There are several Federal fraud and abuse laws that apply to health care professionals.  Two of those have the greatest potential implications for telehealth and include the Anti-Kickback Statute and Stark Law.

  • Anti-Kickback Statute:  This law prohibits the knowing and willful payment of "remuneration" to induce or reward patient referrals or the generation of business involving any item or service payable by Federal health care programs (e.g., Medicare).  This practice is often known as "paying for referrals".  For telehealth, this could mean "giving away:" software licenses, telehealth equipment, peripheral devices and more.
  • Physician Self-Referral Law (Stark Law): This law prohibits physicians from referring patients to receive "designated health services" payable by Medicare ore Medicaid from entities with which the physician or immediate family member has a financial relationship, unless an exception applies.

With that said, it would be useful to read these two article by the Center for Connected Health Policy for a better context and understanding when it comes to fraud and telehealth:

Resources:

  • Self-Referral Disclosure Protocol:  This is the Medicare self-referral disclosure protocol, enabling providers of services and suppliers to self-disclose actual or potential violations of the physician self-referral statute.