The Department of Justiceannouncedon Friday that it ’s charging 138 people — including 42 Doctor , nurse , and myriad medical professionals working in telemedicine — for allegedly participating in a solicitation of healthcare impostor scheme that wound up cost taxpayer around $ 1.4 billion in loss . The freehanded perpetrator ? Telemedicine fraud , according to the DOJ , which was creditworthy for more than three - quarters of the lose funds .
More than $ 1.1 billion in allegedly phony claims were submitted by 43 of the culprits postulate in the telemedicine fraud case , who together with spent those payoff on “ luxury items , include vehicles , yachts , and real demesne , ” the Justice Department said .
Citing judicature records , it lay out the alleged strategy like so : First , the accused telemedicine executives would allegedly bear doctors and nurse to order unnecessary , expensive aesculapian equipment , symptomatic testing , and pain meds , all purchase with piddling ( if any ) patient interaction on their part . Next , medical equipment providers , genetic examination research lab , and pharmacies would all buy back those sham purchases in commutation for “ illegal kickback and payoff , ” the DOJ said , before present more than $ 1.1 billion in phony title to Medicare or other issuer . In some case , these same medical pro are alleged to have billed Medicare for telehealth interview “ that did not occur as represented , ” whatever that might entail .
Photo: David Esnault (Getty Images)
Other schemes mentioned in the DOJ ’s charge admit “ various health care imposter scheme design to work the COVID-19 pandemic , ” like exploiting theincreased accesssome providers had to patient ’s health datum . In these case , nine of the defendants are alleged to have used that newfound data admission to submit Medicare claims for “ unrelated , medically unnecessary , and expensive laboratory tests , include cancer genetic testing . ” The DOJ ’s charge nine of the suspect in this particular heist , which it articulate involve more than $ 29 million in phony billings .
The repose of the cases listed by the DOJ only get scummier from there . Five of the accused spent an nameless sum that they ’d pulled from the federalProvider Relief Fundon Las Vegas casinos and luxuriousness auto , rather than the COVID-19 patients it was mean for . Nineteen are medical professionals who were level with prescribing roughly 12 million back breaker of opioids and other highly addictive narcotic , while also submitting $ 14 million in phony billings on the backend . Another $ 133 million in fictive claims were allegedly submit by defendant who were involve with a phony sober house that would bill occupier for drug testing when it was n’t medically required—“often billing 1000 of dollars for a single trial , ” the DOJ enounce .
The remaining charges being made here mostly imply “ more traditional categories , ” of your health care fraud committed by more than 60 of the remaining defendant , harmonize to the DOJ . They ’re charged with submit roughly $ 145 million in phony insurance claims for medical care that was “ medically unnecessary and often never provided , ” the Justice Department say .
It ’s pretty rough see it all laid out like that , but the DOJ ’s announcement lays bare what you likely already live : that the global pandemic has entrust a slew of ussicker , sadder , and generallymore desperatethan we ’ve ever been before , all while scoundrel get rich . Calvin Shivers , who help channelize the FBI ’s Criminal Investigative Division , noted in his instruction about the heist that these sorts of fraud schemes areexplicitly designedare often direct vulnerable populations . And if the country’srecent surgein covid-19 font is any indicant , thereal , human costfrom these scams will keep on surge right along with it .
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