The Justice Department has charged 78 individuals, including 24 physicians, for their alleged participation in a sweeping $2.5 billion telehealth, pharmaceutical and opioid distribution fraud scheme.
The Justice Department said June 28 that the defendants allegedly defrauded programs that provided healthcare services to elderly and disabled individuals and sometimes used the proceeds to purchase luxury items, including cars, jewelry and yachts.
Charges were filed against 11 individuals for their alleged involvement in submitting more than $2 billion in fraudulent telehealth claims.
In South Florida, one indictment alleges that executives at software and service companies conspired to create and sell templates of physician prescriptions for orthotic braces and pain creams in exchange for kickbacks and bribes. The alleged scheme resulted in $1.9 billion in false claims to Medicare and other federal programs.
Another part of the alleged conspiracy involved a nationwide telemarketing scheme that targeted elderly and disabled individuals through the mail and TV. Contacted individuals would be persuaded to contact offshore facilities and then purchase unnecessary medical equipment and prescriptions. The telemarketing platform would allegedly coordinate illegal payments to telehealth companies to obtain the physician prescriptions for Medicare enrollees.
"The defendants allegedly programmed the software platform to generate false and fraudulent orders for telemedicine practitioners to sign and obstruct Medicare investigations by concealing that the interactions with beneficiaries had occurred remotely using telemedicine," the Justice Department said.
In a separate fraud case in Washington state, a physician was charged for signing more than 2800 fraudulent orders for orthotic braces, which allegedly took less than 40 seconds to review and sign each.
The Justice Department also charged 10 individuals for their alleged involvement in submitting more than $370 million in fraudulent prescription drug claims. The owner of a wholesale distribution company was charged in an alleged $150 million scheme in which the company purchased illegally diverted prescription HIV medication, then resold the medication by saying it was acquired through legal means. The defendant allegedly purchased the medication at a discount from individuals who paid HIV patients cash for their medication. The defendants then created fake labels and product tracing documentation and sold the products to pharmacies for dispensing.
In addition, the DOJ charges involved more than $150 million in false claims related to the illegal distribution of opioids and clinical laboratory testing fraud.