OIG to Audit Home Health Telemedicine Reimbursement

WASHINGTON, D.C. (January 26, 2021)— The Health and Human Services Department’s Office of the Inspector General (OIG) has launched an audit of home health services provided through telehealth during the COVID-19 public health emergency to verify that providers aren’t doing more than they’re supposed to do to qualify for reimbursement.

Providers have complained that Medicare leaves little avenue for telehealth reimbursement, often routing payment through the primary physician. During the COVID-10 public health emergency, the Centers for Medicare & Medicaid Services (CMS) issued section 1135 waivers to allow for more proactive care. This allows home health care providers to use some telemedicine tools in conjunction with in-person visits, as long as the technology is related to the services provided, it’s included in the plan of care and it doesn’t substitute for an in-person visit. The new audit will ensure those rules are being followed.

“We will evaluate home health services provided by agencies during the COVID-19 public health emergency to determine which types of skilled services were furnished via telehealth, and whether those services were administered and billed in accordance with Medicare requirements,” reads the audit announcement. “We will report as overpayments any services that were improperly billed. We will make appropriate recommendations to CMS based on the results of our review.”

The review is expected to be completed in 2022.

Find the audit statement here.