Bills · HR 1785
IN COMMITTEE· 119TH CONGRESS
House BillHR 1785Health
Preventing Medicare Telefraud Act
INTRO MAR 3· LAST ACTION MAR 3
READING
5MIN
COSPONSORS
0
READER REACTIONS0 TOTAL
NO VOTES YET · BE THE FIRST
- Introduced only
LEGISLATIVE PROGRESS
STEP 2 / 8Introduced
In Committee
Reported
Passed House
Passed Senate
Conference
To President
Became Law
WHAT THE BILL DOES
AI-writtenThis bill matters because it addresses concerns about potential fraud and waste within the Medicare system, specifically linked to telehealth services that grew significantly during the pandemic. By requiring an in-person visit before ordering high-cost medical equipment or lab tests via telehealth, the bill aims to ensure a direct patient-provider relationship and medical necessity, potentially saving taxpayer money and preventing fraudulent claims for unnecessary items or services.
If this bill becomes law, it could lead to a reduction in certain types of Medicare fraud but might also create new hurdles for some Medicare beneficiaries and providers who rely heavily on the convenience of telehealth for all their care. If it doesn't become law, the current rules for ordering durable medical equipment and lab tests via telehealth would remain, leaving the system potentially more vulnerable to the types of fraud this bill seeks to prevent.
KEY PROVISIONS
5AI-extractedPROVISION 01
Medicare will not pay for high-cost durable medical equipment ordered via telehealth unless the ordering provider saw the patient in-person within the previous six months.
This aims to ensure medical necessity and a direct patient relationship for expensive items, potentially reducing fraud.
PROVISION 02
Medicare will not pay for high-cost laboratory tests ordered via telehealth unless the ordering provider saw the patient in-person within the previous six months.
This is intended to prevent unnecessary or fraudulent high-cost lab tests ordered remotely.
PROVISION 03
The Centers for Medicare & Medicaid Services (CMS) will define what constitutes "high-cost durable medical equipment" and "high-cost laboratory tests."
This gives CMS the authority to determine which specific items and tests fall under these new restrictions.
PROVISION 04
Medicare administrative contractors will audit providers who order 90% or more of their durable medical equipment or lab tests through telehealth visits.
This provision targets providers who might be primarily using telehealth to facilitate high volumes of orders, increasing oversight.
PROVISION 05
Providers must submit their National Provider Identifier (NPI) number for separately billable telehealth services for Medicare payment.
This ensures proper identification of the billing provider for all telehealth claims, improving accountability.
SPONSORSHIP
1 + 0
D· Texas
YRS IN OFFICE
31
BILLS LED
26
ACTION TIMELINE
2 EVENTSMAR 3
Introduced in House
MAR 3
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 INFO
TypeHouse Bill
NumberHR 1785
Congress119th
StatusIn Committee
IntroducedMar 3, 2025
Last actionMar 3, 2025
READER REACTIONS
OVERALL SENTIMENT
No reactions yet. Be the first to weigh in.
Discussion
Loading comments...
IN COMMITTEE· 119TH CONGRESS · WAYS AND MEANS COMMITTEE · INTRODUCED MAR 3, 2025
House BillHR 1785Health
Preventing Medicare Telefraud Act
INTRODUCED MAR 3, 2025· LAST ACTION MAR 3, 2025
PASSAGE CHANCES
—%
READING
5 min
COSPONSORS
0
COMPLEXITY
Moderate
