Last month, the Department of Health and Human Services (“HHS”) Office of Inspector General (“OIG”) issued a report that identified deficiencies in the ability of states to root out fraud, waste, and abuse in Medicaid mental health services delivered by telehealth (“Report”).
The Report surveyed 37 states about their Medicaid programs. Of those states, the Report described that three states are unable to identify if behavioral health services were rendered by telehealth, thereby “limiting their ability to evaluate and oversee telehealth.”
The Report highlighted the importance of offering behavioral health services, particularly with respect to Medicaid, given that nearly one-fifth of all Medicaid enrollees have a behavioral health diagnosis. However, 23 of the 37 states surveyed stated that fraud, waste, and abuse was a concern with using telehealth to provide behavioral health services. Despite this concern, many states explained that their Medicaid program integrity included little to no efforts that specifically targeted telehealth, and several noted the difficulty they experience in overseeing and verifying that telehealth services are provided appropriately.
“Given the importance of telehealth in Medicaid during the pandemic,” the OIG recommended that states “need to identify the services provided via telehealth so that they can better understand the effects of telehealth on access, cost, and quality of behavioral health services for Medicaid enrollees.” Moreover, the OIG noted that it was “increasingly important that States evaluate the effects of telehealth to inform their decisions about how they will use telehealth in the future.”
How Frier Levitt Can Help
The surge in the use of telehealth to deliver behavioral or mental health care services, coupled with the deficiencies identified by the OIG Report, makes the area of telebehavioral health ripe for enforcement. As such, providers rendering care to Medicaid beneficiaries via telehealth should take steps to confirm that their treatment comports with applicable law. Specifically, providers must evaluate the propriety of any financial relationships involving potential referral sources or recipients. In addition, providers must ensure that their treatment of Medicaid beneficiaries meets both state telehealth requirements, and the requirements for reimbursement of a telehealth visit imposed by the applicable Medicaid programs. Contact Frier Levitt to discuss your telebehavioral health program, or your concerns related to telehealth.
