If enacted, HB1746 will adjust the current Medicare reimbursement protocols significantly, specifically targeting healthcare providers who depend heavily on telehealth for patient consultations. By requiring an in-person visit prior to the prescription of high-cost items, the bill intends to combat the rising tides of Medicare fraud. The Centers for Medicare & Medicaid Services (CMS) will play a critical role in defining what constitutes 'high-cost durable medical equipment' and will oversee the implementation of these new regulations.
Summary
House Bill 1746, titled the 'Preventing Medicare Telefraud Act', seeks to amend Title XVIII of the Social Security Act by introducing new regulations concerning the provision of high-cost durable medical equipment and laboratory tests through telehealth services. The bill stipulates that payment for such expensive medical items can only be made if the prescribing physician has met with the patient in-person at least once in the preceding six months. This provision aims to ensure that telehealth services do not facilitate fraudulent claims and that patients receive necessary in-person assessments before being prescribed costly equipment or tests.
Contention
The bill presents areas of potential contention, particularly between healthcare providers who advocate for telehealth and those who believe tighter regulations are necessary. Proponents argue that the in-person visit requirement can enhance patient care and reduce fraud, while opponents express concerns that this could limit access to care for patients, especially those in underserved or remote areas who rely on telemedicine. The tension between improving oversight and maintaining access is likely to be a key point of debate.
Preventing Medicare Telefraud ActThis bill establishes conditions for payment of certain telehealth services, laboratory tests, and durable medical equipment under Medicare.Specifically, the bill conditions payment for certain high-cost laboratory tests and durable medical equipment that are ordered via telehealth on at least one in-person visit during the preceding six-month period. Additionally, practitioners must submit claims for separately billable telehealth services under the practitioner's unique national provider identification number.