Department of Justice’s Focus on Telemedicine Fraud

With Covid-19 still surging throughout the United States, telemedicine has expanded as a viable option for patients seeking to limit their exposure to doctors’ offices. To meet this need, Federal and State regulators have both implemented and increased a number of measures allowing telemedicine to reach more people, as well as cover more areas of practice.

With any expansion of services, combined with a global health pandemic, the government expects that there will be individuals who abuse the system for their own financial gain. The Department of Justice (DOJ) and the U.S. Department of Health and Human Services, Office Inspector General (HHS-OIG), have targeted many such abuses. Federal law enforcement have netted scores of arrests involving telemedicine operations around the country.

Recent announcements by U.S. Attorney’s Offices and DOJ in New Jersey, Florida, Pennsylvania, Georgia, South Carolina, and New York reveal some

common patterns of fraud. Many schemes involve telemedicine companies pushing Durable Medical Goods (DME), such as braces for wrists, elbows, knees and backs, in addition to genetic tests for cancer and other diseases, to Medicare recipients. These companies employ or contract with marketing companies to locate potential beneficiaries and push as many products as possible on an often vulnerable population of patients. The telemed companies employ physicians that have little to no contact with the patient, prescribe medically unnecessary tests or DME, and are paid on a “per patient,” or prescription basis. A number of telemed-company executives have been charged with soliciting illegal kickbacks and bribes in exchange for unnecessary orders of DME and genetic cancer tests. Charges to date allege more than $4.5 billion in fraud to Medicare and other providers. Healthcare fraud continues to be a major federal and state prosecution initiative around the country.

Stahl Gasiorowski Criminal Defense Lawyers have successfully represented dozens of telemedicine companies, physicians, sales and marketing employees, as well as laboratory owners charged with healthcare fraud. To contact the firm’s NJ office, call 908.301.9001 and to contact the firm’s NYC office, call 212.755.3300, or email Mr. Stahl at rgs@sgdefenselaw.com.