Physicians Charged in $2.1B Healthcare Fraud Scheme

Thirty-five people, including nine physicians, associated with dozens of telemedicine companies and cancer genetic testing laboratories were charged for their alleged roles in one of the largest healthcare fraud schemes ever, according to the Department of Justice.

The defendants allegedly submitted more than $2.1 billion in fraudulent claims to Medicare through the scheme. According to federal prosecutors, the laboratories paid illegal kickbacks and bribes to medical professionals working with fraudulent telemedicine companies to refer Medicare beneficiaries for cancer genetic tests that weren’t medically necessary.

The physicians were allegedly paid to prescribe the testing without any patient interaction or with only a brief telephone call with patients they had never met. The results of the tests were often not provided to Medicare beneficiaries or were worthless to their actual physicians, according to the Justice Department.

“Unfortunately, audacious schemes such as those alleged in the indictments are pervasive and exploit the promise of new medical technologies such as genetic testing and telemedicine for financial gain, not patient care,” Deputy Inspector General for Investigations Gary L. Cantrell of HHS’ OIG said in a press release. “Instead of receiving quality care, Medicare beneficiaries may be victimized in the form of scare tactics, identity theft, and in some cases, left to pay out of pocket. We will continue working with our law enforcement partners to investigate those who steal from federal healthcare programs and protect the millions of Americans who rely on them.”

Source: https://www.beckershospitalreview.com/legal-regulatory-issues/9-physicians-charged-in-2-1b-healthcare-fraud-scheme.html

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