Hundreds in US charged in $6B medical fraud schemes

TNT Newsline October 1, 2020 2 minutes read

The U.S. Justice Department on Wednesday announced charges against 345 people for committing over $6 billion in medical fraud.

Those charged include more than 100 doctors, nurses and other medical professionals who filed fraudulent claims to federal health care programs and private insurers, according to the Justice Department.

The bulk of the fraud — $4.5 billion — was connected to telemedicine, which has surged during the pandemic.

For example, the Cleveland Clinic went from averaging 5,000 telemedicine visits a month before the pandemic to 200,000 visits just in April, the Associated Press reported.

“Telemedicine can foster efficient, high-quality care when practiced appropriately and lawfully. Unfortunately, bad actors attempt to abuse telemedicine services and leverage aggressive marketing techniques to mislead beneficiaries about their health care needs and bill the government for illegitimate services,” U.S. Health and Human Services Deputy Inspector General Gary Cantrell said in a statement. “Unfortunately, audacious schemes such as these are prevalent and often harmful.”

According to the Justice Department, some telemedicine company executives allegedly paid doctors and nurse practitioners to order unnecessary medical equipment, medical tests and pain medications without interacting with a patient or with only a brief telephone conversation with a patient they had never 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,” according to a statement from the Justice Department.

In addition to telemedicine fraud, other defendants were charged with more than $845 million worth of fraud related to substance abuse facilities, and more than $806 million was connected to other health care fraud, including the illegal distribution of opioids.

“This nationwide enforcement operation is historic in both its size and scope, alleging billions of dollars in health care fraud across the country,” Acting Assistant Attorney General Brian C. Rabbitt said in a statement. “These cases hold accountable those medical professionals and others who have exploited health care benefit programs and patients for personal gain.” (VOA)