Toolkit: analyzing telehealth claims to assess program integrity risks
- Collection:
- Health Policy and Services Research
- Uniform Title(s):
- Toolkit (Department of Health and Human Services. Office of Inspector General)
- Contributor(s):
- United States. Department of Health and Human Services. Office of Inspector General. Office of Evaluation and Inspections, issuing body.
- Publication:
- Washington, D.C. : U.S. Department of Health and Human Services, Office of Inspector General, April 2023
- Language(s):
- English
- Format:
- Text
- Subject(s):
- Data Analysis Fraud -- prevention & control Government Regulation Insurance Claim Review Medicaid Medicare Telemedicine United States
- Genre(s):
- Technical Report
- Abstract:
- This toolkit provides detailed information on methods to analyze telehealth claims to identify program integrity risks associated with telehealth services. It is based on the methodology that the Office of Inspector General (OIG) developed for the report Medicare Telehealth Services During the First Year of the Pandemic: Program Integrity Risks (OEI-02-20-00720), which identified Medicare providers whose billing for telehealth services poses a high risk to Medicare. To address this risk, OIG called for targeted oversight of telehealth services. This toolkit is intended to assist public and private sector partners - such as Medicare Advantage plan sponsors, private health plans, State Medicaid Fraud Control Units, and other Federal health care agencies - in analyzing their own telehealth claims data to assess program integrity risks in their programs. Gaining a better understanding of the program integrity risks associated with telehealth services can help policymakers and stakeholders develop necessary safeguards and address individual cases of potential fraud, waste, and abuse. Doing so will help ensure that the benefits of telehealth are realized while minimizing risk in an effective and efficient manner.
- Copyright:
- The National Library of Medicine believes this item to be in the public domain. (More information)
- Extent:
- 1 online resource (1 PDF file (24 pages))
- Illustrations:
- Illustrations
- NLM Unique ID:
- 9918716087106676 (See catalog record)
- Permanent Link:
- http://resource.nlm.nih.gov/9918716087106676