Telemedicine CEO pleads guilty in $424 million Medicare fraud scheme

Henry Kotula

The owner of telemedicine company Video Doctor Network on Friday pleaded guilty for his role in what the Justice Department is calling one of the largest healthcare fraud schemes prosecuted to date in the U.S. Bribes Dept of Justice (DOJ) Fraud Kickbacks Medicare Medicare Fraud Telemedicine

Why It's Time to Embrace Telemedicine


What’s this new thing called Telemedicine? For starters, it’s not new! I t’s more than 40 years old and was developed as a way to use improvements in communication technology to bring quality medical diagnoses and care to individuals in remote parts of the world.

Medicare Opens the Door to Reimbursement for Remote Patient Monitoring

Digital Health Today

When CMS unveiled the first standalone reimbursement for Remote Patient Monitoring (“RPM”) by “unbundling” CPT Code 99091 in the 2018 Medicare Physician Fee Schedule , it opened the door to the widespread use of RPM services for patients and promised there was more to come.

Medicare Reimbursement for Remote Monitoring Should Drive Adoption (What a long, strange trip it’s been….)

The cHealth Blog

The Centers for Medicare & Medicaid Services (CMS) released the 2018 Physician Fee Schedule about two weeks ago and there is at least one nugget in there that should speed the adoption of remote patient monitoring.

Utilizing Telehealth to Improve Home Dialysis

Health Recovery Solutions

i] In a recent speech to kidney disease patients and advocates, Health and Human Services (HHS) Secretary, Alex Azar, stated that Medicare was making a concerted effort to expand the utilization of At-Home Dialysis, including expanding telehealth services.

Do Medicare providers located at a Distant Site have to be hospital-based to provide services?

South Central Telehealth Resource Center

Q: Per Medicare regulations, do the providers at a distant site have to be hospital-based or can they be in a private setting – for example, a group of pulmonologists who want to create a telehealth system on their own? Also, all telehealth services must meet the Medicare established set of criteria for reimbursement. Click here to visit the Medicare Eligibility Analyzer site. To review CCHP information on Medicare, go to: [link]. Medicare

Heart Health at #CES2019 – Food and Tech as Medicine

Health Populi

An important example of this self-care approach is the evidence-based Ornish food regimen which is reimbursed by Medicare (as a form of cardiac rehabilitation). Self-care is the new health care as patients, now consumers at greater financial risk for medical spending, are learning.

Confronting the Diabetes Epidemic – with Tom Daschle

Insulin Nation

By his estimates, 1 in 8 health-care dollars and 1 in 3 Medicare dollars in the U.S. Centers for Medicare and Medicaid Services recently slashed the federal government’s reimbursement rate for most diabetes test supplies by 72 percent. Living Video

Telehealth holds appeal for seniors, survey shows

Healthcare IT News - Telehealth

Of the seniors who are willing to use telehealth, 84% said they would use it for prescription renewals, while more than two-thirds said they would consider using video chats to manage chronic conditions.

Ohio Living achieves low readmission rates with telehealth

Healthcare IT News - Telehealth

percent, nearly half of the state’s Medicare average, by introducing telehealth services. The face-to-face video conferencing allows our nurses to build relationships with patients and continually engage with them and educate them."

Master Guide to Telehealth Statistics for 2019

Enzyme Health

Medicare currently covers many telehealth services depending on coverage level and geography, but still faces some restrictions, with Medicare Advantage plan beneficiaries (about 14 million patients) receiving the broadest access ( ATA Telehealth Basics ).

Essential Telemedicine Terms Clinicians Should Know

Enzyme Health

CMS : Stands for the Centers for Medicaid and Medicare Services. CMS is the federal agency that administers HIPAA standards and develops Medicaid and Medicare reimbursement policies for telemedicine. HD video requires faster internet connection speeds for proper image transmission.

How Maximizing Telehealth Reimbursement Policies Will Change Healthcare for the Better

InTouch Health

By 2030, the Medicare-eligible population in the United States is expected to reach 69.7 Meanwhile, Medicare’s acute care costs are expected to soar to around $259.8 In addition to seeing patients in-person, providers can reduce costs, improve patient outcomes, and increase patient access using virtual care technology, including live “face-to-face” video, “store and forward” patient consultations, and remote patient monitoring.

