Telehealth Services Increased Medicare Fraud

The COVID-19 pandemic made telehealth essential. With shutdowns across the country, people still needed medical care, and telehealth came to the rescue. The number of “virtual” physicians increased from zero to thousands overnight.

Unfortunately, telehealth makes it easier to commit fraud. The Department of Health and Human Services (HHS) encountered more schemes, which cost taxpayers millions. Here is how this problem developed and how it is addressed now.

Growth of a new problem

In 2019, 840,000 telehealth visits were billed to Medicare. That changed significantly with the panic. In 2022, there were 52,7 million visits.

The change was necessary. Telehealth reduced doctors’ exposure to COVID, and stay-at-home orders kept people out of doctor's offices. Also, the overburdened health system needed a break, and telehealth seemed to be the perfect solution.

Unfortunately, telehealth increased fraudulent claims. Providers could prescribe expensive durable medical equipment without a physical visit. Patients and doctors took advantage of this loophole to receive larger payments and more benefits. Doctors frequently billed for visits that never occurred.

Addressing telehealth Medicare fraud

Even with COVID spread slowing, telehealth remains popular. Fraudulent claims have continued, but there are solutions.

The primary solution is whistleblowers. Whistleblowers (thanks to protection under the False Claims Act) helped recover over $40 billion in healthcare funds since 1986. For telehealth, the False Claims Act is responsible for recouping millions, including $24.5 million from a Florida provider group. The HHS is listening and encouraging people to come forward with claims.

Did you witness telehealth irregularities at your medical office? You may be able to receive an award through the False Claims Act and join the fight against fraud. For assistance, contact a whistleblower attorney at Kardell Law Group. We can help you plan your claim strategically and represent you if your employer retaliates.