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US uncovers $1.2 billion telemedicine fraud scheme

This content was published on July 20, 2022 – 18:00

New York, Jul 20 (EFE).- The United States Justice announced this Wednesday that it has uncovered a fraud plot in the telemedicine sector, very popular after the covid-19 pandemic, in which 36 people throughout of the country are accused of diverting 1,200 million dollars.

It is alleged that the telemedicine companies – whose name or number are not mentioned – agreed with different doctors to prescribe very expensive tests and medical supplies, regardless of whether the patients needed them, after a brief telephone conversation or even without interacting with them. .

The indictment is the result of a coordinated federal investigation between the FBI, six health care fraud units and eight federal prosecutors’ offices, among other agencies, and has led to the first charges for the billing of fraudulent cardiovascular genetic tests, according to a note official.

Test results and ordered medical materials often did not reach patients, or were of no value to their primary care physicians, the document added.

Among those charged are an executive of a telemedicine company, owners and executives of clinical laboratories, long-term medical equipment companies, marketing companies and medical professionals.

Authorities said lab owners and operators paid “kickbacks” and bribes to doctors working for “fraudulent telemedicine companies” to refer patients to them.

In addition, some defendants controlled an international marketing network with which they deceived “thousands of elderly and/or disabled patients” and ordered their telemarketers to induce beneficiaries of the public health program Medicare to undergo expensive genetic tests.

The Department of Justice also indicates that the cardiovascular and cancer genetic tests in question were “medically unnecessary”, since they are not used as a diagnostic method nor are they approved by Medicare to preventively check the risk of developing diseases.

An operator of several labs allegedly used test orders to claim $174 million worth of Medicare reimbursements, even though the results were not used for any treatment, and then laundered that money through a network of banks and entities. buying luxury vehicles, a yacht and real estate.

Apart from the charges announced by Justice, the Centers for Medicare and Medicaid and the Center for Program Integrity, which pursues its abuse, today took administrative action against more than fifty medical providers involved in similar plots. EFE

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