Industry Voices—Relaxing telehealth regulations does not mean relaxing fraud enforcement


Patricia Calhoun and Patricia Carreiro

The COVID-19 pandemic rapidly expanded telemedicine use. Telehealth currently addresses everything from routine to pandemic-related care.

To facilitate this expansion, federal healthcare programs have loosened, at least temporarily, telehealth restrictions.

These eased restrictions, however, create increased opportunities for healthcare fraud and abuse, including Anti-Kickback Statute (AKS) and False Claims Act (FCA) violations.

Recent telehealth regulation changes and telehealth scrutiny

The Department of Health and Human Services (HHS) and the Centers for Medicare & Medicaid Services adjusted their telehealth requirements to expand telehealth’s ability to serve patients during the pandemic:

Patients no longer need to reside in designated rural areas or have preexisting relationships with their providers.

Patients can have their telehealth appointments from the convenience and safety of their homes without traveling to medical facilities.

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