Fraud, robocalls a concern for CMS when considering permanent coverage for telephone visits

Seema Verma, CMS administrator, spoke Aug. 6 during a videoconference with physicians and healthcare leaders in Massachusetts about telehealth during the pandemic, according to a report from 22 News.

She said although the agency would like to make telehealth benefits permanent, she is still grappling with how to best cover telephone visits to avoid fraud. While visits with established patients make sense, she is concerned about creating an environment that would allow for fraudulent robo-calls to take advantage of the system.

Massachusetts was the highest utilizer of telehealth during the pandemic, with around 50 percent of the state's Medicare fee-for-service beneficiaries conducting virtual visits since March. Gov. Charlie Baker also saw the need for more covered telehealth early and required all private insurers in the state to cover medically necessary telehealth services at the same rate as in-person services during the pandemic.

Massachusetts General Hospital jumped from conducting 800 telemedicine visits weekly to 8,000 virtual visits in a day.

Ms. Verma said President Donald Trump aimed to make telehealth permanent with his executive order issued on Aug. 3, but needs Congress to expand telehealth benefits outside of rural areas. She also stays connected with insurance companies and hopes that private insurers will follow CMS' lead in permanently covering telehealth.


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