Preventing Medicare Telefraud Act

HR 1746, the Preventing Medicare Telefraud Act, requires that Medicare not pay for high-cost durable medical equipment or laboratory tests ordered via telehealth unless a patient had an in-person visit with the provider within the prior six months. It also mandates that providers submit their actual National Provider Identifier (NPI) number when billing for telehealth services, rather than using a placeholder. Providers who order 90% of their durable medical equipment or lab tests via telehealth will trigger mandatory audits to verify compliance. The bill applies to Medicare beneficiaries seeking these specific services and takes effect after the pandemic emergency period ends.