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Don’t let OIG fraud alert disrupt your practice’s telehealth program

Part B News

Part B News, in its August 29 issue, wrote that the Office of Inspector General's (OIG) recently issued Special Fraud Alert regarding telemedicine scam shouldn't discourage practitioners "from using the COVID-19 public health emergency (PHE) waivers to provide telehealth services." As telehealth continues to show its sustainable future, legal experts emphasized the importance of compliance, starting with the basics, such as appropriate documentation and coding, adherence to existing waiver-period rules, and internal revisions of claim.

Physicians should also expect closer scrutiny of at-risk services. Sheppard Mullin partner Sara Shanti spoke with Part B News commenting, “There are legitimate arrangements for providing these services via telehealth; however, certain laboratory tests and equipment can easily be overutilized. Specifically, they are generally chosen because of their low risk of physical harm to patients, broad clinical rationale, and being commonplace enough to avoid additional inquiry.”

It is encouraged that practitioners are patient for medical reviews and audits as telehealth regulation continue to shape. Audits and enforcement actions to ensure compliance will also evolve, Shanti says. “Enforcement will only grow, and with digital health comes a digital footprint, which reflects a practitioner’s actions.”

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