Since the beginning of the ongoing COVID-19 pandemic, the use of telemedicine and telehealth services has skyrocketed. In March, we wrote about the temporary expansion of telehealth services by the Center for Medicare and Medicaid Services (CMS). Specifically, CMS temporarily waived some of the requirements that providers typically have to follow to bill for telehealth services (e.g., the requirement that the patient be present at a physician’s office or other authorized facility) in order to ensure that patients can receive appropriate medical treatment without having to risk physically going to a doctor’s office.
While telehealth and telemedicine provide exciting and convenient opportuneness for the provision of medical care, particularly during this challenging time, it is fraught with fraud-and-abuse-related peril. Last April, for example, the U.S. Department of Justice (DOJ) announced that 24 people were charged in connection with an alleged fraud scheme involving telemedicine and durable medical equipment (DME). Dubbed “Operation Brace Yourself,” the enforcement action also lead to the execution of over 80 search warrants in 17 federal districts.
The temporary expansion of legitimate telehealth services aside, fraud and abuse enforcement actions related to telehealth and telemedicine do not appear to be slowing. Earlier this month, the U.S. Attorney’s Office for the Southern District of Georgia announced that Patrick Wolfe, who operated a DME company, pled guilty to one count of Conspiracy and admitted that he paid kickbacks in return for telemedicine “leads” which, according to the DOJ, “were in actuality signed orders from physicians and nurse practitioners.” According to the government’s press release, the prosecution of Wolfe and 25 other individuals arose out of Operation Brace Yourself and “Operation Double Helix” (which involved telemedicine and laboratory services), involved $480 million in alleged fraud, and represented “the largest fraud operation in the history of the Southern District of Georgia.” Those charged include eight physicians, two nurse practitioners, three operators of different telemedicine companies, three brokers of patient data, and several other owners of DME companies.
Physicians and other healthcare providers who avail themselves of the opportunities that telehealth and telemedicine provide must remain vigilant when it comes to potential fraud and abuse concerns. The attorneys at Chilivis Grubman represent healthcare clients of all types and sizes in connection with government investigations (both criminal and civil) and regulatory matters, including matters involving the DOJ and HHS-OIG. If you need assistance with such a matter, please contact us today.