By: Karina Gonzalez
The US Department of Health and Human Services, Office of Inspector General (OIG) reports that as part of its 2017 Work Plan it will be reviewing Medicare Part B payments for telehealth services. These services support rural access to care and Medicare pays telehealth services provided through live, interactive videoconferencing between a Medicare beneficiary located at an origination site and a healthcare provider located at a distant site.
The OIG is reviewing Medicare claims that have been paid for telehealth services that are not eligible for payment because the beneficiary was not at an originating site when the consultation occurred. A beneficiary’s home or office is not an originating site, an eligible originating site must be a practitioner’s office or a specified medical facility.
The review is for Medicare claims paid for telehealth services provided at distant sites that do not have a corresponding claim from an originating site.
These services require an interactive telecommunication system with audio and video permitting two-way, real-time interactive communication between the beneficiary and the distant site physician or practitioner. The physician or practitioner at the distant site must be licensed to furnish the service provided under State law.
Telehealth Services are gaining a lot of popularity, especially with home-bound patients and are being increasing delivered but the manner of delivery many times does not meet Medicare criteria for payment.