Since the beginning of the COVID-19 pandemic, Chilivis Grubman attorneys have written about the temporary expansion of telehealth services and related increased government scrutiny.  In March 2020, the Trump administration announced that Medicare providers could use certain telehealth technologies with no penalties, provided blanket HIPAA waivers, and announced that qualifying telehealth services were reimbursable by Medicare.  The Office for Civil Rights (OCR) at the U.S. Department of Health and Human Services (HHS) announced that it would exercise its enforcement discretion and waive potential penalties for HIPAA violations related to using telehealth technologies.  OCR also provided guidance related to its enforcement discretion.

While telehealth rapidly expanded under the government’s temporary emergency declarations and enforcement discretions, so did the potential for fraud and abuse.  For example, the U.S. Department of Justice (“DOJ”) announced “Operation Brace Yourself,” where 24 people were charged in connection with an alleged scheme involving telemedicine and durable medical equipment.  

On May 26, 2021, the DOJ announced “first in the nation” charges related to a telehealth scheme during the COVID-19 pandemic. According to the press release, Michael Stein, an owner of a consulting company, and Leonel Palatnik, an owner of testing laboratories “allegedly exploited temporary waivers of telehealth restrictions enacted during the pandemic by offering telehealth providers access to Medicare beneficiaries for whom they could bill consultations.”  According to the government, some consultations billed to the government did not occur.  In exchange for the telehealth leads, the providers agreed to refer patients to Mr. Palatnik’s laboratories for medically unnecessary cancer and cardiovascular genetic testing, according to the government.  

Besides telehealth enforcement, the government’s announcement also discussed the third Provider Relief Fund (“PRF”) related indictment, which comes less than two months from the government’s second PRF related indictment.  According to the press release, Petros Hannesyan, an owner of a home health agency, allegedly obtained and misappropriated over $229k.  The government also alleged that Mr. Hannesyan submitted false loan information and documents to the government as part of the scheme.  

The PRF has billions in allocations and reimburses eligible providers for healthcare-related expenses and lost revenue attributable to COVID-19.  Chilivis Grubman attorneys have cautioned providers on government enforcement efforts related to the PRF and COVID-19 aid.  Audits and enforcement actions will continue, as evidenced by HHS’ Office of Inspector General updating its Work Plan to include audits of PRF distributions.

The attorneys at Chilivis Grubman – which includes a former federal prosecutor – represent businesses and individuals in connection with government investigations and audits, including those conducted by HHS-OIG and the DOJ.  If you need assistance with such matters, please contact us today.