New OIG Project Expands Telemedicine Audits to State Medicaid Programs


Following his plans for review of health insurance payments for health services Telehealth The Federal Office of the Inspector General (OIG) of the Department of Health and Human Services (HHS) just announced a new project to review Medicaid payments for telemedicine and other remote services. As a result, providers who bill Medicaid programs for telemedicine, telehealth or remote monitoring services can expect these applications to be reviewed to confirm that the payment has been correctly made in accordance with the coverage conditions. The project will be added to the OIG 2017 work plan.

How the OIG defines the projects contained in its work plan

Historically, at the beginning of each new fiscal year, the OIG released its work plan, outlining the compliance and enforcement projects and priorities that OIG expects to continue through the course of the year. to come up. In early June, the Office began updating the annual work plan on a monthly basis. The work plan contains dozens of projects involving Medicare and Medicaid providers, providers and payers, as well as public health exams and department-specific exams.

The work plan reflects (in large part) two aspects of the work of the IGO:

Projects from the Office of Audit Services (OAS), which performs financial, billing and performance audits of HHS programs; and
Projects from the Office of Evaluations and Inspections (OEI), which provides management reviews and evaluations of HHS program operations.

Except in providing general statistics, the work plan itself does not detail the work of the Bureau of Investigations or the Office of the Inspector General's Counsel to investigate matters involving particular suppliers and suppliers . The new Medicaid telemedicine project will be managed by the OAS.

Review of Medicaid Services Provided Using Telecommunication Systems

The BIG describes its new project for the revision of telemedicine as follows:

"Medicaid supports telemedicine, telehealth and telemonitoring services delivered through a range of interactive video, audio or data (telecommunication) services, with Medicaid programs seeing a significant increase in claims for these services and We expect this trend to continue, and we will determine whether Medicaid payments from selected states for services provided through telecommunication systems were eligible under the Medicaid requirements. "

The expected date of issuance of the OIG report is 2019, which is understandable given the broad scope of the project and the significant gaps in the coverage rules between the various state Medicaid programs. .

As in the case of the OIG Health Insurance Review, telemedicine service providers should not fear the new OIG project or consider it as a reason not to offer telehealth services to their patients. Indeed, the project and its final report can help shed light on areas of compliance that the OIG considers important. In the meantime, providers should continue to ensure that their telehealth programs and applications meet Medicaid requirements, including coverage, coding, and documentation rules.

For more information on innovations in telemedicine, telehealth and virtual care, including the team, publications and other documents, visit the Foley & # 39 site. Telemedicine .


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