Telemedicine continues to thrive in a post-pandemic world, but with the expansion of services comes an expansion of fraud.
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The Office of the Inspector General (“OIG”) has warned healthcare entities to use ‘tightened surveillance’ when entering telemedicine settings which have the suspicious characteristics of a fraudulent scheme.
OIG has stated that a common characteristic of fraudulent schemes is the use of bribes to recruit and reward healthcare practitioners.
OIG further warned that enforcement is continuing. OIG and the Department of Justice (DOJ) have investigated many cases of fraud involving telemedicine companies.
In their investigations and cases, healthcare practitioners, telemedicine companies, and other participants have been held civil, criminal, and administrative responsible for their participation.
Some of these violations include:
- Violation of federal anti-kickback law,
- File a lawsuit that violates the False Claims Act, and/or
- Other violations of federal criminal law.
Often, these cases involve healthcare practitioners ordering or prescribing goods or services for patients who claim to have never been examined or assessed in a meaningful way to determine medical needs.
What should you watch out for?
Healthcare practitioners should be alert to any suspect characteristics, including, but not limited to:
- Patients identified or recruited by telemedicine companies,
- Insufficient contact or information of admitted patients to assess medical needs,
- Compensation from telemedicine companies based on the volume of goods or services ordered or prescribed,
- Telemedicine companies that provide goods and services only to beneficiaries of federal health programs,
- Telemedicine companies that provide only one product or one product class which may limit treatment options, and
- Telemedicine companies that do not expect practitioners to follow up with patients or provide follow-up contact information.
Why is this important to you?
Health care entities involved with fraudulent telemedicine companies can face criminal, civil, or administrative liability, depending on the circumstances.
It is very important to check your vendor well. If you need help checking vendors, contact Rickard & Associates today.
If you have questions or need assistance with your health care contract or termination clause, contact Rickard & Associates today.
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The post Can You Prevent Telehealth Scams? first appeared in Rickard & Associates.
