Telefraud and OIG focus

Telefraud and OIG focus (CMS Work Plan Audits) Eric Rubenstein, MS, CFE, AdvizeHealth LLC Sean Weiss, CHC, CEMA, CMCO, CPMA, CPC-P, CMPE, CPC, DoctorsManagement, LLC  Telehealth vs. Telefraud – Define and provide examples of each  Carouseling – diabetic testing supplies (inordinate amount) and then then resold to pharmacies, etc.  Historical growth – diabetic testing schemes to pharmacy compounding with shift to DME (Orthotics, Prosthetics, and Braces)  Recent Audit Activity on Telehealth (Audio Only v. Interactive)  OIG and CMS Work Plan - Off Shoring - outside US Telehealth prohibited under the SS Act.  LCDs from Federal and Commercial Payers  Proactive Compliance Measures