Health Information Compliance Alert

Published on Sat Mar 06, 2021 PDF

If you’ve noticed a spike in telehealth fraud talk from the feds, you’re not alone. However, the HHS Office of Inspector General (OIG) chief wants to clarify that enforcement of “telefraud” and oversight of telehealth services used during COVID-19 are not the same.

Details: From the onset of the pandemic, OIG in coordination with other federal healthcare agencies addressed the critical need for telehealth services in the industry, indicates Christi A. Grimm, OIG Principal Deputy Inspector General in a release.

“As we observed in recent rulemaking, OIG recognizes the promise that telehealth and other digital health technologies have for improving care coordination and health outcomes,” Grimm says. However, “it is important that new policies and technologies with potential to improve care and enhance convenience achieve these goals and are not compromised by fraud, abuse, or misuse.”

That’s why OIG ramped up its significant oversight and began auditing telehealth services used during the public health emergency (PHE) across a variety of federal health programs.

Caveat: Parallel to OIG’s spotlight on telehealth services, the agency has also seen an escalation of “telefraud” cases, according to the brief.

“OIG has conducted several large investigations of fraud schemes that inappropriately leveraged the reach of telemarketing schemes in combination with unscrupulous doctors conducting sham remote visits to increase the size and scale of the perpetrator’s criminal operations,” Grimm relates. She further clarifies that though this fraud did involve telehealth services, the fraudulent billing was for items rather than the visit.

Read OIG’s release at >https://oig.hhs.gov/coronavirus/letter-grimm-02262021.asp?utm_source=oig-covid-portal&utm_medium=oig-news&utm_campaign=oig-grimm-letter-02262021.