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COVID-Fueled Growth in Telemedicine Could Lead to More Fraud Prosecutions

The Federal Docket

As COVID-19 continues to change the way Americans live their lives, from eating at restaurants to seeing their doctors, there has been a significant increase in the use of “telemedicine,” also known as “telehealth” or “virtual medical care.” Earlier this year, the Medicare chief announced government measures to increase and promote telemedicine, mostly by lifting certain restrictions and federal regulations. The intent behind expanding telemedicine is to promote a way for people to get medical attention without having to travel to see their doctor in person.

At the same time, government officials have signaled that they will take an aggressive approach to targeting healthcare providers they suspect are committing healthcare fraud, such as by overbilling or billing for telemedicine services that were never rendered. As more healthcare providers adapt to the new environment under COVID-19 and try to provide telemedicine services to their patients, there is a real risk that the government ends up targeting providers who are new to telemedicine and are simply making mistakes due to a lack of familiarity with the regulations. Further increasing this risk is the fact that the federal government has created “dozens of new billing codes” and waived certain limitations and regulations given the COVID-19 pandemic, making it harder for healthcare providers to know what is and isn’t allowed in the rapidly changing new world of telemedicine.

Even before this latest growth in telemedicine, the Department of Justice had been very aggressive in prosecuting and targeting telemedicine providers suspected of healthcare fraud, including a case last year involving 35 defendants and an alleged $2.1 billion scheme.

The government has signaled what kind of conduct they will likely pursue with criminal sanctions as the use of telemedicine services increases, such as pursuing providers billing the government for “coronavirus emergency kits” that contain over-the-counter items, providers billing for fraudulent COVID-19 cures, and those providing telemedicine without the proper license. The government will also likely target suppliers and vendors of medical equipment who work with telemedicine providers to sell their products.

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Tom Church - Tom is a trial and appellate lawyer focusing on criminal defense and civil trials. Tom is the author of "The Federal Docket" and is a contributor to Mercer Law Review's Annual Survey in the areas of federal sentencing guidelines and criminal law. Tom graduated with honors from the University of Georgia Law School where he served as a research assistant to the faculty in the areas of constitutional law and civil rights litigation. Read Tom's reviews on AVVO. Follow Tom on Linkedin.

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