Lawyers Address OIG, DOJ Telehealth Fraud Enforcement Trends in Compliance Today Magazine

July 13, 2021

McGuireWoods’ partners Andrea Lee Linna and Michael Podberesky and associate Amanda Ray co-authored a July article published by Compliance Today magazine on the likely increase in telehealth fraud enforcement by the Office of Inspector General and the Department of Justice.

The article examined recent DOJ enforcement actions regarding two high-value telehealth fraud schemes, as well as OIG and Medicare Payment Advisory Commission pronouncements on telehealth oversight and reimbursement policies.

The authors noted that some industry stakeholders have questioned whether the actions targeted by the OIG and DOJ constitute telehealth fraud, and the OIG has not clarified whether there is a distinction between telefraud and noncompliance with Medicare telemedicine requirements. Ultimately, however, judges and juries will determine whether telehealth billing errors resulted from confusion and good-faith efforts or reckless indifference, deliberate ignorance or willful misconduct.

The article concluded with a list of telehealth compliance best practices that providers should consider adopting to decrease the risk of facing OIG or DOJ scrutiny of telehealth claims.