Medicare Improperly Paid for Telehealth Claims
Posted by donna@healthlawcenterplc.com in Apr, 2018
The Department of Health and Human Services Office of Inspector General (OIG) recently published Report A-05-16-00058 indicating that approximately one-third of Medicare telehealth claims in a recent audit did not meet reimbursement requirements. The audit was conducted on a sample of 100 telehealth claims from 2014 and 2015. Most of the rejected claims were associated with telehealth services provided at non-rural originating sites. Currently Medicare pays for telehealth services only if the patient receives them at an “originating site” like physician’s office, hospital or skilled nursing facility located outside a metropolitan statistical area or in a health professional shortage area. Other reasons for improper billing were due to ineligible institutional providers or services that were not provided through interactive telecommunication systems. Based on its findings, OIG estimated Medicare paid $3.7 million in improper claims during the audit period.
Category: Medicare, Telemedicine
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