tci Medicare Compliance & Reimbursement - 2019 Issue 10

Fraud and Abuse: Case Illustrates the Importance of Compliant Telehealth Arrangements

Documentation backs up telemedicine claims. The convenience of offering clinical services electronically is a great option for your patients, but telemedicine has its drawbacks, too. In fact, a recent case suggests the feds aren’t playing any games when it comes to proving medical necessity for clinical care provided electronically. Context: Last month, the Department of Justice (DOJ), in collaboration with the Department of Health and Human Services (HHS), and the Federal Bureau of Investigation (FBI), charged 24 defendants, including three licensed clinicians, for Medicare abuse and fraud. Five telemedicine firms, 130 durable medical equipment (DME) companies, and medical...

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