Telemedicine practices involved in Medicare fraud crackdown

Jun 15 2021

Medical professionals have had to make drastic changes to remain competitive in the modern marketplace. Long gone are the days of doctors having close relationships with every member of a family or knowing the details of their patient’s medical histories without checking their charts.

Modern doctors see far more patients, and those seeking care have started to expect treatment that values their time more than the standard waiting room experience at an office does. Telemedicine is increasingly in demand. Patients are busier than ever and many don’t want the hassle of an in-person appointment for something simple like an external referral or a review of flu-related symptoms.

There are many benefits to telemedicine

Telemedicine has become a way for doctors to connect with more patients with less risk of infection spreading between patients in waiting areas or treatment rooms. Telemedicine makes care accessible without transportation or long waits.

However, telemedicine, like many forms of digital business, can make it easier for some people to commit fraud. Those working at a telemedicine medical practice, especially in support or billing positions, should know about the risks that come along with this change in business model.

It has never been easier for professionals to bill fraudulently

Telemedicine appointments are easy for patients to attend, but they are easy for unscrupulous medical care providers to falsify. Patients may have less clear memories about the care they receive when they don’t have to go to an appointment in person.

It will be easier for a physician to submit duplicate appointments through telemedicine practices without patients recognizing the overbilling. Anyone involved in fraudulent medical billing activity, including office staff at a medical facility, could find themselves facing serious white-collar criminal allegations due to improper or illegal billing practices.

The state and federal governments watch for Medicare fraud

Every older adult has the right to Medicare benefits, but that doesn’t mean the government just approves any claim that comes in. Given the widespread issues with medical provider fraud, coordinated enforcement efforts between state and federal authorities shouldn’t surprise anyone.

In a recent crackdown that involved fraudulently billing for telemedicine appointments and multiple other kinds of fraudulent Medicare billing activity, interstate efforts led to arrests and fraud cases, including some here in New York.

Facing health care fraud charges related to insurance billing could limit your career options unless you fight back against those allegations to protect your reputation and future.

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