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DOJ says telemedicine responsible for bulk of latest fraud takedown

DOJ says telemedicine responsible for bulk of latest fraud takedown

WASHINGTON – The Department of Justice has announced criminal charges against 138 defendants for their alleged participation in various health care fraud schemes, including those involving telemedicine and DME, that have resulted in about $1.4 billion in alleged losses. 

Of the total, 43 defendants have been charged for their participation in schemes involving telemedicine, resulting in $1.1 billion in alleged losses. Certain telemedicine execs allegedly paid doctors and nurse practitioners to order unnecessary DME, 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, according to court documents.  

The focus on telemedicine fraud, the DOJ says, builds on the impact of the “Operation Brace Yourself” takedown in 2019, which resulted in an estimated cost avoidance of $1.9 billion in the amount paid by Medicare for orthotic braces in the 20 months following the takedown. 

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