More than 340 individuals were charged with submitting $6 billion in fraudulent claims to federal healthcare programs and private insurers for telehealth consultations and substance abuse treatment, among other services, the Justice Department announced Wednesday, describing it as the largest healthcare fraud takedown in history.
About $4.5 billion of the alleged fraud involved telehealth, where telehealth executives were accused of paying doctors and nurse practitioners to order unnecessary durable medical equipment, genetic and diagnostic tests and pain medication. The medical professionals either allegedly did not contact patients or had limited phone conversations, and DME companies, genetic testing labs and pharmacies would purchase those orders in exchange for kickbacks and bribes.
The defendants span telemedicine executives, owners of durable medical equipment companies and those connected to genetic testing laboratories and pharmacies across 51 judicial districts. CMS revoked the federal healthcare billing privileges for 256 medical professionals.
"This marks the largest amount of fraud ever charged by the Department of Justice in a single takedown operation," Acting Assistant Attorney General Brian Rabbitt said during a news conference Wednesday.