Dive Brief:
- Providers generally followed Medicare rules when delivering care via telehealth at the height of the COVID-19 pandemic, according to a report by the HHS’ Office of Inspector General published this week.
- The rapid changes to the Medicare program during the pandemic might have risked fraud or waste, and it’s key for regulators to keep an eye on telehealth delivery to ensure quality of care, according to the report.
- But the audit found physicians and other practitioners complied with Medicare requirements for 105 of the 110 sampled evaluation and management services provided from March to November 2020. Payments that didn’t follow requirements largely resulted from clerical errors or the inability to access records.
Dive Insight:
Telehealth utilization soared during the early days of pandemic as regulators eased Medicare rules about virtual care and providers quickly pivoted to telehealth amid social distancing.
The audit found that 14% of the total amount Medicare paid for evaluation and management care — which doesn’t include services like diagnostic tests or procedures — during the early pandemic period was provided through telehealth, compared with less than 0.1% a year earlier.
Providers generally complied with Medicare requirements when delivering these services via telehealth, according to the OIG. The program paid just $446 for the five sampled services where providers didn’t meet Medicare requirements.
An earlier OIG report published in 2022 suggested telehealth fraud was rare in Medicare, and relatively few providers were billing for services that were never delivered or weren’t medically necessary.
The latest audit comes as legislators face a deadline to enshrine some pandemic-era Medicare flexibilities for telehealth. A number of the flexibilities are still temporary measures that could expire without congressional action.
Bipartisan legislators have shown support for making some pandemic-era flexibilities permanent, arguing that telehealth could help people receive needed care, especially for rural patients or substance use disorder treatment.
