These schemes involve telemedicine companies paying practitioners in exchange for prescribing telemedicine services to patients, often when these services are not medically necessary. This type of behavior violates the federal Anti-Kickback Statute, according to the July 20 report.
The OIG report created a list of behaviors that should alert practitioners to potential fraud:
- The telemedicine company or an associated telemarketing service identifies the patients for whom the practitioner orders or prescribes medical items.
- The practitioner doesn’t have enough contact or information about the patient to assess whether these items are medically necessary.
- The telemedicine company pays the practitioner based on the volume of items prescribed to patients.
- The telemedicine company only provides to patients who are beneficiaries of federal healthcare.
- The telemedicine company says they provide items and services to only nonfederal patients; however, they bill federal healthcare.
- The telemedicine company only provides one type of healthcare product or service. This behavior can restrict practitioners’ treatment options.
Read the full report here.
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