Medicare fraud

$1.2 Billion International Telemedicine Medicare Fraud Crackdown

MARLENE MAHEU, PhD

April 14, 2019 | Reading Time: 2 Minutes
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Following the execution of over 80 search warrants in 17 federal districts, the CEOs, COOs and others associated with five telemedicine companies, owners of dozens of durable medical equipment (DME) companies as well as licensed medical professionals were indicted for Medicare fraud in early April. In one of the largest health care fraud crackdowns ever investigated by the FBI and the U.S. Department of Health and Human Services Office of the Inspector General (HHS-OIG) and prosecuted by the Department of Justice, 24 defendants were recently indicted for allegations that included telemedicine Medicare fraud. Losses are estimated at being more $1.2 billion.

The April 9, 2019 Department of Justice announcement stated:

The charges announced today target an alleged scheme involving the payment of illegal kickbacks and bribes by DME companies in exchange for the referral of Medicare beneficiaries by medical professionals working with fraudulent telemedicine companies for back, shoulder, wrist and knee braces that are medically unnecessary.  Some of the defendants allegedly controlled an international telemarketing network that lured over hundreds of thousands of elderly and/or disabled patients into a criminal scheme that crossed borders, involving call centers in the Philippines and throughout Latin America.  The defendants allegedly paid doctors to prescribe DME either without any patient interaction or with only a brief telephonic conversation with patients they had never met or seen.  The proceeds of the fraudulent scheme were allegedly laundered through international shell corporations and used to purchase exotic automobiles, yachts and luxury real estate in the United States and abroad.

“These defendants — who range from corporate executives to medical professionals — allegedly participated in an expansive and sophisticated fraud to exploit telemedicine technology meant for patients otherwise unable to access health care,” said Assistant Attorney General Benczkowski.  “This Department of Justice will not tolerate medical professionals and executives who look to line their pockets by cheating our health care programs.  I commend the Criminal Division prosecutors and our partners from U.S. Attorney’s Offices and law enforcement agencies across the country for their unrelenting efforts to stop this alleged fraud before more money was stolen from American taxpayers.”

The alleged telemedicine Medicare fraud cases are being prosecuted and investigated by U.S. Attorney’s Offices nationwide, along with MFSF teams from the Criminal Division’s Fraud Section and from the U.S. Attorney’s Offices in the District of New Jersey, District of South Carolina, Southern District of California, District of Nebraska, Middle District of Florida, Eastern District of Missouri and Western District of Washington; along with agents from the FBI, HHS-OIG, IRS-CI and other federal law enforcement agencies.

The Department of Justice announcement made it clear that “A complaint, information or indictment is merely an allegation, and all defendants are presumed innocent until proven guilty beyond a reasonable doubt in a court of law.” Any licensed professionals potentially involved with the scheme through the following five telemedicine companies are encouraged by the FBI to call the FBI hotline: Video Doctor USA, AffordADoc, Web Doctors Plus, Integrated Support Plus and First Care MD. The FBI hotline can be reached by dialing 1-800-CALL-FBI.
Additional documents related to this medicare fraud announcement will shortly be available here.

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