Foley & Lardner LLP partner Thomas (T.J.) Ferrante is quoted in the Inside Health Policy article, “Recent OIG RPM Fraud Alert Points To Possible Takedown,” about a recent consumer fraud alert issued by HHS’ Office of the Inspector General on remote monitoring scams. Specifically, the OIG’s focus on RPM-related fraud could bring new challenges for those in the telehealth industry as they pursue legislation to expand coverage and reimbursement of remote monitoring technologies.
Ferrante noted that, “Telehealth stakeholders argue that the fraud identified in OIG’s recent alert was not really RPM fraud but instead was pharmacy and durable medical equipment fraud, and they worry conflating the two could complicate their legislative efforts. But the OIG’s move to alert consumers of the scheme likely means it is already looking to bring enforcement action.” He continued, “When you have seen these in the past, typically, shortly thereafter, there is a major takedown. That means it is already happening right now. It is already in the works.”
He went on to explain that the RPM consumer fraud alert is similar to previous OIG fraud announcements of alleged telemedicine fraud. “If the idea of remote monitoring and fraud become linked, it could create new hurdles for movement on bills in Congress that seek remote monitoring payment reform, especially efforts to lessen the 16-day data reporting requirement for billing,” he said.
“The fraud alert, and any potential ensuing actions against companies,” said Ferrante, “could help keep legitimate remote monitoring providers on the straight and narrow to stay compliant.” He recommended that remote monitoring companies review their billing practices to “ensure they are billing to the letter of the CPT codes.”