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In recent years, telehealth and telemedicine providers have come under increased scrutiny from payors, federal regulators, and state licensing authorities. These audits, investigations, and compliance reviews can have severe consequences, including huge recoupments, network terminations, and even criminal prosecution. If telehealth or telemedicine claims come under scrutiny, it is critical to act immediately to limit potential consequences.
Looking to grow your telehealth practice? Our telehealth attorneys are former government regulators with deep experience navigating multi-state licensing requirements and structuring compliant referral relationships. We help telehealth providers maximize reimbursement by implementing billing and coding strategies designed to meet telehealth insurance requirements and prevent costly denials. Do not wait until your telehealth practice comes under scrutiny. Call us today.
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Former Government Regulators on Your Side – Our team of healthcare defense specialists is spearheaded by former federal and state prosecutors who understand how the government and its contractors use data mining and proprietary algorithms to identify potential Fraud, Waste & Abuse (FWA) for audits and investigation. Because we understand how the government builds cases, we use their playbook to beat them.
Healthcare Specialty Attorneys and Consultants – Health Law Alliance specializes in healthcare law and is dedicated to defending providers and their licenses from overreach. Our founding partner previously served as a top executive for the biggest companies in healthcare, including McKesson, Relay Health, CoverMyMeds, United Health Group, Optum, and United Healthcare. We know the tricks insurance companies use to deny claims, and use that inside information against them.
Proven Track Record – Some clients turn to us when stakes are the highest, when their businesses are threatened, when their license is challenged, and when their options are limited. Our wins against the government and insurance companies can be reviewed HERE. Many more clients, however, turn to us at the first sign of potential trouble, when we can neutralize the problem before it grows. Either way, we have your back from beginning to end.
Frequently Asked Questions About Telehealth Audit Defense & Regulatory Compliance
What kinds of services can I provide via telehealth?
Licensed providers can offer anumber of services to patients on a remote basis, including wellness visits,behavioral, physical, and occupational therapy, and follow-up appointments. Insome cases, providers may also be able to offer prescription managementservices, including prescribing certain medications. However, state laws varywidely in the rules and restrictions placed on telehealth providers. Ourattorneys can help you navigate these complexities with ease.
How can I ensure my telehealth practice is prepared for an audit?
There are many actionable steps you can take to ensure your practice is prepared for an audit. Conducting internal or external self-audits is key, and should include a review of billing, coding, and documentation protocols. Providers should also review their internal compliance programs, policies, and protocols, revising them regularly as new laws and regulations arise. Our team can help ensure your practice is prepared.
My telehealth practice is being audited. Can Health Law Alliance help me with my response?
Absolutely. Our experienced attorneys at Health Law Alliance can guide you through the audit process, from helping you compile the necessary documentation to formulating a defensive strategy to protect your practice. If you receive results you believe are inaccurate, our team can represent you through the appeals process to protect your practice from unwarranted penalties. We’re here to help you every step of the way.
How can I update my compliance protocols to align with federal and state telehealth laws?
Operating a legally compliant telehealth practice requires providers to exercise special care to avoid a number of legal risks, including HIPAA breaches, improper referral arrangements, and billing and coding errors. As attorneys with dedicated compliance experience, our team can offer guidance to help ensure your practice is aligned with all legal requirements.
I want to provide telehealth services to patients outside of my state. What are the licensure requirements for out-of-state telehealth providers?
All states require some form of in-state licensure or approval to treat patients outside of the provider’s state of practice. However, some states have adopted alternatives to allow out-of-state telehealth providers to provide care without going through the full licensure process, including limited licensure exceptions and interstate licensure compacts. Our guidance can help you ensure your practice is compliant with all applicable state licensing laws.
Can I prescribe medications via telehealth?
Generally, DEA-registered providers can prescribe most medications via telehealth. However, restrictions on telehealth prescribing (including the types of eligible medications and requirements for establishing patient-provider relationships) exist at both the state and federal level. Health Law Alliance can help you ensure your prescribing practices are compliant with all applicable laws and regulations.
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