In December 2020 the Pandemic Response Accountability Committee (PRAC) issued the report: Insights on Telehealth Use and Program Integrity Risks Across Selected Health Care Programs During the Pandemic. To better understand the PRAC and the report, we spoke with Erin Bliss, Assistant Inspector General for Evaluation and Inspections at the Office of Inspector General for the Department of Health & Human Services.
As she explains in this podcast, the PRAC was formed as an outcome of the CARES Act. Its mission is to promote transparency and coordinate oversight of the federal coronavirus response; prevent and detect fraud, waste, misuse and mismanagement; and identify risks across agencies. The Offices of Inspector General from HHS, Justice, Veterans Affairs, Defense, Labor and Office of Personnel Management are all PRAC members.
The report revealed how great an increase there was in telehealth. In the first year of the pandemic, telehealth usage increased from roughly 3 million people across six federal programs to 37 million. This change was largely the result of an expansion of the Medicare rules, which previously had limited telehealth to rural communities during in-office visits.
While few today dispute the value of telehealth, that does not mean its use has not come without challenges. More data, the report notes, is still needed for oversight of telehealth’s use and impact, particularly on quality of care. In addition, data collection policies need to be improved since many providers have kept only rudimentary information.
At the same time, the report identified activity that indicated waste, fraud and abuse. These included billing the same service twice, billing for extremely high amounts of telehealth services, billing for services that did not seem appropriate for telehealth, and billing at the highest, most expensive level.
If there is good news to these findings, it is that the risks are ones already familiar to healthcare providers. Established risk management and compliance tools will likely be useful.
Listen in to learn more about what the report revealed and what steps you can take, including active monitoring, to ensure the integrity of your organization’s telehealth services.