A report by the United States Department of Justice (DOJ) identified $4.5billion in fraudulent medical billing related to telehealth scams.
Telehealth executives are giving their company’s data to telemarketers who target patients – mostly seniors – and direct them to get a COVID-19 test. But, while they are at it, they also get them to take a number of unnecessary and expensive tests.
And here’s the billion-dollar money trail:
“Samples are sent to labs for processing, and telehealth providers give the necessary referrals for the labs to get reimbursed.
“The telemarketers make money by charging the labs that will eventually file the claim.
“Labs make money by charging for unnecessary tests.
“And telehealth providers are paid both by the telemarketers for the data, and by labs for the referrals.”
In the end, it adds up to a staggering $4.5 billion scam.
Of course, not all people are abusing the system. And, as we have long stated, telehealth is a great tool to lower costs and expand access – when done right.
These scams show is the importance of making sure telehealth is done right.
Legislation like the General Assembly’s proposed House Bill 149 could, unfortunately, exacerbate telehealth’s vulnerabilities and lead to even more fraud.
Not only does the proposal allow you to be billed for every phone call, email and text message, it also mandates you pay for anything - from home birth to physical therapy and phlebotomy -through telehealth if you'd also pay for it in-person.
High costs are nothing new to the healthcare industry. But telehealth has the potential to be a cost-saver.
We shouldn’t squander that potential by passing laws that open the door for more excessive billing and fraud.