Telehealth Update: Controlled Substances & E/M Claims

Prior to the COVID-19 public health emergency (“PHE”), the federal Ryan Haight Act allowed a provider to prescribe controlled substance medications to a patient only after conducting an in-person evaluation of that patient (with limited exceptions). At the beginning of the PHE, the Drug Enforcement Agency (“DEA”) granted temporary exceptions to the in-person requirement and …

DEA Reverses Course and Extends Telehealth Prescriptions of Controlled Substances

Reversing previously proposed rules, the DEA recently issued new guidance allowing the continued use of telehealth when prescribing controlled substances following the end of the Covid-19 public health emergency (“PHE”). Waivers of the requirement for in-person encounters that were in place during the PHE will remain in effect for practitioner-patient telehealth relationships established as of …

Telehealth Update: Telehealth Waivers Post-PHE and Fraud and Abuse

The current Public Health Emergency expiration deadline is this month.  However, the Secretary of the Health and Human Services indicated he would provide a 60-day notice before ending the PHE in order to minimize disruptions and potential loss of government and private insurance coverage.  That notice has not yet occurred.  Therefore, we expect another 90 …

White House issues recommendations on telehealth and SUD services – Part II

On June 22, 2022, via the Legislative Analysis and Public Policy Association, the White House Office of National Drug Control Policy (ONDCP) released its “Telehealth and Substance Use Disorder Services in the Era of COVID-19: Review and Recommendations” (Guidance). While this publication does not have the force of law, it is clear direction to legislators …

White House Issues Recommendations on Telehealth and SUD services

In June 2022, the White House Office of National Drug Control Policy (ONDCP), via the Legislative Analysis and Public Policy Association, released its “Telehealth and Substance Use Disorder Services in the Era of COVID-19: Review and Recommendations” (the “SUD Recommendations”). Although this publication does not have the force of law, it provides clear directions to …

Post-Pandemic HIPAA Guidelines for Audio-Only Telehealth

The Department of Health and Human Services (“HHS”) recently announced guidelines for the application of the Health Insurance Portability and Accountability Act of 1996 (“HIPAA”) to audio-only telehealth encounters following the end of the declaration of the COVID-19 public health emergency (“PHE”). As reported here at the beginning of the Covid-19 pandemic, the HHS Office …

Telehealth Fraud Year in Review

The Department of Justice recently released their Year in Review summary of activity by the Healthcare Fraud Unit, detailing enforcements efforts related to some of the more significant telehealth-related fraud claims in 2021. The DOJ’s litigation unit significantly expanded last year to support the Fraud Unit, resulting in material criminal prosecutions and sentences. Since 2019, …

Telehealth Fraud Enforcement Activity

As anticipated, the federal government has been monitoring the potential for fraud and abuse involving telehealth.  Providers, lab owners, and medical equipment companies have been recent targets of investigations.  The government’s attention has focused on claims related to durable medical equipment and lab testing. In September, the Department of Justice announced a nationwide enforcement action …

New Safe Harbors for Telehealth

New and modified safe harbors to the Stark Law and Anti-Kickback statue allow healthcare providers and entities more flexibility to create and expand telehealth platforms in compliant fashion. On November 20, 2020, the Centers for Medicare & Medicaid Services (“CMS”) and the Office of the Inspector General (“OIG”) finalized the rules modifying the safe harbors …

New CMS “Guidance” – Clear As Mud

The Centers for Medicare and Medicaid Services recently issued new guidance for healthcare providers on documenting and reporting electronic clinical quality measures (“eCQMs”) for telehealth encounters.  The new guidance was intended to provide clarity but may in fact lead to more confusion about what claims will be reimbursed if provided by telehealth methods as opposed …