Medicare Compliance & Reimbursement

Even before COVID hit, trends suggested that telehealth was gaining steam — but the pandemic caused digital healthcare to skyrocket, suggests a new HHS Office of Inspector General (OIG) report. In fact, the results could inform what happens with remote visits in the future, according to the feds.

A recent report from the OIG shows how telehealth usage escalated during the early stages of the pandemic from March to December 2020, with more than 26 million Medicare beneficiaries receiving at least one service digitally.

“While the expansion of telehealth has been essential to maintaining beneficiaries’ access to care, there have been concerns about the potential for fraud, waste, and abuse associated with expanded telehealth services,” the OIG says. “These data are critical to informing decisions about how to structure telehealth services in Medicare on a more permanent basis.”

About 84 percent of Medicare beneficiaries received all their telehealth services during COVID from providers with whom they had an established relationship, the OIG says in the new study.

Telephone evaluation and management (E/M) and preventive services visits were the kinds of visits where the most beneficiaries had preexisting relationships and accounted for 87 percent. The type of visit where the fewest beneficiaries had preexisting relationships with the provider — 58 percent — were home visits, the OIG notes. The watchdog agency defines “home visits” as E/M services provided by a physician to a beneficiary in their private residence, not requiring a homebound designation.

For remote patient monitoring (RPM) visits, 77 percent of beneficiaries had a preexisting relationship with the provider before their visit.See more data in the six-page report at https://oig.hhs.gov/oei/reports/OEI-02-20-00521.pdf.