The Honeymoon Phase Is Over: OIG to Audit COVID-19 Part B Telehealth Services

Sheppard Mullin Richter & Hampton LLP

Telehealth services and providers have been in high demand as the world copes with the COVID-19 public health emergency.  Federal and state agencies have amended, and often loosened, regulations in an attempt to facilitate and expand access to telehealth.  However, the honeymoon phase of relaxed oversight may be coming to an end as the world adjusts to a new-normal.

On January 26, 2021, the Department of Health and Human Services, Office of Inspector General (“OIG”) announced a new telehealth-related audit targeting the implementation of telehealth waivers by home health agencies during the public health emergency, which we previously covered here.  On the same day, OIG announced a second telehealth-related audit to investigate a broad swath of telehealth services, dubbed “Audits of Medicare Part B Telehealth Services During the COVID-19 Public Health Emergency” (the “Announcement”).

In the Announcement, the OIG reveals its plan to conduct a series of audits of Medicare Part B telehealth services.  The audits will occur in two phases.  The first phase aims to make an early assessment of whether services “such as evaluation and management, opioid use order, end-stage renal disease, and psychotherapy” meet Medicare requirements.  The second phase will dive deeper into a broad range of Medicare Part B telehealth services and compliance issues, including “distant and originating site locations, virtual check-in services, electronic visits, remote patient monitoring, use of telehealth technology, and annual wellness visits.”

Robust compliance programs are key to avoiding censure and other unwanted penalties that could result from the OIG’s ramp-up of telehealth oversight.

We will continue to monitor the OIG’s telehealth-related activities, particularly as OIG begins to rollback policies that enabled rapid expansion of telehealth services at the beginning of the COVID-19 public health emergency.

DISCLAIMER: Because of the generality of this update, the information provided herein may not be applicable in all situations and should not be acted upon without specific legal advice based on particular situations.

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