DMERx, an online DME platform, served as the basis for a massive fraud against Medicare and other insurers. Gregory Schreck, a Kansas man who was the vice president of DMERx, orchestrated a sophisticated fraud scheme to bill Medicare and other insurers over $1 billion, resulting in payments of over $350 million. The scheme used DMERx’s
Telehealth
NYS OMIG Publishes 2025 Work Plan
On January 29, the New York State Office of the Medicaid Inspector General (OMIG) published its 2025 Work Plan, which provides a preview of the OMIG’s program integrity initiatives for the upcoming year. While this post highlights several areas that the OMIG will focus on, Medicaid providers should refer to the Work Plan for…
DEA Announces New Telemedicine Rules Expanding Access to Controlled Substances
On January 16, the U.S. Drug Enforcement Administration (DEA) announced three new telemedicine rules that extend prescribing flexibilities for controlled substances, following the expiration of temporary flexibilities granted during the COVID-19 pandemic. The new rules, which include both final and proposed regulations, aim to balance patient access with safeguards against misuse.
The rules apply only…
Some COVID-Era Medicare Telehealth Waivers Extended through March 31
The American Relief Act, 2025, signed into law on December 21, included a short-term extension of certain telehealth waivers that went into effect in the early days of the COVID-19 Public Health Emergency. These waivers, for telehealth services provided to Medicare beneficiaries, had been set to expire on December 31, but have now been…
Telehealth for 2025: Federal and State Legal Changes and Trends
On Thursday, December 12, in the next installment of Rivkin Radler’s Healthcare Compliance Lunch & Learn series, Rivkin Radler Partner Eric D. Fader will present an update on the regulatory landscape for the provision of telehealth services, including the latest trends and recent changes to federal and state laws and rules. The program will take…
Know When to Bill Facility Fee for Telehealth Services!
The U.S. Attorney’s Office for the District of Connecticut recently announced that Supportive Care Holdings, LLC and its related companies agreed to pay the federal government nearly $4,600,000 to resolve allegations of submitting false claims. The Supportive Care companies provide behavioral health services via telehealth to patients residing in skilled nursing facilities.
Supportive Care’s companies…
AG Garland Announces Nationwide Healthcare Enforcement Action
On June 27, U.S. Attorney General Merrick Garland announced the results of a two-week nationwide law enforcement action by the Department of Justice (DOJ) in 32 federal districts against 193 defendants for their participation in a variety of healthcare fraud schemes. These federal enforcement actions also included the seizure of more than $230 million in…
NP Gets Jail Time for DME Fraud Scheme
On April 10, Virginia-based nurse practitioner Daphne Jenkins was sentenced to prison for her participation in a $7.8 million telemedicine fraud scheme that involved medically unnecessary orders for durable medical equipment (DME). As part of the scheme, Medicare claims were submitted based on false documentation and tainted by kickbacks.
The orders Jenkins signed were pre-populated…
2024 Medicare Physician Fee Schedule Extends Telehealth Flexibilities
The 2024 Medicare Physician Fee Schedule final rule, released by the Centers for Medicare & Medicaid Services (CMS) earlier this month, extended certain telehealth-related flexibilities that were implemented during the early days of the COVID-19 pandemic. CMS issued a Fact Sheet summarizing the telehealth updates, as well as other important Medicare policy changes.
Until 2020…
OCR Releases Resource Documents on Telehealth Risks
The U.S. Department of Health and Human Services’ Office for Civil Rights (OCR) recently released two resource documents to help healthcare providers explain the privacy and security risks of telehealth to their patients.
The first document, entitled “Educating Patients about Privacy and Security Risks to Protected Health Information when Using Remote Communication Technologies…