About 1,714 providers billed Medicare inappropriately for telehealth early in the COVID-19 pandemic, according to a new report from the HHS Office of Inspector General.
The HHS gathered data from Medicare fee-for-service claims and Medicare Advantage encounter data from March 2020 through February 2021.
The regulators focused on the roughly 742,000 providers that billed for a telehealth service, looking for indicators of fraud, waste or abuse, and set a high threshold to identify providers with billing practices that pose a "high risk" to Medicare.
Five things to know:
- The HHS found that roughly half a million Medicare beneficiaries have received almost $127.7 million in fee-for-service payments in one year.
- More than half of the high-risk providers were part of a medical practice with at least one other high-risk provider, which could indicate certain practices are encouraging such billing practices, the HHS said.
- Forty-one high-risk providers appear to be associated with telehealth companies, although the HHS said there is no systematic way to identify these companies in the Medicare data.
- HHS recommends that CMS strengthen monitoring of telehealth services, further educate providers on appropriate billing practices and identify telehealth companies that bill Medicare.
- The report comes after the HHS' Office of Inspector General released an alert July 20 urging practitioners to remain cautious about entering into business arrangements with telehealth companies due to the rise in fraud and kickback schemes in the telehealth market.