DOJ Announces Criminal Charges in Alleged Health-Care Fraud Involving Telemedicine

On September 17, 2021, the Department of Justice (DOJ) announced criminal charges against 42 medical professionals and nearly 100 other people for alleged health-care fraud amounting to about $1.4 billion in suspected losses. The charges include fraud involving the use of telemedicine services, which accounts for approximately $1.1 billion of the alleged losses. The telemedicine cases built on prosecutions launched in 2019 and 2020 involved allegations of billing Medicaid for fraudulent genetic cancer testing and telemedicine executives paying doctors and nurses to order unnecessary durable medical equipment, diagnostic testing and medications without actual patient interaction or limited interaction involving only a brief call with individuals they had never met. Telehealth advocates have criticized the Department’s rhetoric involving these cases for its “failure to distinguish traditional fraud carried out using the reach of telemarketing from fraudulent claims for the provision of telehealth services.” It is believed the distinction is needed in order to prevent the chilling effect these cases could have on the future of telehealth. Telehealth expanded rapidly during the Covid-19 pandemic and Assistant Attorney General Kenneth Polite told reporters the DOJ recognized its importance. “The ability to provide health care remotely is a critical tool in the delivery of health care services, and is a reason the Department of Justice remains committed to ensuring that the adoption of this technology is not tainted by wrongdoers.”