Three medical professionals, owners of dozens of durable medical equipment (DME) companies and individuals associated with five telemedicine companies are among 24 people who have been charged for alleged participation in what has been described as “one of the largest healthcare fraud schemes” in United States history.
According to a statement from the US Department of Justice, the alleged scheme involved Medicare patients being prescribed medically unnecessary back, shoulder, wrist and knee braces at the expense of taxpayers, with US Attorney Craig Carpenito saying the defendants had taken the advantage of “unwitting patients who were simply trying to get relief from their health concerns”.
Court documents allege that international call centres recruited Medicare beneficiaries who were then up-sold “free or low-cost” DME braces, regardless of medical necessity. The call centre allegedly paid illegal kickbacks to telemedicine companies to obtain DME orders for these Medicare beneficiaries. The telemedicine companies then allegedly paid physicians to write "medically unnecessary DME orders". It is alleged that the international call centre sold the DME orders that it obtained from the telemedicine companies to DME companies.
The schemes led to losses of more than $1.2 billion.