Exploring Fraud, Waste, and Abuse Within Telehealth

Healthcare Fraud Prevention Partnership: Exploring Fraud, Waste, and Abuse Within Telehealth

The Healthcare Fraud Prevention Partnership (HFPP) released a white paper providing background on the use of telehealth services prior to and during the COVID-19 PHE. The purpose of the paper was to identify fraud schemes that take advantage of increased telehealth usage. The paper reviews current telehealth policies, summarizes the benefits and multi-level barriers in telehealth care delivery, describes vulnerabilities, and identifies and characterizes telehealth-related schemes. The paper also reviews methods to identify and mitigate fraud, waste, and abuse in telehealth using referrals and hotlines, data analytics, databases and electronic health records, health care provider and patient education, and cross-disciplinary collaboration and information sharing. It also identifies several systemic challenges in detecting fraud, waste, and abuse in telehealth, and provides recommendations to mitigate these vulnerabilities.