The U.S. Pandemic Response Accountability Committee’s Health Care Subgroup recently issued a report identifying program integrity risks posed by the increased use of telehealth by federal programs during the COVID-19 pandemic. The report suggests additional oversight steps that Medicare and other relevant federal programs should take to address potential fraud and abuse stemming from telehealth services. This report underscores that government watchdogs will continue to closely scrutinize the spike in telehealth usage that took place during the pandemic.
During the first year of the pandemic, six U.S. agencies spent more than $6.2 billion on telehealth services. The majority of the spending was in the fee-for-service Medicare program, which accounted for $5.1 billion (Medicare Advantage expenditure data are unavailable). Overall, the number of individuals that used telehealth services in the selected programs from March 2020 through February 2021 soared to approximately 37 million, compared with approximately 3 million from the year preceding the emergence of COVID-19. Medicare had the largest increase, with over 80 times the number of individuals using telehealth during the first year of the pandemic compared to the prior year. Much of this increase is due to the billing flexibilities offered by the Centers for Medicare & Medicaid Services (CMS) during the pandemic.