The Toolkit lists the steps for analyzing telehealth claims and identifies program integrity measures to apply to telehealth claims data. The Toolkit is intended to be used by public and private parties, including Medicare Advantage plan sponsors, private health plans, State Medicaid Fraud Control Units, and other Federal healthcare agencies to identify providers whose billing practices may present a high risk and warrant further review. The Toolkit appears to be driven by the OIG’s concerns about the increased risk of fraud, waste, and abuse in connection with the recent explosion of telehealth utilization.
Department of Health and Human Services Office of Inspector General (“OIG”) published a new toolkit titled “Analyzing Telehealth Claims to Assess Program Integrity Risks” designed to analyze claims data for telehealth services and identify program integrity risks to Federal healthcare programs (“Toolkit”).
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