Foley & Lardner LLP partner Thomas (T.J.) Ferrante is quoted in The Information article, “A Healthtech Unicorn Leaves a Trail of Clinic Complaints, Concerns Over Billing Practices,” about Athelas, a health care startup, and questions being raised about its billing practices.
In 2020, the company expanded its business by helping clinics offer remote patient monitoring services through a variety of devices, and for health care providers, seek to sign up eligible patients for remote monitoring and manage the billing process related to the services. But employees raised concerns about some of the company’s billing practices for this remote patient monitoring.
Ferrante said, “One reason was that to receive reimbursement from insurers for the use of a remote monitoring device, CMS requires that patients’ devices collect and transmit health data for at least 16 days out of 30, a rule intended to limit reimbursement to situations when patients consistently use their devices. While CMS guidance applies to federal programs like Medicare and Medicaid, it is common for commercial insurers to follow the agency’s lead.”
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