By Joseph F Zielinski, Dinsmore & Shohl
Why are we here?
Since the onset of the COVID-19 pandemic, health care providers and entities have embraced and incorporated telehealth as a way of providing care to patients who would otherwise have lost access because of regulatory restrictions or their own hesitation with traveling to treatment centers. To remove barriers to telehealth, federal and state regulators waived or exempted prior restrictions related to the provision of telehealth at the outset of the pandemic. Since many of these waivers and exemptions were only temporary, providers and entities that deliver or offer telehealth need to be cognizant of and keeping pace with evolving compliance requirements.
Where are we going?
This article will provide recommendations for creating efficiencies and building a better telehealth program. You will learn how to proactively evaluate your program and make necessary changes. For example, we will look at waivers that were issued in response to the COVID-19 pandemic, many of which are now facing an uncertain future. We will discuss how to monitor and assess your program as well as review best practices for telehealth programs post-COVID.
Why is this important?
Many health care organizations shifted their business models as a result of COVID-19 and quickly implemented telehealth programs or greatly expanded their telehealth offerings. Due to the sudden need to pivot, organizations took advantage of the many waivers that were offered. However, many waivers face an uncertain future, and health care organizations that do not adapt accordingly may find themselves out of compliance.
Telehealth has become a leading area of government action and enforcement. Currently the Office of Inspector General (OIG) has several different active audits focusing on telehealth. In addition to these audits, there was a National Health Care Fraud Enforcement Action on September 17, 2021, of which there were over $1.4 billion in alleged losses. Of these $1.4 billion in alleged losses, approximately $1.1 billion of the fraud was committed using telemedicine. Further, there have been two other recent nationwide investigations by federal authorities around telehealth, which have resulted in hundreds of arrests and allegations of more than $4.5 billion in false and/or fraudulent charges. Finally, there have been several civil and criminal actions by individual states. These actions demonstrate a clear intent to scrutinize and act against unscrupulous and even unwitting actors in the telehealth arena. To avoid unwanted scrutiny, now is an ideal time to review your telehealth program and determine its current compliance with applicable rules and regulations.
Read more here.
If you would like to submit content or write an article for the Health Care & Life Sciences Section, please email Kara Sikorski at ksikorski@indybar.org.
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