Telemedicine has been growing over the last several years, and COVID-19 has accelerated that growth. Several provisions in the CARES Act relaxed telemedicine rules. In addition to the CARES Act, there have been many other legislative and policy changes on both the national and state levels. However, providers should recognize that these policy changes do not make them immune to healthcare fraud investigations and allegations. See https://wirskyelawfirm.com/telemedicine-fraud-and-kickback-cases/.
An example of a telehealth prosecution is the recent indictment of Michael Stein and Leonel Palatnik. According to the Department of Justice press release, the defendants “exploited policies that were put in place by CMS to enable increased access to care during the COVID-19 pandemic.” The allegations involve billing for services not rendered based on the defendants submitting false and fraudulent claims to Medicare for sham telemedicine encounters that did not occur. There are also kickback allegations based upon medical professionals allegedly being paid bribes in exchange for their referrals for expensive and medically unnecessary cancer and cardiovascular genetic testing. https://www.fdicoig.gov/press-release/doj-announces-coordinated-law-enforcement-action-combat-health-care-fraud-related.
Overall, there is greater willingness to utilize telemedicine by patients and providers, and legislative changes also have been more accepting of telehealth. However, providers should be vigilant with their practices. This includes thoroughly documenting all patient encounters and not entering into any arrangements that could be suspect under the Anti-Kickback Statute or other bribery statutes. Because of its growth, telemedicine will continue to be under increased scrutiny by the government.