OIG to audit Medicaid telehealth payments as claims increase

02:04 pm
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The U.S. Department of Health and Human Services’ Office of the Inspector General will audit Medicaid payments for telemedicine and telehealth payments to ensure compliance with reimbursement requirements.

The report is scheduled for 2019, given the breadth and scope of the project. The audit was added to OIG’s work plan this week, as the agency noted a “significant increase in claims for these services and expect this trend to continue.”

“We will determine whether selected States' Medicaid payments for services delivered using telecommunication systems were allowable in accord with Medicaid requirements,” according to the plan.

Medicaid providers who bill state programs for telehealth, telemedicine and remote monitoring services may have those claims reviewed for accuracy in accordance to coverage conditions.

However, the audit should not make organizations hesitant to provide telehealth services: The audit is designed to shed light on flaws and reveal the compliance areas OIG holds most important. The Office of Audit Services will conduct the review.

The planned audit adds to an initial audit to review Medicare Part B telemedicine payments announced earlier this year, which is focused on claims for telehealth provided at distant sites that lack a claim from an originating site.

OIG updated its plan last month and will release its report in 2018.

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