Telehealth is transforming healthcare, and remote patient monitoring (RPM) is leading the way. But in 2025, the Office of Inspector General (OIG) is zeroing in on RPM services—meaning that providers using RPM face audits and investigations from federal regulators, Medicare Administrative Contractors (MACs), and even private payors. Even small errors in documentation or coding can quickly snowball. The result? Major financial consequences for your practice.
At Health Law Alliance, we partner with telehealth providers to navigate the complicated legal landscape of telehealth regulations and RPM payor requirements. We help you get paid fairly and avoid big risks, giving you peace of mind to use and bill for RPM services with confidence.
· Comprehensive Audit Preparation: We review your practices to find and fix compliance risks before audits happen.
· Appeals and Legal Representation: Our team represents you throughout the audit process, from handling communications with regulators and auditors to navigating appeals.
· Ongoing Compliance Guidance: Our attorneys create custom compliance plans for your practice. We tailor our advice to your unique risk areas to catch billing errors before they become vulnerabilities.
Don't wait until the OIG comes knocking. Partner with Health Law Alliance today to keep your telehealth practice protected and compliant. Call us now.
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Recent Wins
Win over Optum
- PBM audit uncovered 25,000 unit discrepancy of Zegerid and other violations.
- PBM referred "fraud" to Massachusetts Attorney General—Medicaid Fraud Control Unit (MFCU).
- MFCU indicted Pharmacy & Owner on numerous criminal charges, including False Claims & Larceny.
- After HLA was retained, State dropped all charges before trial and abandoned the prosecution.
- Owner admitted no wrongdoing and was not excluded; Pharmacy avoided all network sanctions.
Win over CVS
- PBM audit uncovered $6.5 million inventory shortfall in compound cream APIs.
- PBM referred "fraud" to U.S. Attorney's Office for the Eastern District of Pennsylvania, FBI, and HHS-OIG.
- After HLA was retained, federal prosecutors declined to bring criminal charges against Owner.
- Client settled case for $2.5 million, or less than 40% of the government's claimed loss on claims paid.
- Owner admitted no wrongdoing, was not excluded, and suffered no licensing or other consequences.
Win over ESI
- PBM audit uncovered $600,000 inventory shortfall in brand and generic medications.
- PBM referred "fraud" to Pennsylvania Attorney General—Medicaid Fraud Control Unit (MFCU).
- MFCU opened grand jury investigation against Pharmacy and Owner for Medicaid Fraud and Theft.
- After HLA was retained, State declined to bring criminal charges against Owner.
- MFCU charged the Pharmacy, a corporate entity, instead.
