FWA Briefs

Relaxed telehealth restrictions is a necessary step to limit potential COVID-19 exposure in physician offices in the emergency period. With this change, unfortunately, the US Justice Department estimates telehealth-related fraud has expanded significantly since early 2020 – approximated at 4.5 billion dollars.

The role of nutrition in chronic disease management is especially crucial, as it is a modifiable risk factor for many conditions such as chronic renal failure (CRF), diabetes mellitus (DM), obesity and coronary artery disease (CAD). Payers who bear significant long-term healthcare utilization burdens due to obesity and cardiovascular risk factors may determine that Medical Nutrition Therapy (MNT) preventive coverage is a cost-effective policy approach for their beneficiaries.

During the pandemic, healthcare claim fraud prevails as new fraud schemes develop and adapt to the changes in healthcare guidelines enacted, so providers can continue to treat patients. Two major areas of FWA expansion during the pandemic include Telehealth and COVID-19-related laboratory testing add-on services.

Context4 Healthcare is thrilled to announce that our Medical Director Dr. Steve Nesnidal has earned certification as an Accredited Health Care Fraud Investigator (AHFI), an important healthcare anti-fraud professional designation from the National Health Care Anti-Fraud Association (NHCAA).

Context 4 Healthcare and VBA co-host webinar on Fraud, Waste and Abuse Prevention Strategies.