Several recent telemedicine-related cases have helped to underscore the seriousness with which regulators are approaching fraudulent billing schemes. In April, United States Attorneys in Pennsylvania charged a Nevada man with wire fraud for submitting more than $4.8 million in fraudulent claims to private health insurance companies, the United States, and Pennsylvania. According to DOJ, the scheme consisted of the accused’s pharmacy submitting claims for prescriptions provided by a telemedicine company. The prescriptions were allegedly written without the knowledge of the patients listed on the prescriptions, and the medications were never provided.
These charges come on the heels of an indictment issued by U.S. Attorneys in New York charging a Brooklyn-based orthopedic surgeon with submitting $10 million in false and fraudulent claims to Medicare and Medicare Part D plans. According to the indictments, both cases involved the submission of fraudulent claims for services rendered via telemedicine.
If convicted, the accused individuals in these cases could each face 10-20 years in prison.