Watch out for telemedicine fraud
As your partner in fighting fraud, waste and abuse, we’re sharing an alert from the Office of the Inspector General (OIG) about telemedicine fraud. The OIG released this alert after conducting dozens of investigations of fraud schemes involving companies that purport to provide telehealth, telemedicine, and telemarketing services. Although these fraud schemes vary in design, there are common “suspect characteristics” to be aware of.
What to look for
- Using kickbacks to aggressively recruit and reward providers to further fraud schemes by arranging for providers to order or prescribe medically unnecessary items and services for “purported patients.”
- Paying providers in exchange for items or services for patients who have limited, if any, interactions with the provider and without regards to medical necessity. Payments are sometimes described as payment per review, audit, consult or assessment of medical charts.
- Telling providers they don’t need to contact the patient or can only speak to the patient by phone.
- Not giving providers the opportunity to review the patient’s real medical records.
- Selling the order or prescription created by the provider to other individuals or entities that become fraudulently billed for unnecessary items and services.
This list is not exhaustive, so we encourage providers to exercise caution when working with telemedicine companies.