Federal officers discovered few situations of fraud in Medicare billing practices for telehealth providers throughout the first 12 months of the COVID-19 pandemic.
There have been 1,714 suppliers out of roughly 742,000 whose billing was deemed “excessive threat” for Medicare, in keeping with a report launched this month by the U.S. Division of Well being and Human Companies’ Workplace of Inspector Basic.
Suppliers’ billing practices had been thought-about a excessive threat in the event that they confirmed regarding billing practices on a minimum of one out of seven measures, similar to billing for telehealth providers and facility charges for many visits, billing at the costliest degree every time or billing for a excessive variety of days in a 12 months.
The suppliers in query billed for telehealth providers for half one million beneficiaries and obtained $127.7 million in fee-for-service funds, in keeping with the report.
The Facilities for Medicare and Medicaid Companies stated it can evaluation the high-risk circumstances.
“Provided that this report was performed outdoors of CMS’s and legislation enforcement entities’ program integrity efforts, CMS might want to fastidiously evaluation the problems recognized to evaluate whether or not these points have already been addressed, and if not, whether or not further CMS actions are wanted,” CMS Administrator Chiquita Brooks-LaSure wrote in a response to the report.
Telehealth exploded in recognition when the pandemic hit, and two-in-five Medicare beneficiaries, or greater than 28 million folks, used these providers within the first 12 months. In that timeframe, beneficiaries used telehealth providers 88 instances greater than the earlier 12 months, the report discovered.
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