CMS Proposes Major Expansion of Reimbursement for Telehealth Services

care innovations

Reimbursement for telehealth services by the Centers for Medicare and Medicaid Services (CMS) has long been a point of contention. Senators: Medicare Reimbursement Restrictions Are ‘Outdated’.

Can you identify 7 qualities of a successful telehealth program?

South Central Telehealth Resource Center

New legislation at state and federal levels is making it possible for telehealth services to be reimbursed by Medicare, Medicaid and private insurance carriers. In addition to self-pay patients, reimbursement can be sought through Medicaid, Medicare and commercial/private payers.

Bringing Telehealth to the Rehabilitation Industry

Advanced Medical Reviews

As the Center for Connected Health Policy (CCHP) notes, different telehealth modalities include: Live video: referred to as “synchronous” format and uses live interaction between two parties over video.

Reimbursement Update: It’s raining new codes!

The cHealth Blog

In that post, I had referenced the Lemony Snicket movie, “A Series of Unfortunate Events,” noting that Medicare reimbursement for remote monitoring was just the opposite: it was the culmination of a series of fortunate events.

Telemedicine Reimbursement

American Well

In a national study of over 2,000 consumers , 64% said they would be willing to have a telehealth visit with their doctor via video. And more than half of doctors themselves are willing to see patients over video. Medicare . A Final Note – Medicare Advantage.

Understanding the Value of Remote Patient Monitoring

InTouch Health

Using a range of wearable devices and live video and audio, providers can use this technology to ensure their patients are adhering to prescribed treatment methods and recovering as planned. They can use live video and audio and wearable devices like heart monitors, ankle bracelets, and blood sugar monitors to monitor and record a patient’s health status from a remote location. Why More Hospitals and Health Systems Are Investing in RPM.

The 2019 Invasion of Disruptors in Healthcare (Part 2) — Google, Lyft, Uber, IBM

Phoenix Health Systems

Many have connected with health providers through online messaging, apps, texting and video chat. In a strategic windfall, the Centers for Medicare and Medicaid Services (CMS) announced last April that it would cover non-emergency transport, freeing up hundreds of thousands of dollars for rideshare companies. Earlier this year Lyft announced an expanded partnership with Medicare Advantage plans for people over 65 with BlueCross BlueShield and Humana.

ATA Releases Updates on Telemedicine Coverage and Reimbursement

InTouch Health

As of 2019, 16 states will only cover real-time telehealth services, such as provider-patient consulting using live audio and video. Other states are starting to cover audio-only telehealth services, which can benefit patients and providers in areas where broadband access can be hard to come by and video feeds can be unreliable. 13 states use integrated care for Medicare-Medicaid dual-eligibles and four states use HCBS waivers.

The Evolution of Self-Care for Consumers – Learning and Sharing at CHPA

Health Populi

Payors have begun to recognize the value of nudging consumers toward over-the-counter products under Medicare Advantage plans. Here’s a video that talks about some of these findings – with the tagline, “Don’t waste your day feeling sick. Self-care in health goes back thousands of years.

NVNA and Hospice expands telehealth pilot, cuts readmission rates

Healthcare IT News - Telehealth

A further expansion of the program is planned for next month, providing the tablet program to hospice patients in the community, offering educational videos and 24-hour access to a nurse, among other features.

Why telemedicine and remote patient monitoring demand will skyrocket in 2019


According to Deloitte’s 2018 Survey of US Physicians , only 23% of patients have had video visits and just 14% of physicians have video visit capability. While video visits are only one aspect of telemedicine, these numbers make it clear that the technology still has not reached the point of mass adoption and use. Technologies include video conferencing, the internet, store-and-forward imaging, streaming media, and terrestrial and wireless communications.

Three Trends Shaping the Future of Telehealth

Advanced Medical Reviews

Comprised mostly of remote patient monitoring, video conferencing, mobile health and the electronic transmission of medical information via a secure transmission, telehealth is commonly used in the medical fields of dermatology, urology, chronic disease, intensive care and mental health.

Extending Care Series: 3 Key Considerations for Telehealth Adoption


That being said, recent US legislation expanding reimbursement from Medicare, Medicaid, and private payers has provided a significant incentive to make the leap from traditional in-person care to virtual services.

