U.S. looks deeper into telehealth fraud

The ability to talk with our health care providers via video or phone was a great convenience and safety measure during COVID shutdowns.

But there are indications that some providers used the convenience of “telehealth” to bamboozle patients and even facilitate the illegal distribution of opioids.

In a press release issued Sept. 17, 2021, the U.S. Department of Justice announced criminal charges against 138 defendants, including 42 doctors, nurses and licensed medical professionals across the country.

The federal government alleges about $1.4 billion in total losses related to fraud committed using telemedicine.

According to documents filed with the court, defendants paid doctors and nurse practitioners to order unnecessary medical equipment, genetic and diagnostic testing and pain medications, either without any patient interaction at all or with only a brief phone conversation with patients they’d never met or seen.

Medical equipment companies, testing laboratories and pharmacies then bought those orders in exchange for illegal kickbacks and bribes, submitting more than $1.1 billion in false and fraudulent claims to Medicare and other government insurers.

Meanwhile, the watchdog for the U.S. Department of Health and Human Services found that many states do not monitor telehealth fraud for services delivered to people covered by Medicaid. Fierce Healthcare reports just one of 37 states the agency evaluated had looked at the impact of telehealth on cost, particularly delivery of mental health services.   Voices for Affordable Health surveyed consumers and shared reports about the benefits and unexpected costs related to telehealth care.

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