Medicare Compliance & Reimbursement

See the feds two-phase audit plan.

Medicare providers now have another reason to bolster their telehealth billing know-how. The HHS Office of Inspector General (OIG) added telehealth services used during the pandemic to its audit agenda.

Details: In January, OIG made Part B telehealth services utilized during the COVID-19 public health emergency (PHE) a Work Plan Active Item. Due to its importance during the PHE, the watchdog agency intends to “conduct a series of audits” through a two-phase approach, the OIG brief indicates.

The first audit phase will investigate whether Medicare telehealth requirements were followed for E/M visits, “opioid use order, end-stage renal disease, and psychotherapy,” OIG explains. “Phase two audits will include additional audits of Medicare Part B telehealth services related to distant and originating site locations, virtual check-in services, electronic visits, remote patient monitoring, use of telehealth technology, and annual wellness visits to determine whether Medicare requirements are met,” the agency adds.

Plus: OIG also added home health care provided as telehealth services during the PHE to the Work Plan Active Item list, too. The feds want “to determine which types of skilled services were furnished via telehealth, and whether those services were administered and billed in accordance with Medicare requirements,” the Active Item says.

“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,” OIG warns in the home health audit brief.

Resource: See the Work Plan and other recently added Action Items at https://oig.hhs.gov/reports-and-publications/workplan/active-item-table.asp.