicare is billed for those services.

Providers billing for telehealth services should ensure that billing is compliant.