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(3) The telemedicine company compensates the Practitioner based on the volume of items or services ordered or pre- scribed, which may be characterized to the Practitioner as compensation based on the number of purported medical records that the Practitioner reviewed.
(4) The telemedicine company only furnishes items and services to Federal health care program beneficiaries and does not accept insurance from any other payor.
(5) The telemedicine company claims to only furnish items and services to individuals who are not Federal health care program beneficiaries but may in fact bill Federal health care programs.
(6) The telemedicine company only furnishes one product or a single class of products (e.g., durable medical equip- ment, genetic testing, diabetic supplies, or various pre- scription creams), potentially restricting a Practitioner’s treating options to a predetermined course of treatment.
(7) The telemedicine company does not expect Practitioners (or another Practitioner) to follow up with purported patients nor does it provide Practitioners with the information required to follow up with purported patients (e.g., the telemedicine company does not require Practitioners to discuss genetic testing results with each purported patient).
The Alert clarifies that the above list is not exhaustive, and the presence or absence of any one of the suspect characteris- tics is not determinative of whether an arrangement would be grounds for legal sanctions, such as criminal, civil, or admin- istrative liability (including possible disciplinary action against the Practitioner’s health professional license or registration). The Alert encourages Practitioners to use heightened scrutiny and exercise caution before entering into an arrangement with a telemedicine company.
For this purpose, physicians who are considering entering into an arrangement with a telemedicine company should con- sult with legal counsel to review any written agreement with the telemedicine company and to ensure that the arrangement is legitimate and enables the physician to comply with applica- ble state and federal laws. For example, Michigan law prohibits a physician or other health professional from providing a tele- health service without directly or indirectly obtaining consent for treatment. Proof of such consent must be maintained in the patient’s up-to-date medical record that is retained in accor- dance with the Public Health Code’s medical record retention requirements. In addition, Physicians should ensure that they provide telemedicine services only to patients who are located in states in which the physician is licensed or authorized to provide telemedicine services. •
NCMIC
Third Quarter 2022
Detroit Medical News 19