Disclaimer: This blog article was written by an AdvancedMD partner. The views and opinions expressed in this article are those of the author(s) and do not necessarily reflect the official policy or position of AdvancedMD.
On August 10, 2021, the Department of Justice issued a press release announcing the indictment of Creaghan Harry, Florida resident and owner of multiple telemedicine companies, for telemedicine fraud.
The federal grand jury’s superseding indictment charged Harry with orchestrating health care fraud and accepting illegal kickbacks. Involving the submission of over $784 million in false claims, it’s one of the largest Medicare fraud schemes ever charged by the Justice Department. The indictment also charges the defendant with concealing scheme proceeds to avoid income tax payment.
According to the indictment, Harry and his co-conspirators solicited illegal kickbacks from durable medical equipment (DME) suppliers and marketers in exchange for orders of braces and medications. Harry’s telemedicine companies allegedly paid physicians to write medically unnecessary orders for these braces and medications. Then fraudulent claims were submitted to Medicare for repayment on these false orders. Of the $784 million in claims submitted, Medicare ended up paying over $247 million.
There is really nothing new in this indictment. Improper prescriptions were written, doctors were paid to write the improper prescriptions, and the suppliers provided kickbacks in the form of monetary payment for placing the orders. What is new is the use of telemedicine to manage the scheme and the amount fraudulently claimed. The government now understands how, given their extended reach, telemedicine operations can leverage patient access to commit fraud on a much greater scale than could be achieved by conventional medicine practices.
If you are currently engaged in telemedicine or considering adding telemedicine to your practice, it is vital that you:
- Document the medical necessity of all items you order, including medicine and DME.
- Do not allow a telemedicine provider to select vendors when ordering items.
- Do not accept anything of monetary value outside of direct product purchase from vendors, including those you refer patients to and those that supply medical products paid for by a healthcare payor.
- Understand the government may investigate telemedicine claims more carefully now, auditing more for telemedicine fraud, waste, and abuse.
Michael L. Brody, DPM
Disclaimer: Dr. Brody is the CEO of TLD Systems. TLD Systems assists practices in compliance with HIPAA, OSHA and the Federal Fraud, Waste and Abuse statutes. For more information, visit http://www.tldsystems.com , email [email protected], or call (631) 403 6687.