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Feds charge 138 medical professionals with $1.4B in healthcare fraud, including telehealth schemes

by Heather Landi | September 20, 2021

The Department of Justice on Friday announced criminal charges against 42 doctors and nurses and nearly 100 other medical professionals for alleged healthcare fraud schemes that cost $1.4 billion in losses.

The charges target approximately $1.1 billion in fraud committed using telehealth services, $29 million in COVID-19 healthcare fraud, $133 million connected to substance abuse treatment facilities, or “sober homes,” and $160 million connected to other healthcare fraud and illegal opioid distribution schemes across the country, according to the DOJ in a press release.

“These fraudulent activities prey on our most vulnerable—those in pain, the substance-addicted, and even the homeless—those who are most susceptible to promises of relief, recovery, or a new start,” said Drug Enforcement Administration (DEA) Administrator Anne Milgram in a statement. “Not only do these schemes profit from desperation, but they often leave their victims even deeper in addiction. We are grateful to our partners who stand with us to keep our communities safer and healthier through our collective efforts to prevent the misuse and over-prescribing of controlled medications.”

According to court documents, certain defendant telemedicine 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 telephonic 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 over $1.1 billion in false and fraudulent claims to Medicare and other government insurers. In some instances, medical professionals billed Medicare for sham telehealth consultations that did not occur as represented, according to the DOJ in a press release.

The defendants then allegedly spent the money on luxury items, including vehicles, yachts and real estate.  

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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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