The Office of Inspector General has found that many states do not conduct telemedicine specific to monitoring even if they report concerns regarding fraud, waste, and abuse.
The US Department of Health and Human Services Office of Inspector General has issued a data brief this month. It aims to offer an insight into the state evaluations and the oversight of behavioral telehealth.
The brief has examined the oversight efforts of January and February of 2020. This brief stems from a survey of Medicaid directors from 37 states and structured interviews with relevant stakeholders.
CMS and state efforts are about to evaluate and oversee telehealth which is critical to meet Medicaid enrollees’ behavioral health needs. Also, it is necessary to safeguard the Medicaid programs from potential fraud, waste, and abuse.
In response to the pandemic, patients have turned to telemedicine for the need of behavioral health. Though tele-behavioral health gets offered through live, two-way video, some states allow audio-only, text-only, or email connection.
According to OIG, these services are highly necessary. Medicaid enrollees experience a higher rate of disorders in behavioral health than the general population. Also, many go undiagnosed.
OIG has found that most of the states can identify the services of telehealth, while a few have reported being unable to limit their ability to evaluate and oversee the poor program. Only a few states have evaluated the effects of telehealth. Others believe that virtual care can have uncertain impacts on costs.
The agency also noted that 23 out of 37 states had reported fraud, waste, and abuse, which are the concerns of using telehealth.
OIG has issued some of the recommendations for the US Centers for Medicare and Medicaid Services. It also recommended to ensure that the three states who are unable to distinguish between in-person services and telehealth must take necessary indicators to do so.
States must conduct evaluation and support the efforts to evaluate the effects of telehealth access, quality, and cost. States must conduct monitoring for fraud, waste, and abuse.
Fraud is a concern for many stakeholders that creates obstacles in the future of telehealth. OIG said that it was working on significant work to assess the telehealth service during the public health emergency.