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OIG Work Plan Includes Review of Medicare Payments for Telehealth Services

Posted in Hospitals and Institutions, Legislation and Public Policy, Medicare and Medicaid, Reimbursement Matters

The updated Work Plan published this month by the U.S. Department of Health and Human Services Office of Inspector General (OIG) includes a new audit of Medicare claims paid for telehealth services. The audit section of the Work Plan may be found here.

Medicare Part B covers expenses for telehealth services if they meet certain requirements set forth in 42 CFR § 410.78(b):

  • The services are on the Medicare telehealth list;
  • The services are provided through live, interactive videoconferencing between a beneficiary located at a rural originating site and a practitioner located at a distant site; and
  • An eligible originating site must be the practitioner’s office or a specified medical facility, not a beneficiary’s home or office.

The OIG audit will review telehealth claims to determine whether the paid services met Medicare requirements.

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