Medicare Fraud News and Resources for Healthcare

Telehealth Companies Face Repercussions for Medicare Fraud Scheme

July 27, 2023 - The owner of Conclave Media (Conclave) and Nationwide Health Advocates (Nationwide) pleaded guilty to a telehealth fraud scheme that involved ordering medically unnecessary durable medical equipment (DME) on behalf of Medicare beneficiaries. The charges against David Santana, 38, consisted of one count of conspiracy to commit healthcare fraud....

DOJ Files Criminal Charges in Telemedicine Fraud Schemes Totaling $1.2B

July 22, 2022 by Anuja Vaidya

The Department of Justice (DOJ) has filed criminal charges against 36 defendants in telemedicine-enabled fraud schemes involving illegal kickbacks for genetic testing and durable medical equipment...

Telehealth Company Owners Charged in $64M Fraud Scheme

May 12, 2022 by Mark Melchionna

Stephen Luke and David Laughlin, the owners of telemedicine company RediDoc LLC, pleaded guilty to violating the federal Anti-Kickback Statute and committing healthcare fraud in a federal...

Surgeon Charged in $10M Telemedicine Fraud Scheme

April 22, 2022 by Mark Melchionna

The Department of Justice announced that orthopedic surgeon Elemer Raffai, MD, has been indicted in a telemedicine fraud scheme that involved the submission of false and fraudulent claims to...

Medical Group Settles False Claims Allegations Involving Telehealth

April 14, 2022 by Anuja Vaidya

Physician Partners of America (PPOA) and two of its leaders will pay $24.5 million to resolve allegations that they fraudulently billed federal and state healthcare programs for unnecessary medical...

Telemedicine Fraud Conspirators Billed for Faulty Genomic Testing

December 22, 2021 by Victoria Bailey

The owner of a telemedicine company has pleaded guilty to conspiracy to pay and receive kickback payments, which led to Medicare and Medicaid programs losing millions of dollars through fraudulent...

Telemedicine Fraud Scheme, Faulty Prescriptions Led to $37M in Losses

December 13, 2021 by Victoria Bailey

Four individuals have been charged for their involvement in a telemedicine fraud scheme that swindled public and private payers out of $37 million through the generation of unnecessary prescriptions...

US Reps Introduce Bill to Ensure Permanent Access to Telehealth

December 10, 2021 by Victoria Bailey

Members of the House Ways and Means Health Subcommittee have introduced a bipartisan bill that seeks to ensure permanent access to telehealth services. U.S. Rep. Lloyd Doggett (D-TX), who is the chair...

Fraud Enforcement Followed Spike in Telemental Care

November 24, 2021 by Anuja Vaidya

Amid a rise in telehealth use for mental healthcare, fraud and consequent enforcement activities also increased, according to a new report. Released by law firm Epstein Becker Green, the report...

Kickback Fraud Exploited COVID-19 Medicare Telehealth Policies

September 08, 2021 by Victoria Bailey

A Florida man has pleaded guilty to a kickback conspiracy that exploited temporary COVID-19 Medicare telehealth policies meant to increase access to care for Medicare beneficiaries. Co-owner of Panda...

DOJ Files Charges Linked to Abuse of COVID-19 Telehealth Freedoms

May 27, 2021 by Eric Wicklund

(Updated on May 28 with further comments) Justice Department officials have announced the first criminal charges linked to telehealth coverage laws that have been relaxed during the coronavirus...

OIG Defends Recent Telehealth Audits, Recognizes Telefraud Challenges

March 02, 2021 by Eric Wicklund

Federal authorities are cracking down on telehealth fraud and misuse during the coronavirus pandemic, and that has the attention of advocates who worry that connected health may be getting a bad rap in...

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