Ryan K. Cochran, Member of the Firm in the Health Care & Life Sciences practice, in the firm’s Nashville office, co-authored an article in Medical Economics, titled “Patient Monitoring Services Need Increased Scrutiny to Prevent False Claims Act Enforcement Action.”

Following is an excerpt:

Lenders to, buyers of, and managers of medical practices, rural health care clinics, and federally qualified health centers should increase their due diligence of remote patient monitoring services used by physicians. Physicians should also increase their scrutiny of the remote patient monitoring services they use.

Telehealth Prevalence Grows

The Centers for Disease Control and Prevention reported that in 2021, 37% of adults had used telehealth services in the last twelve months. Telehealth can be provided through video chats, remote patient monitoring devices, and phone calls. Remote patient monitoring involves the collection and analysis of patient data used to develop and manage a treatment plan related to a chronic or acute health condition. Remote patient monitoring can benefit patients by eliminating the time and cost of travel to a provider. Remote patient monitoring can also increase a patient’s adherence to a treatment plan.

For physicians, patient monitoring services can increase net patient revenue. Chronic Care Management is one of several monitoring services to help patients stay on track by getting support for their chronic illness between visits. Chronic Care Management is coordinated services done outside of the regular physician office visits. These services are typically not face-to-face and allow eligible practitioners to bill for at least 20 minutes or more of care coordination services per month with an average reimbursement of $38-$65 per qualifying patient. Physicians should consider patient monitoring services as a way to increase the quality of patient care and increase net patient revenue.

While there are many reputable patient monitoring services, there is no concrete way to determine if a patient monitoring service is reputable. However, there are guidelines that must be followed for patient monitoring services to comply with CMS guidelines, and those guidelines should be confirmed by the patient monitoring service provider in advance of delivering the services like patient eligibility, consent, certified EHR, allotted time per patient, patient care plan, coding compliance and good record keeping for auditing purposes.

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