Medicare And MediCal Fraud Likely Involved In Some TeleHealth claims

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The federal government has generally been in favor of TeleHealth since the beginning of the COVID-19 pandemic.  However, a recent report from the Department of Health and Human Services Office of Inspector General found less than 1% of the 742K Medicare-certified doctors billed Medicare nearly $28 million in TeleHealth claims that resulted in a half million claims that are “problematic.â€Â  This is sure to cause further investigation.

Monterey, CA Telehealth Continues To Boom

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Telehealth continues to boom even as the pandemic has begun to slow.  It’s quicker, easier, and doctors can see more patients.  Prior to the pandemic, telehealth made up less than 0.01% of healthcare visits across the United States.  By mid-April of 2020, that number had jumped to 69%.  Both Community Hospital of the Monterey Peninsula, or CHOMP, and Dignity Health care are actively promoting telehealth.  This is particularly great news for those with rare diseases for which there are just a handful of specialists nationwide.  A new study found that 83% of those with rare diseases were offered a telehealth visit by their health care provider and 92% of those felt it was a positive experience.

How Technology Can Reduce Doctor Visits

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Technology is advancing at an incredibly rapid rate and there are now numerous devices that you can buy which will monitor various aspects of your health which may be able to help you reduce doctor visits.  Medical technology placed in the home can allow patients and caregivers to run tests, such as blood pressure and glucose-level readings and ever do kidney dialysis and take X-rays.  In 2020, the Centers for Medicare & Medicaid Services (CMS) issued a statement that “more than 60 different acute conditions such as asthma, congestive heart failure, pneumonia and chronic obstructive pulmonary disease (COPD), can be treated appropriately and safely in home settings with proper monitoring and treatment protocols.â€Â  More and more seniors are taking advantage of this.  The number of U.S. telehealth visits in 2020 was 63x higher than in 2019, according to a study by the Department of Health and Human Services.

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At Home Medical Tests Expanding In The Midst Of COVID-19 Pandemic

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The COVID-19 pandemic seems like it has been going on forever.  However, it has produced some positives such as consumers being more open to test for different medical conditions at home.  Self-diagnostic products are becoming more popular, which has caused medical companies to develop new types of at-home tests, including for flu and strep throat.  Home tests can help people know whether they are sick and can be faster and less costly and more convenient than laboratory-based tests, Nitika Pant Pai, a medical professor at McGill University, told The Wall Street Journal.  At home tests for things like blood-sugar monitoring, pregnancy and HIV have been around for years, however, the pandemic has been able to get this industry moving into high-growth.

 

Telehealth Use Remains Popular With Patients And Physicians

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The use of Telehealth soared during the early days of the pandemic, but still remains strong years into the coronavirus pandemic.  Prior to this crisis, most health care plans covered Telehealth, but very few patients used it.  Social distancing to help reduce the spread of COVID-19 led many health care providers to start delivering more services remotely.  Medicare suspended restrictions on which telehealth services it covered, the geographic location of the beneficiary and whether the visit had to originate in a health care facility.  This further fueled the use of Telehealth by seniors.  A new study used data from Cosmos, a HIPAA-defined Limited Data Set of more than 126 million patients from 156 organizations including data from 889 hospital and 19,420 clinics from 50 states. It found that Telehealth use soared from less than 1% before the pandemic to 13% of outpatient visits in the first 6 months of the pandemic, then declined to 11% during the next 6 month period and was down to 8% in the latest period measured (March-August of 2021).  Still, 8% is a pretty high number and it’s nice seniors still have this option under the current Medicare system.

Telehealth Has Become The Norm For Seniors During The Pandemic

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Telehealth has become a normal part of the daily life of seniors, although there has been a big behind the scene battle being played out as Medicare has threatened to stop reimbursing for these visits once the pandemic has lifted.  However, with the new Omicron strain of COVID-19 spreading like wildfire, for now, at least, Medicare has backed down and extended coverage of remote health care through at least 2023.  Granted, it does have its limitations.  For instance, patients and physicians worry that the lack of face-to-face visits won’t allow the doctor to pick up on subtle clues about the patient’s health that body language might reveal with a personal visit.  However, with 52.7 million Medicare visits clocked last year versus only 840K in 2019, clearly something is working!

Carmel, CA Telemedicine Is Here To Stay, Says Medicare

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More than three times as many Medicare beneficiaries had access to their doctors via a phone or video visit during the pandemic than before, a trend which is likely to continue with the new COVID-19 variant causing another surge in coronavirus cases.  The Kaiser Foundation, which recently conducted a study on this issue, said that expanded telehealth care is really good news for people of color, those with disabilities and low income families.   Those living in rural areas had difficulty getting to the doctor even before coronavirus.  Believe it or not, Monterey County is considered rural and indeed in South and North County populations are spread out over quite a large footprint. Thankfully, in early 2020, Medicare expanded coverage of such visits to enable all enrollees to keep up with their medical care while minimizing their risk of exposure to the coronavirus.  Although the rules only extend through the end of 2021, there are a number of bills in Congress which would make telehealth coverage permanent.

https://www.aarp.org/health/medicare-insurance/info-2021/telehealth-increase-covid-pandemic.html

 

Pebble Beach, CA Telemedicine Is Here To Stay, Says Medicare

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More than three times as many Medicare beneficiaries had access to their doctors via a phone or video visit during the pandemic than before, a trend which is likely to continue with the new COVID-19 variant causing another surge in coronavirus cases.  The Kaiser Foundation, which recently conducted a study on this issue, said that expanded telehealth care is really good news for people of color, those with disabilities and low income families.   Those living in rural areas had difficulty getting to the doctor even before coronavirus.  Believe it or not, Monterey County is considered rural and indeed in South and North County populations are spread out over quite a large footprint. Thankfully, in early 2020, Medicare expanded coverage of such visits to enable all enrollees to keep up with their medical care while minimizing their r4isk of exposure to the coronavirus.  Although the rules only extend through the end of 2021, there are a number of bills in Congress which would make telehealth coverage permanent.

https://www.aarp.org/health/medicare-insurance/info-2021/telehealth-increase-covid-pandemic.html

Pacific Grove, CA Telemedicine Is Here To Stay, Says Medicare

A person holding a stethoscope in front of a laptop.


More than three times as many Medicare beneficiaries had access to their doctors via a phone or video visit during the pandemic than before, a trend which is likely to continue with the new COVID-19 variant causing another surge in coronavirus cases.  The Kaiser Foundation, which recently conducted a study on this issue, said that expanded telehealth care is really good news for people of color, those with disabilities and low income families.   Those living in rural areas had difficulty getting to the doctor e//ven before coronavirus.  Believe it or not, Monterey County is considered rural and indeed in South and North County populations are spread out over quite a large footprint. Thankfully, in early 2020, Medicare expanded coverage of such visits to enable all enrollees to keep up with their medical care while minimizing their r4isk of exposure to the coronavirus.  Although the rules only extend through the end of 2021, there are a number of bills in Congress which would make telehealth coverage permanent.

 

https://www.aarp.org/health/medicare-insurance/info-2021/telehealth-increase-covid-pandemic.html