Enforcement: Get Ready for More Telehealth Services Scrutiny

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Note:  The following article synopsis was NOT provided by AAPC. It was created by Find-A-Code/innoviHealth.

Article Overview

This article reviews federal enforcement attention on telehealth services used during the COVID-19 public health emergency, with emphasis on Medicare and Medicaid oversight, billing review, program integrity, and compliance considerations for providers. It is aimed at healthcare organizations, coders, auditors, and compliance staff who want to understand the broad areas the OIG is examining and the operational issues that may be reviewed in telehealth programs.

Why This Topic Matters

Telehealth expanded quickly during the public health emergency, and the article explains why providers should expect increased audit and enforcement activity. It matters for organizations seeking to assess telehealth billing, documentation, compliance controls, and readiness for post-PHE oversight.

Article Sections

  1. Warning and enforcement context

    Introduces the federal enforcement focus on telehealth services used during the public health emergency and explains why this area is drawing attention.

  2. Home Health and Home Care Services

    Covers oversight of skilled services furnished through telehealth during the emergency period and related billing review themes.

  3. Medicare Part B Telehealth Services

    Summarizes planned audits involving Medicare Part B telehealth and the service categories under review.

  4. Home Health Agencies’ Strategies and Challenges Responding to COVID-19 Pandemic

    Discusses how home health agencies responded operationally to the pandemic, including staffing, preparedness, and virtual care adoption.

  5. Medicare Telehealth Service During COVID-19 Pandemic Program Integrity Risks

    Addresses program integrity review of telehealth billing patterns and provider characteristics that may be examined by auditors.

  6. Use of Medicare Telehealth Services During the COVID-19 Pandemic

    Covers Medicare telehealth utilization trends, comparisons with in-person care, and the scope of the OIG review.

  7. Medicaid Telehealth Expansion During COVID-19 Emergency

    Describes state Medicaid telehealth expansion during the emergency and the federal review of state oversight and guidance.

  8. Bonus: Use This Opportunity as a Check-In

    Highlights internal compliance review topics for organizations evaluating telehealth operations and broader virtual care readiness.

What You Will Learn

  • The main oversight areas the OIG is reviewing for telehealth services
  • How Medicare and Medicaid telehealth claims may be examined
  • What types of operational and compliance issues organizations should assess internally
  • How telehealth adoption during the public health emergency may affect future enforcement attention

Who Should Read This

  • Healthcare providers
  • Medical coders
  • Medical auditors
  • Compliance officers
  • Practice managers
  • Revenue cycle staff

Codes Discussed

  • CPT: E/M

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