OIG to review Medicaid telehealth payments amid an increase in claims

Audit with magnifying glass
OIG plans to audit Medicaid telehealth payments, adding to a review of Medicare payments announced earlier this year. (Getty/cacaroot)

The Department of Health and Human Services’ Office of the Inspector General (OIG) plans to audit Medicaid payments for telehealth services to gauge compliance with reimbursement requirements.

The OIG added the review to its work plan this week, noting that Medicaid programs are “seeing a significant increase” in claims for telehealth and telemonitoring services, a trend the watchdog agency expects will continue. The report is scheduled for 2019.

“We will determine whether selected States' Medicaid payments for services delivered using telecommunication systems were allowable in accord with Medicaid requirements,” the OIG update read.

RELATED: More than half of executives plan to grow their telehealth program, creating an ‘Amazon effect’ in healthcare

It adds to another audit announced by the agency over the summer, which plans to review Medicare Part B telehealth payments. That review includes a specific focus on telehealth claims provided at distant sites that do not have corresponding claims to originating sites. In an update issued last month, the OIG pushed the date of that report to 2018.

Nathaniel Lacktman, a partner at Foley & Lardner who chairs the firm’s telemedicine team, said those two audits are clear indication that the federal government expects to see a spike in telehealth claims as more providers expand their programs.

“If they thought [telehealth] wasn’t getting traction or material amounts of money, they wouldn’t add it to the work plan,” he told FierceHealthcare.

According to a report released last week by the Center for Connected Health Policy, 48 states and Washington, D.C., reimburse for live video telehealth visits, and 15 allow payments for store-and-forward technology. But those laws still vary widely from state to state.