On September 17, the U.S. Department of Justice (DOJ) announced criminal charges against 138 defendants for alleged healthcare fraud schemes that resulted in $1.4 billion in losses. Those charged included 23 doctors, 19 nurses and other licensed professionals, and 96 laypeople, in 31 federal districts across the U.S.
Telehealth-related fraud accounted for about $1.1 billion of the total, while the remainder included schemes involving illegal opioid distribution, substance abuse treatment facilities, and false billings related to the COVID-19 pandemic. The telehealth fraud involved alleged kickbacks and bribes to doctors and nurse practitioners to order unnecessary durable medical equipment (DME), genetic and other diagnostic testing, and pain medications, either without any patient interaction or with only brief telephone conversations with patients they had never met. The defendants allegedly spent the money on luxury items, including vehicles, yachts and real estate.
Telehealth fraud, often involving fraudulent genetic and cancer testing, has been a frequent target for DOJ over the past two years. The COVID-19 actions built upon a previous coordinated takedown in May, which was discussed here. DME fraud has also been a recent DOJ focus, as discussed here.