Wednesday, April 19, 2023 Revenue Integrity Insider - National Association of Healthcare Integrity (NAHRI
The Office of Inspector General (OIG) announced it will audit CMS’ use of remote patient monitoring services. The review will focus on the nature of these services, as well as the characteristics of Medicare enrollees who use them.
In addition, the OIG will look for any indications of fraud, waste, or abuse in provider billing for remote patient monitoring services. The audit will be based on Medicare fee-for-service claims and Medicare Advantage encounter data.
Although there is limited research on this topic, the OIG is hoping to find more information about the relevant types of patients, providers, and health conditions. The report is expected to be released in fiscal year 2024.
Remote patient monitoring falls under CMS’ telehealth umbrella. The agency defines it as "the use of digital technologies to collect health data from patients in one location and electronically transmit that information securely to providers in a different location.”
CMS previously released provider-specific fact sheets and a transition roadmap for the COVID-19 public health emergency (PHE) conclusion, which is expected to take place on May 11. These documents detail policies, including telehealth policies, that will end with the PHE, as well as flexibilities that have been extended for various time periods. NAHRI recently released resources on significant Medicare PHE extensions and adjustments for hospitals and critical access hospitals, rural health clinics and Federally Qualified Health Centers, and physician services.
Revenue integrity professionals should prepare for the PHE conclusion and ensure their organization is in compliance with CMS telehealth requirements, including those for remote patient monitoring services.