Telehealth’s Rapid Growth Comes with Concern About Fraud

After the expansion of telehealth by the Trump Administration in early March, medical professionals have received a massive relief from regulations that could take time away from treating patients. A new reality for healthcare was born out of telehealth, or telemedicine, but there has been reason to believe that the government-backed system comes with danger to the public’s privacy in the form of fraudulent schemes. 

“In an emergency, those on the front lines shouldn’t have to worry about federal rules and red tape hamstringing them when they need flexibility above all else. And we’re doing everything in our power to make sure that that doesn’t happen,” White House Medicare chief Seema Verma said. 

Mike Cohen, an operations officer with the Health and Human Services Inspector General’s Office, argued that the anti-fraud “guardrails have been removed under this epidemic. The concern is that things will never go back to what they were.” Cohen added, “There will be a lot of pressure on CMS to make at least some of these changes permanent.”

Pros to telehealth 

Telehealth covers a broad range of services via video, telephone or email. Since early March, the Centers for Medicare & Medicaid Services have approved dozens of new billing codes to allow medical professionals to bill for these services. Amidst the stay at home mandate, older patients have benefited greatly from this as they can now consult with doctors about everything from a check-up to flu symptoms or a backache to a psychiatry visit from their homes. 

The government has also allowed telehealth providers to waive patient deductibles and copayments during the coronavirus emergency. Under normal conditions, these actions could be seen as kickbacks, because they could discourage patients from complaining about charges or lead to overuse of medical services.

But don’t be fooled

Scammers are leveraging the COVID-19 pandemic to steal your money, your personal information, or both. Just as fraudulent schemes are arising with the distribution of the government stimulus package, scammers have found their way to telehealth as well.

“A crisis always spawns fraudsters,” said Krista Drobac, executive director of the Alliance for Connected Care, which advocates for telehealth.

Cohen said investigators are already seeing “tons” of fraud cases linked directly to COVID-19. They attack where we are weak– our desire for a COVID-19 cure. Scammers are hacking patient accounts to bill for bogus “coronavirus emergency kits” and “testing kits”. Once marketers obtain a patient’s billing numbers, they often tack on thousands of dollars in other scam attempts. 

“There are unscrupulous providers out there, and they have much greater reach with telehealth,” said Cohen, but it only takes a “few to do a whole lot of damage.” The telehealth industry argued that its operations are no more prone to billing abuses than any other branch of health care.

Fraudulent coronavirus schemes to look out for:

  • Individuals and businesses selling fake cures for COVID-19.
  • Phishing emails from entities posing as the World Health Organization or the Centers for Disease Control and Prevention. 
  • Websites that appear to be sharing Coronavirus-related information, but actually gain and lock access to your devices
  • Seeking donations fraudulently for illegitimate or non-existent charitable organizations.
  • Medical providers obtaining patient information for COVID-19 testing and then using that information to fraudulently bill for other tests and procedures.     
  • Rollbacks in telehealth regulations that could appear sketchy and controversial, such as relaxing restrictions on opioid prescriptions via video or easing licensing requirements for doctors who practice across state lines.

The future is telehealth

The coronavirus has “stopped [the medical] profession in its tracks, and we need to adapt to a new reality,” said Dr. Joseph Kvedar, a Harvard Medical School professor and president-elect of the American Telemedicine Association, a nonprofit that promotes access to the technology.

Kvedar said virtual visits at Partners HealthCare, where he is a senior adviser, have jumped from 1,600 virtual visits in February 2019 to 90,000 amidst the pandemic. New York City alone has seen spikes ramping up from zero to 5,500 visits in a single day. “There’s a lot more interest now that people have to stay home.”

“Telehealth is going mainstream,” said CEO Geoffrey Boyce of InSight + Regroup, a national telepsychiatry company. “It has been on the fringes for a number of years. We’re at the point now where there is no going back.”

Government’s response to telehealth fraud 

“Our organization’s top priority is to protect the public and the health and well-being of HHS program beneficiaries – and this duty has never been more important as we all confront the COVID-19 pandemic. While many Americans are nobly rising to the occasion, sadly, some bad actors are preying on people’s fears for profit, perpetrating fraud schemes, including marketing fake COVID-19 test kits and unapproved treatments through telemarketing calls, social media platforms, and door-to-door visits,” said Christi A. Grimm, Principal Deputy Inspector General of the U.S. Department of Health and Human Services.

How to protect yourself against fraud

Here are some of the top ways to protect yourself during this time:

  • Be cautious of unsolicited requests for their Medicare or Medicaid numbers.
  • Be suspicious of any unexpected calls or visitors offering COVID-19 tests or supplies.
  • Ignore offers or advertisements for COVID-19 testing or treatments on social media sites. Only a physician or other trusted healthcare provider can approve any requests for COVID-19 testing.

If you suspect COVID-19 fraud, contact the National Center for Disaster Fraud Hotline (866) 720-5721 or [email protected] or contact the COVID-19 Fraud Alert.

 


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