Telemedicine is the future.
Fraudulent telemedicine is apparently already here.
Is anyone actually shocked?
Recently, the U.S. Department of Justice, in coordination with the OIG and the FBI, announced the fruit of their coordinated law enforcement action targeting fraudulent genetic cancer testing by dozens of cancer genetic testing labs and dozens of telemedicine companies, and various individuals, including doctors, in connection with an alleged combined $2.1 billion Medicare scam.
Additionally, CMS’s Center for Program Integrity announced its action against other cancer genetic testing companies and medical professionals in connection with an additional $1.7 billion in alleged fake Medicare claims.
In total, those actions were part of a September push by the federal government that resulted in charges against 380 individuals who allegedly billed federal health care programs for billions in fraudulent charges.
In connection with the telemedicine prosecutions, the government alleged that cancer genetic testing labs paid illegal kickbacks and bribes in exchange for the referral of Medicare beneficiaries. The recipients were said to be medical professionals working with fraudulent telemedicine companies.
It’s claimed that some conspirators controlled a telemarketing network that lured hundreds of thousands of elderly or disabled patients into the trap. The government alleges that some of the defendants paid doctors to prescribe cancer genetic testing without any patient interaction or with only a brief telephone conversation with patients they had never met or seen.
Telemedicine may be new, but healthcare scams are as old as one can imagine. Elixirs and tonics of all variety sold out of the back of a covered wagon were simply less sophisticated versions of preying on the fears and hopes of those via modern means.
Among the defendants charged in these various task force actions are:
Richard Garipoli, 42, of Loxahatchee, Florida, the owner of telemedicine company Lotus Health LLC. He’s charged with conspiracy to commit health care fraud, conspiracy to pay and receive kickbacks, and substantive counts of health care fraud and receiving kickbacks.
Jamie Simmons, 62, a resident of South Carolina, and the owner of telemedicine companies MedSymphony LLC and Meetmydocc LLC in Ft. Lauderdale, Florida. Simmons is charged with conspiracy to commit health care fraud, conspiracy to pay and receive kickbacks, and substantive counts of health care fraud and receiving kickbacks.
Khalid Satary, 47, of Suwanee, Georgia, was charged based on his role in an alleged scheme to solicit medically unnecessary cancer genetic tests from Medicare beneficiaries through telemarketing and “health fairs.”
Daniel R. Canchola, M.D., 49, of Flower Mound, Texas, was charged for his alleged referral of Medicare beneficiaries for medically unnecessary cancer screening genetic tests. The government charged Canchola with receiving illegal kickbacks and bribes for the screening orders he signed without examining or speaking to patients and in the absence of any physician-patient relationship.
Sekhar Rao, M.D., 48, and Vinay Parameswara, M.D., 46, both of Austin, Texas, were charged for their role in alleged referrals of TRICARE beneficiaries for medically unnecessary cancer screening genetic tests and toxicology tests. The government claims Rao and Parameswara did not examine or speak with the beneficiaries for whom they signed testing orders, and that there was no physician-patient relationship.
Money, big money, is tempting. I know because I’ve counseled many clients in connection with telemedicine “ventures” paying what they must have thought was money from heaven.
Yes, telemedicine has many valid applications. Violation of the AKS and committing fraud are not among them.
And, the money’s not from heaven. It’s from hell.