Day 4: The Lawyers Spoke
It turns out that there are still rules and they are being enforced.
This lecture woke me up to two facts:
1) Even the we received many waivers to the regulations that affect how we practice and bill, we still are responsible to know the law and to follow it.
2) They are people who use the expanding technology to blatantly violate the law and decency for their own benefit even if it hurts people.
It’s really hard for me to sit through a legal lecture, but it was good for me to hear all of these speakers deliver their messages.
It began covering some of the recent waivers from federal agencies that allowed and fueled the massive expansion of telemedicine services, including the addition of 80 new CPT codes and the relaxation of HIPAA while retaining “good and faithful efforts”.
It seems like we are being told, “just do right.”
The presentation also included an outline of the overlapping, and often conflicting, layers of regulations. As the rules change and (potentially) change back, there will be confusion and uncertainty.
The Bad Guys
Several case studies were presented on groups using telemedicine to cheat the system. Operation Double Helix investigated a Cancer Genetics company who allegedly paid doctors to order unnecessary tests and bill Medicare billions of dollars. These doctors never saw the patients when ordering the tests and never provider the results. All with telemedicine.
In April 2020 (middle of the relaxed restrictions) Operation Brace Yourself charged telemedicine companies with providing kickbacks for DME providers of needless neck and back braces.
Criminal telemedicine cases all have limited communication between the patient and doctor, provide prescriptions that are unwanted or not needed and route prescriptions to a specific provider.
Now What?
The Public Health Emergency was originally established for 90 days then extended for 90 more. It is scheduled to end in July. There is a great deal of speculation as to what will happen when the declared emergency ends. Some rules policies can be extended with a simple rule change, others require a literal act of Congress.
Nobody knows.
For those of you who like the details, you should read this.