The HHS Office of Inspector General has issued a fraud alert for physicians entering telemedicine arrangements, according to a July 25 article in JDSupra from the law firm Sheppard Mullin Richter & Hampton.
The inspector general issued the special warning July 20, the same day that the U.S. Justice Department charged 36 people in schemes involving $1.2 billion in fraudulent telemedicine, durable medical equipment and cardiovascular and cancer testing.
The inspector general identified the following characteristics as suspicious:
1. Patients who are recruited by the telemedicine company, telemarketing company, sales agent and other entities advertising free or low-cost items and services
2. Physicians who don't have sufficient information from the patient to assess the medical necessity of items or services
3. Telemedicine companies that pay the physician based on volume of items or services
4. Telemedicine companies that only offer items and services to federal payers and don't accept private insurance
5. Telemedicine companies that claim to only offer items and services to patients who are not insured by federal payers, but may bill those programs
6. Telemedicine companies that only offer one product of a single class of product