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Telemedicine or telescam? Heed the warnings in the latest special fraud alert

Part B News

The Office of Inspector General (OIG) recently issued the Special Fraud Alert (SFA) targeting practitioners who were approached by purported telemedicine companies as it may lead to Medicare defraud schemes. The SFA detailed information about fraudulent telemedicine companies that use kickbacks and deception to attract practitioners to enable Medicare defraud schemes by prescribing medically unnecessary items and services.

OIG is equipping its practitioners with compliance education, including identifying the seven red flags and carefully monitoring the industry as well as on-noticed practitioners.

Sheppard Mullin partner Sara Shanti spoke with Part B News commenting, “The SFA also spreads compliance education and industry norms making it potentially more difficult for a practitioner to assert that they were not aware of being engaged in a prohibited (kickback) arrangement.”

It is also advised that practitioners know the compliance rules and be aware of scamming signs. Scammers might have their own pitches that go beyond matters of large compensation, for example, they might claim that working with them is the solution to burnout or violence in the workplace and emphasize benefits such as “a nice work-life balance, with remote work, generous compensation, and less environmental stress for recruited professionals,” Shanti observed. Practitioners are also not the only at-risk targets. “Certain patients may also be targeted, such as those without a health care advocate or with a private or stigmatized treatment, like seniors and patients seeking life-style treatments, as they are less likely to question a test or welcome scrutiny, respectively,” Shanti says.

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