Over the last few years, the telehealth industry has exploded and will likely become the primary source for various types of care in the future. Both healthcare providers (hospitals, physicians, mental/behavioral health professionals, etc.) and the technology companies that support them need to understand the impact that various regulatory and payment requirements can have on their business operations and relationships.
Key Takeaways
- Accepting Medicare and Medicaid requires strict adherence to compliance obligations. Providers need to understand the Anti-Kickback Statute, the Stark Law, and various complex enrollment and billing rules. When establishing compliance mechanisms for a telehealth program, operate as if Medicare will be a payor source.
- Understand the various perspectives of government. While Congress appears to consider telehealth as the way of the future, regulatory agencies, state medical boards, and state pharmacy boards may be more wary due to past experience.
- Substantive physician involvement is critical. Lax oversight on the provision of telehealth services or issuance of prescription drugs may be major areas of regulatory focus.
- Exclusive arrangements must be carefully scrutinized to ensure they do not violate the Anti-Kickback Statue, which is a complex, “facts and circumstances” based test and nontraditional telehealth relationships will require careful analysis.
Note: This presentation was one of the most popular in the 2019 Technology May-rathon webinar series.