EMR 62

April 2019 Telemedicine News

Enzyme Health

billion telemedicine Medicare fraud scheme between a handful of US telemedicine companies, dozens of durable medical equipment companies, and a few licensed medical professionals could limit patient’s trust in telemedicine and increase insurance concerns over malpractice. The device is meant for the home, allowing patients to perform comprehensive medical exams and then use the TytoHome app to send the data and connect with a healthcare provider for a video consult.

Why Alexa’s bedside manner is bad for health care

Lloyd Price

Logic holds that some digital health tools have tremendous potential: A neurologist can view a patient by video to see if lopsided facial movements suggest a stroke. It makes sense: A doctor can’t use a stethoscope to listen to lungs or wiggle an otoscope into a kid’s ear by video.

What Are the Factors Driving Telehealth Growth in 2019?

care innovations

Video visits are more convenient and sometimes even require a lower co-pay than an in-person appointment,” writes Kate Ashford in a Forbes rundown of the survey’s findings.

Value-based or Fee-For-Service Connected Health Reimbursement: Which Canoe Should We Put Our Feet In?

The cHealth Blog

Medicare ACOs are based largely on a shared savings model. For the population that Medicare defines as ours, providers get paid through the usual Medicare financial channels (i.e., If I am a doctor seeing Medicare patients, I still get paid for office visits and procedures.

The Role of Case Management in Healthcare


By using dedicated managers to handle 750 different Medicare beneficiaries, this payer-provider union reduced readmisssions by 56 percent compared to Medicare-covered individuals in Maine who weren’t receiving any specific attention of this variety.

Virtual Reality Applications in Workers’ Compensation Reviews

Advanced Medical Reviews

Until very recently, only the video game industry saw much success with commercial VR products, but advancements in the accessibility of this technology have spurred innovative applications of VR in the healthcare industry. For years, many insurance carriers offered limited coverage options for such telehealth consultations conducted via phone/VoIP or video conference, for several reasons, including: Lack of a clear definition of what services qualified as telemedicine.

Experts: Telemedicine in Healthcare Nearing ‘Tipping Point’

care innovations

There's so much more to a program than just the technology,” advise our experts in a series of educational videos from the RPM Academy. RPM goes beyond technology by starting with an overall program design,” explains Care Innovations CEO Randy Swanson in a video from the RPM Academy.

The Top 10 Questions Physicians Ask About Telehealth

American Well

Video-based telehealth enables a two-way, face-to-face conversation between the patient and provider that allows you to see the patient and guide them through a physical examination, as well as see elements of their environment for more informed decision-making. #2:

Weekender 3/8/19

HIStalk Weekender

The original Obamacare bill had a subscription-based expansion of Medicare, i.e. a 25-year-old could pay premiums directly to Medicare for enrollment. For math warm-ups, we often watch videos that help my students learn to count to 100 by 1s, 2s, 5s, and 10s. Weekly News Recap.

Getting Started with Telehealth


CCHPCA State Laws and Reimbursement Policies and their State Telehealth Laws and Reimbursement Policies PDF (April 2017) – This resource also you to stay up to date on all Telehealth laws, policies, regulations, and Medicare/Medicaid programs state by state. Medicare.

Can you identify 7 qualities of a successful telehealth program?

South Central Telehealth Resource Center

New legislation at state and federal levels is making it possible for telehealth services to be reimbursed by Medicare, Medicaid and private insurance carriers. In addition to self-pay patients, reimbursement can be sought through Medicaid, Medicare and commercial/private payers.

The Top Telehealth Terms to Know

American Well

Appointment Scheduling: In addition to on-demand video visits, patients and physicians can schedule video appointments with one another. Multiway video can be used for a range of reasons, from clinical collaboration and family care, to translation services.

USDA Telehealth Report Sees ‘Lag’ in Rural Access

care innovations

The Centers for Medicare & Medicaid Services (CMS) loosened its reimbursement requirements for remote care in 2018, with a further expansion set for 2019. A CMS proposal would also expand coverage telehealth services for Medicare Advantage plans.”. A new U.S.

Why telemedicine is a great option for Medicaid recipients

American Well

Anecdotally, we’ve had partner health systems tell us that their Medicaid populations are actually the most savvy about finding free sources of wifi, and often know how to make video calls through this free wifi alone, saving them any data usage or call minute fees.