COVID-19 has changed and redefined how we do things, how we interact with one another and how healthcare can be accessed. Everything is tech-reliant now, our food, shopping for groceries, our working environment, social gathering and as it turns out even healthcare. Telemedicine is being hailed as the most reliable and beneficial tech in decades. While this statement is indeed true, one cannot and should not overlook the liabilities this technology brings.
Telemedicine has helped save lives and has aided in offsetting the revenue losses incurred as a consequence of the pandemic. It has drastically increased emergency response time. It has helped ease the load and optimise ER and OR facilities. This tech has prioritized patient engagement and consumer satisfaction, both key elements to success and longevity of a business, which is guaranteed to be a good ROI plan. If one has to list direct and indirect benefits of telemedicine, it would be miles long. But considering all that, it cannot be denied that this tech while old in inception, its acceptance and implementation is somewhat new and it has not been made secure.
In the wake of COVID-19, the government needed to ensure that its people had access to safe healthcare and as a result with the help of several waivers and relaxations, telemedicine was endorsed, popularized and widely implemented. In fact telemedicine is one of the handful sectors that profited as a result of the pandemic. The healthcare sector began aggressively investing and developing in the technology, which paved the way for Telemedicine to be valued at a $176 billion industry by 2026.
When people began to realize the importance and advantages of virtual services, they turned a blind eye to the possible risks of this technology. There are many reasons why telemedicine was not so widely adopted prior to the pandemic, chief among them being that it is not fully secure. It can be exploited and given the chance it can be used against the very people it is meant to treat. It is no exaggeration to say that, anything connected to the internet, given enough time and resources can be hacked and telemedicine is a tech that solely relies on the internet. Even prior to telemedicine, hospitals & health systems fell victims to ransomware attacks and other cyber attacks, which compromised patient data. Some of the researchers feel that with the unprecedented rise of telemedicine, there is going to be an unprecedented rise of patient data theft and other related crimes.
Real Example Of Telemedicine Fraud
Let us take a look at one of the biggest telemedicine frauds that occurred in the few months after telemedicine became popular.
Charlene Frame, an operator of two telemedicine companies in Georgia has been charged in a $60 million telemedicine fraud scheme. The key details of this ongoing case are:
- Charlene Frame, an operator at Royal Physician Network and Envision It Perfect, is accused of conspiring to pay physicians and nurses in exchange for durable medical equipment orders.
- The charges against Ms. Frame is the latest in a slew of telemedicine-related fraud cases. Eight physicians, two nurse practitioners and two other telemedicine company operators were previously charged, along with durable equipment company owners.
- Ms. Frame is the 23rd person charged in the fraud operation, and the financial total for thousands of orders facilitated through her two companies exceeds $60 million.
- There have been about $470 million in fraud charges in the Southern District of Georgia, part of a national U.S. Justice Department crackdown.
- As of date, this investigation is still ongoing.
This example is just the case of an obvious fraud. There are other cases where fraud is subtle or in some genuine cases unintentional. Like the case of a patient in New York named David Dekeyser, who reported to Kaiser Health News, that he was charged $280 without notification for a virtual visit with a physician for COVID-19 concerns. Mr. Dekeyser was ultimately able to get the bill reversed. Not all of us can be that fortunate.
The reason why these cases exist is because telemedicine has been allowed to grow wild without any particular check and balance system. It is a newly adopted tech and they are making up the rules on a trial and error basis. In a recent announcement on permanency of telemedicine, Ms. Seema Verma, the CMS Administrator said, “ I think the genie’s out of the bottle on this one. I think it’s fair to say that the advent of telehealth has been just completely accelerated, that it’s taken this crisis to push us to a new frontier, but there’s absolutely no going back.”
In fact telemedicine has already been so aggressively implemented that on March 28, The Wall Street Journal reported that CMS telehealth visits went from 10,000 per week to 300,000 per week, and the agency expects that to increase. To the same effect, the Massachusetts General Hospital, further illustrates the growth of telemedicine where, from conducting 800 telemedicine visits weekly they jumped to 8,000 virtual visits in a day.
Due to all this growth, the concern for safety has been steadily mounting. As a result steps are being taken to ensure the safe telemedicine services. A recent report from 22 News states that on Aug. 6th, Ms. Verma, spoke during a videoconference with physicians and healthcare leaders in Massachusetts about telehealth during the pandemic. She said although the agency would like to make telehealth benefits permanent, she is still grappling with how to best cover telephone visits to avoid fraud. While visits with established patients make sense, she is concerned about creating an environment that would allow for fraudulent robo-calls to take advantage of the system.
One can conclude from this that, at the very least the government is aware of the risk and is cautiously navigating the uncharted territory, also known as telemedicine security. While disadvantages and liabilities exist because exploiters have found a new venue to take advantage and defraud people, one needs to understand that, there is no completely secure tech, at least not when the tech is still evolving and is in its developmental stage. Fortunately, the majority of the people understand that and realize that the benefits outweigh the flaws and are willing to trust telemedicine services and as long as that trust exists, telemedicine can evolve and be developed to be made safe for all.
At BillingParadise, we understand the importance and the need for telemedicine services. That is why we ensure that we provide our clients with end-to-end IT and billing support along with a robust, secure & compliant telemedicine platform at affordable rates.
