The Justice Department alleges that some telemedicine executives paid doctors and nurse practitioners to order unnecessary medical equipment.
Photo: Graeme Sloan/Sipa USA/ASSOCIATED PRESS
This article is in your queue.
The Justice Department has brought criminal charges against nearly 140 people, including medical professionals, for alleged healthcare fraud schemes that resulted in an estimated $1.4 billion in losses.
Around $1.1 billion of the alleged fraud involved telemedicine, with more than 43 criminal defendants in 11 judicial districts allegedly submitting false and fraudulent claims for remote health visits.
Some telemedicine executives allegedly paid doctors and nurse practitioners to order unnecessary medical equipment, diagnostic testing and pain medications, according to the Justice Department. The orders and tests were done either without any patient interaction or over a brief phone conversation with patients who had never been seen. Defendants spent the proceeds on luxury items, including yachts and real estate, the department said.
Assistant Attorney General Kenneth A. Polite Jr. says the Justice Department worked with 28 U.S. attorneys’ offices as well as federal and state law-enforcement agencies.
Photo: Rod Lamkey/CNP/Zuma Press“We are stopping corrupt medical professionals in their tracks,” Assistant Attorney General Kenneth A. Polite Jr., of the Justice Department’s Criminal Division, said Friday.
Of the 138 charged, 42 were doctors, nurses and other licensed medical professionals.
Mr. Polite said the Criminal Division worked in coordination with 28 U.S. attorneys’ offices around the country, as well as the Federal Bureau of Investigation, the Department of Health and Human Services Office of Inspector General, the Drug Enforcement Administration and other federal and state law-enforcement agencies.
In addition to the alleged telemedicine fraud, nine defendants allegedly exploited the Covid-19 pandemic, submitting more than $29 million in false billings. The Justice Department said one plan involved defendants’ misusing patient information to submit claims to Medicare for medically unnecessary and expensive tests.
An additional $133 million was connected to false and fraudulent claims for treatment for substance and alcohol addiction, the department said. Several charges against medical professionals and others involve prescribing more than 12 million doses of opioids and other prescriptions, while submitting over $14 million in false billings.
“These fraudulent activities prey on our most vulnerable—those in pain, the substance-addicted, and even the homeless,” said DEA Administrator Anne Milgram. “Not only do these schemes profit from desperation, but they often leave their victims even deeper in addiction.”
Mr. Polite said there were more than 70,000 opioid-related deaths in 2020.
Write to Talal Ansari at Talal.Ansari@wsj.com
Copyright ©2021 Dow Jones & Company, Inc. All Rights Reserved. 87990cbe856818d5eddac44c7b1cdeb8