The U.S. Department of Justice (DoJ) has released details of a wide range of alleged medical fraud cases that have cost taxpayers billions of dollars.
The first, said to be the largest prosecution of advanced telemedicine programs to date, resulted in fraudulent claims to Medicare and other government insurers for products such as orthodontic appliances and prescription skin creams. was submitted as $1.9 billion.
Read more about medical fraud: Man sentenced to 10 years in prison for multi-million dollar Medicare fraud
First, telemarketers targeted elderly and disabled patients with ads urging them to call contact centers, selling unnecessary equipment and prescriptions at high prices. The individual would then be verified for Medicare coverage and handed over to a telemedicine company for a doctor to examine and sign the prescription.
Defendants worked for a software company that used the tool to create fake orders for telemedicine doctors to sign, falsely claiming to see patients in person and perform diagnostic tests. It is said that
The company’s original CEO sold the company to a new organization that allegedly chose to continue its existing fraud scheme, the Justice Department said.
Another telemedicine fraud case charged a doctor with signing more than 2,800 fraudulent orders for braces, including for patients who had already had their limbs amputated.
Other cases indicted by the Justice Department and revealed yesterday include:
- Pharmaceutical wholesaler owner charged in connection with $150 million fraud scheme to buy and resell expensive HIV drugs purchased through illegal buyout scheme
- An individual was sentenced to 15 years in prison for a buyout scheme to obtain medicines from prescribed but not yet taken patients, repackage them and sell them to wholesalers.
- Indictment against 24 clinicians who illegally prescribed opioids to unnecessary patients. These doctors and medical companies were paying bribes to patient recruiters and patients in exchange for information they could submit to Medicare for reimbursement.
In total, the Justice Department announced charges related to drug fraud, with 10 people charged with filing more than $370 million in fraudulent claims related to prescription drugs.
