The Doctor Will See You Now (Virtually)

Everything’s digital these days, from Netflix movies to online gaming, and increasingly doctors’ visits are going the digital route as well. A typical telemedicine service lets a patient interact with their doctor remotely, courtesy of a computer hookup. Telemedicine is booming, with Medicare spending growing from $61,000 in 2001 to $17.6 million in 2015, but the growth is also drawing more scrutiny from the government.

Government enforcement agencies are often suspicious of new technology due to the worry that health-care providers could end up coming up with new ways to cheat the Medicare system, Jeremy Sherer, a health-care attorney with Hooper, Lundy & Bookman PC in Boston, told me.

“As telehealth usage continues to grow, government scrutiny will likely follow, and state Medicaid Fraud Control Units may increase their own investigations,” Sherer said.

A recent report from the Health and Human Services Office of Inspector General uncovered numerous claims for telemedicine services that didn’t meet Medicare requirements. More reports are likely, as the OIG added telemedicine billing issues to its work plan last year.

The rise of telemedicine could also lead to anti-kickback violations, William Chang, a health-care attorney with Crowell & Moring LLP in Washington, told me. As the program expands, patients in rural and underserved areas will have to connect with doctors qualified to practice telemedicine, and it’s not hard to imagine how marketing and financial arrangement could arise that would trip the anti-kickback statute, Chang said.

Enforcement could also surge if telemedicine fraud gets tied up with opioid drug diversion, Chang said. The 12 federal districts that the Department of Justice has identified as areas with high levels of opioid abuse have significant overlaps with the rural areas that are growth areas for telemedicine, Chang said.

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