Doctors Warned About Telehealth Fraud
The Office of Inspector General and Department of Health and Human Services on July 20 warned practitioners to exercise caution when entering arrangements with purported telemedicine companies.
According to the fraud alert, dozens of investigations of fraud schemes have revealed that telemedicine companies are intentionally paying physicians and nonphysician practitioners kickbacks to generate orders for prescriptions for medically unnecessary durable medical equipment, genetic testing, wound care items or prescription medications. This has resulted in submissions of fraudulent claims to Medicare, Medicaid and other federal health programs.
Telemedicine companies have been aggressively recruiting and rewarding practitioners to order or prescribe medically unnecessary items and services for individuals. The companies advise the practitioners that there is no need to contact the patient regarding the request and many times the practitioners are not given the opportunity to review the patient’s medical records. In many cases, the telemedicine company then sells the order or prescription generated to individuals or entities that then fraudulently bill for unnecessary items and services.
In cases examined by the OIG and DOJ, these practitioners and the telemedicine companies are held liable for the payment and in violation of the False Claims Act or other federal criminal laws.
The notice provides a list of “suspect characteristics” of telemedicine companies that are acting unlawfully, including only compensating the practitioner on the volume of items or services ordered.
The fraud notice encourages all practitioners to use heightened scrutiny and caution when entering arrangements with telehealth companies, but the alert is not intended to discourage legitimate telehealth arrangements.
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