Federal officials indicted four people in Tennessee for an alleged scheme that involved using telemedicine to bilk insurers out of about $174 million.
The defendants allegedly submitted at least $931 million of fraudulent claims after tricking tens of thousands of patients and more than 100 doctors.
Peter Bolos, Andrew Assad, Michael Palso and Larry Everett Smith were each charged with conspiracy to commit healthcare fraud, mail fraud and introducing misbranded drugs into interstate commerce, according to the U.S. Justice Department.
The four defendants and their companies worked with telemedicine company HealthRight to get fraudulent insurance coverage information and prescriptions from patients, according to court documents. After getting doctors to approve the prescriptions, which were invalid in the first place, the defendants would bill payers—including Blue Cross and Blue Shield of Tennessee—for greatly marked-prescriptions, reaping the rewards of overpayment. They did this repeatedly over the course of three years, with the scheme ending in April 2018, the Justice Department alleged.
HealthRight and its CEO, Scott Roix, pleaded guilty to felony conspiracy. The company offers on-demand medical consultations through a smartphone app.
HealthRight and Roix were both also charged with conspiring to commit wire fraud. They allegedly used HealthRight to falsely sell million of dollars of weight loss pills, skin creams and other products, deceiving customers along the way.
HealthRight did not immediately respond to a request for comment.