FinancialRegulatory

DOJ charges 86 defendants with $4.5 billion in telehealth fraud

October 1, 2020 / Jeff Lagasse, Associate Editor

The Department of Justice on Wednesday charged 345 people, including doctors, nurses and other medical professionals, across 51 federal districts in what the agency is calling the largest healthcare fraud takedown in history. 

The charges are in connection to cases accounting for more than $6 billion in losses, including more than $4.5 billion connected to telehealth.

According to court documents, 86 defendant telehealth executives allegedly paid doctors and nurse practitioners to order unnecessary durable medical equipment, genetic and other diagnostic testing, and pain medications, either without any patient interaction or with only a brief phone conversation with patients they had never met or seen.  

Durable medical equipment companies, genetic testing laboratories, and pharmacies then purchased those orders in exchange for illegal kickbacks and bribes and submitted false and fraudulent claims to Medicare and other government insurers.  

In addition to the criminal charges, the Centers for Medicare and Medicaid Services’ Center for Program Integrity separately announced that it has taken a number of administrative actions related to telehealth fraud, revoking the Medicare billing privileges of 256 additional medical professionals for their involvement in various schemes.

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Josh Sandberg

Josh Sandberg is the President and CEO of Ortho Spine Partners and sits on several company and industry related Boards. He also is the Creator and Editor of OrthoSpineNews.

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