Submitting OIG:
Report Description:
Medicare paid a total of $17.6 million in telehealth payments in 2015, compared with $61,302 in 2001. Medicare telehealth payments include a professional fee, paid to the practitioner performing the service at a distant site, and an originating-site fee, paid to the facility where the beneficiary receives the service. A Medicare Payment Advisory Commission study of 2009 claims found that Medicare professional fee claims without associated claims for originating-site facility fees were more likely to be associated with unallowable telehealth payments. We analyzed 2014 and 2015 (our audit period) telehealth claims and found that more than half of the professional telehealth claims paid by Medicare did not have matching originating-site facility fee claims. Therefore, we focused our review on telehealth claims billed through a distant site that did not have a corresponding originating-site fee.
Date Issued:
Thursday, April 5, 2018
Agency Reviewed / Investigated:
Submitting OIG-Specific Report Number:
A-05-16-00058
Component, if applicable:
Centers for Medicare & Medicaid Services
Location(s):
Agency-Wide
Type of Report:
Audit
Funds for Better Use:
$3,699,848
Number of Recommendations:
3
View Document:
Attachment | Size |
---|---|
51600058.pdf | 579.62 KB |
Additional Details Link: