Lack of evidence for telehealth fraud

Abstract

Despite evidence to the contrary, U.S. policy makers, payers, and the public continue to express apprehension that the use of telehealth is associated with increased risk of fraud and abuse. The fraudulent use of telehealth is multifaceted and complex, ranging from potentially false claims to miscoding, inaccurate billing, and kickbacks. For the past 6 years, the U.S. Federal Government has undertaken research studies to examine potential fraud issues related to the use of telehealth, including up-coding time spent with the patient, misrepresentation of the service provided, and billing for services that were not rendered. This article reviews previous efforts to assess the risk of fraud associated with the delivery of virtual care in America, concluding that there is little evidence for higher levels of fraud and abuse related to the use of telehealth.

Keywords: Telemedicine; cost; fraud; program integrity; telehealth.