The Alliance for Connected Care sent a letter to HHS Office of Inspector General (OIG) Principal Deputy Inspector General Grimm urging OIG to update posts on “telehealth fraud” to better distinguish traditional fraud from telehealth fraud. The Alliance supports several recommendations to address improper telehealth payments:
- Conduct periodic post-payment reviews to disallow payments for errors for which telehealth
claim edits cannot be implemented (for example, unallowable originating sites or unallowable
means of communication - Work with MACs to implement all telehealth claim edits listed in the Medicare Claims Processing
Manual; - Offer education and training sessions to practitioners on Medicare telehealth requirements and
related resources.
In addition, the Alliance requested OIG consider meeting with experts to learn about the tools and tactics that can best differentiate legitimate telehealth providers from fraud actors pretending to offer telehealth.
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