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Preventing Medicare Telefraud Act

USA119th CongressHR-1785| House 
| Updated: 3/3/2025
Lloyd Doggett

Lloyd Doggett

Democratic Representative

Texas

Ways and Means Committee, Energy and Commerce Committee

  • Introduced
  • In Committee
  • On Floor
  • Passed Chamber
  • Enacted
This legislation establishes new requirements under Medicare to prevent potential fraud and abuse associated with certain services delivered via telehealth, focusing on high-cost durable medical equipment and laboratory tests. It aims to ensure a necessary level of in-person patient interaction for these specific items. A key provision prohibits Medicare payment for high-cost durable medical equipment or laboratory tests ordered through telehealth unless the ordering physician or practitioner has provided an in-person service to the patient within the preceding six months. The Centers for Medicare & Medicaid Services (CMS) Administrator will define what constitutes "high-cost" for these items, with these payment restrictions taking effect 180 days after enactment. The bill also mandates that Medicare administrative contractors audit providers who prescribe a high volume of durable medical equipment or laboratory tests predominantly via telehealth, specifically those with 90 percent or more telehealth-based prescriptions over a 12-month period. Additionally, physicians and practitioners will be required to submit their National Provider Identification (NPI) number for all separately billable telehealth services to enhance accountability and tracking.
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Timeline

Bill from Previous Congress

HR 118-1746
Preventing Medicare Telefraud Act
Mar 3, 2025
Introduced in House
Mar 3, 2025
Referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
  • Bill from Previous Congress

    HR 118-1746
    Preventing Medicare Telefraud Act


  • March 3, 2025
    Introduced in House


  • March 3, 2025
    Referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.

Health

Preventing Medicare Telefraud Act

USA119th CongressHR-1785| House 
| Updated: 3/3/2025
This legislation establishes new requirements under Medicare to prevent potential fraud and abuse associated with certain services delivered via telehealth, focusing on high-cost durable medical equipment and laboratory tests. It aims to ensure a necessary level of in-person patient interaction for these specific items. A key provision prohibits Medicare payment for high-cost durable medical equipment or laboratory tests ordered through telehealth unless the ordering physician or practitioner has provided an in-person service to the patient within the preceding six months. The Centers for Medicare & Medicaid Services (CMS) Administrator will define what constitutes "high-cost" for these items, with these payment restrictions taking effect 180 days after enactment. The bill also mandates that Medicare administrative contractors audit providers who prescribe a high volume of durable medical equipment or laboratory tests predominantly via telehealth, specifically those with 90 percent or more telehealth-based prescriptions over a 12-month period. Additionally, physicians and practitioners will be required to submit their National Provider Identification (NPI) number for all separately billable telehealth services to enhance accountability and tracking.
View Full Text

Suggested Questions

Get AI-generated questions to help you understand this bill better

Timeline

Bill from Previous Congress

HR 118-1746
Preventing Medicare Telefraud Act
Mar 3, 2025
Introduced in House
Mar 3, 2025
Referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
  • Bill from Previous Congress

    HR 118-1746
    Preventing Medicare Telefraud Act


  • March 3, 2025
    Introduced in House


  • March 3, 2025
    Referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
Lloyd Doggett

Lloyd Doggett

Democratic Representative

Texas

Ways and Means Committee, Energy and Commerce Committee

Health

  • Introduced
  • In Committee
  • On Floor
  • Passed Chamber
  • Enacted