WASHINGTON – Members of the Government Accountability Office testified before Congress last week saying, while Medicare beneficiaries and providers have benefitted from program waivers and other flexibilities, their continued use beyond the pandemic increases risks and raise considerations. 

Among those risks and considerations: 

  • Increased spending: Telehealth waivers can increase spending in both Medicare and Medicaid, if telehealth services are furnished in addition to in-person services. 
  • Program integrity: The suspension of some program safeguards has increased the risks of fraud, waste and abuse that the GAO previously noted in its high-risk report series. 
  • Beneficiary health and safety: Although telehealth has enabled the safe provision of services, the quality of telehealth services has not been fully analyzed. 

CMS has issued more than 200 waivers and other flexibilities for Medicare. Telehealth waivers, the GAO points out, have resulted in utilization increasing from a weekly average of about 325,000 services in mid-March to a peak of about 1.9 million in mid-April 2020. 

“The long-term effect of these waivers on spending and quality of care is not yet known,” wrote Jessica Farb, director, health care, and Carolyn Yocom, director, health care, in their testimony. “In addition, we reported that careful monitoring and oversight is warranted to prevent potential fraud, waste and abuse that can arise from these new waivers.” 

CMS has approved more than 600 waivers or other flexibilities for Medicaid. 

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