Justice Department Charges Hundreds with Medical Fraud
By: Dave Michaels (WSJ)
S E E D E D C O N T E N T
WASHINGTON—More than 300 people were charged with bilking insurance providers of more than $6 billion in a federal sweep of alleged fraud involving the misuse of telemedicine, drug-treatment facilities and prescription opioids, authorities said Wednesday.
The Justice Department said it has filed 192 criminal cases across the country over the past several months against defendants such as physicians, telemedicine companies and operators of substance-abuse treatment facilities.
“Telemedicine has proven all the more critical during this national crisis, when so many Americans are isolating, quarantining or otherwise restricting their face-to-face interactions,” said Brian Rabbitt, acting assistant attorney general for the Justice Department’s criminal division. “Telemedicine, unfortunately, also can be exploited by criminals.”
Over $4.5 billion of the fraud alleged Wednesday involved the misuse of telemedicine, a service that increasingly plays a role in health-care scams, authorities said.
In one case filed this week in federal court in the Southern District of Georgia, authorities said several co-conspirators used telemedicine to justify over $1 billion in fraudulent Medicare billings over four years. One defendant in the case, Toni De Lanoy, agreed to plead guilty this week, according to court filings.
Ms. De Lanoy allegedly advised one company that used call centers to acquire patients’ information. She and others later sold that data to medical-equipment companies, according to the charges described in court documents. The company, which wasn’t named in the documents, operated a digital platform that allowed doctors to prescribe the equipment often “without any physician-patient encounter at all,” according to court filings.
Ms. De Lanoy couldn’t be reached for comment and her attorneys didn’t immediately respond to messages seeking comment.
Justice Department officials said many of the cases were discovered through database analysis that helps to identify red flags in Medicare and other insurance-provider billings. An interagency group of investigators and prosecutors, known as the Health Care Fraud Strike Force, led the effort.
More than $845 million in alleged fraud was related to tests and treatments for patients seeking treatment for drug or alcohol addiction, authorities said. Patients were sometimes prescribed controlled substances and other medications that enticed them to stay at a facility, they said. In other cases, facilities or clinics allegedly exchanged kickbacks to refer patients to new treatment centers.
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