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HomeMedicare Dispatch → OIG Report Finds Improper Billing for Telemedicine Services

OIG Report Finds Improper Billing for Telemedicine Services Print E-mail
Written by Vitale Health Law   
Tuesday, 24 April 2018 17:17

As the push to increase the use of telemedicine grows, so too do concerns over questionable billing practices.

In a recently released report, the U.S. Department of Health and Human Services Office of Inspector General (OIG) found that the Centers for Medicare and Medicaid Services (CMS) paid practitioners for services that did not meet Medicare requirements.

To give you an idea of how much the use of telemedicine is growing, the OIG points out that in 2001, Medicare paid a total of $61,302 for telemedicine services. In 2015, that figure skyrocketed to $17.6 million.

Between 2014 and 2015 the watchdog agency reviewed 191,118 distant-site telemedicine claims that did not have corresponding originating site claims, totaling approximately $13.8 million.

Certain conditions must be met for providers to submit telehealth claims through Medicare Part B. For example, the originating site must be a practitioner's office or a medical facility, not in a patient's home, and the beneficiary must be located in a qualifying rural area.

OIG found that out of 100 sample claims reviewed, 31 claims did not meet Medicare requirements. It breaks down like this...

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