Telehealth Popularity Draws Government Scrutiny

You know you’ve made it to the big leagues when the government decides to audit you, and that’s exactly what’s happened with the Medicaid telehealth program. The Health and Human Services Office of Inspector General recently added an investigation of the Medicaid telehealth program to its work plan, with a report due in fiscal year 2019. The audit was motivated by the surge in Medicaid telehealth claims and will look at whether the claims met Medicaid billing requirements.

An OIG audit is a positive step for telehealth providers, signaling that the program is a viable service, Nathaniel Lacktman, a health-care attorney with Foley & Lardner LLP in Tampa, Fla., told me. Medicaid telehealth is nearly universal, Lacktman said, with 48 out 50 states offering the service.

Telehealth has proven to be popular with patients, and can also help state Medicaid agencies cut costs, Lacktman said. Many state Medicaid agencies are currently paying for patient transportation to a provider for medical services, but a larger shift to telehealth would reduce that cost, as patients wouldn’t have to take as many trips, Lacktman said.

However, some obstacles remain for telehealth services, Lacktman said. For example, many hospitals have explored the idea of “off-shoring” their telehealth services, i.e. contracting with physicians who are based overseas. There’s a big incentive in these arrangements, as they can lower costs, but off-shore telehealth can’t be billed to Medicaid, Lacktman said.

Another potential stumbling block is the growth of text-based telehealth, where patients and doctors communicate via text messages or similar applications, Lacktman said. Many state Medicaid agencies require telehealth to include either a video or audio component, so the text-based arrangement may run into some trouble.

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