Georgia is Ground Zero for Telemedicine Fraud

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The United States Attorney’s Office for the Southern District of Georgia has become a leader in telemedicine fraud enforcement since 2019. Yesterday’s press release by the Department of Justice, announcing a historic nationwide health care fraud enforcement action involving 345 charged defendants across 51 federal districts, is just the latest evidence of this. The DOJ credited the Southern District with a minimum of ten newly charged defendants, most of who are facing health care fraud and telemedicine related allegations. Only two other U.S. Attorney’s Offices had a greater impact on this newest DOJ takedown.

The Southern District’s has made itself an integral part of each of the Department’s telehealth fraud takedowns. As the U.S. Attorney Bobby Christine noted at a February 5, 2020 conference, the Southern District of Georgia was ranked third in the country, out of 93 total districts, for the most health care fraud prosecutions in 2019. This relatively small U.S. Attorney’s Office was able to outperform most of its counterparts across the country due in large part to Operation Brace Yourself and Operation Double Helix. During these two historic takedowns, more than 30 defendants—including durable medical equipment company owners, doctors, patient brokers, laboratory owners, physician recruiters, and telemedicine company executives—were charged in the Southern District of Georgia alone.

Over a year later, the Southern District of Georgia has made one thing clear—it has no intention of slowing down. The District’s health care fraud prosecutions remain inordinately high with Telehealth defendants bearing the brunt of the District’s prosecutorial efforts. As Polsinelli previously reported, the Southern District charged a California DME operator in April 2020, accusing him of conspiring to pay kickbacks to physicians in exchange for obtaining physicians orders for DME. This was the 22nd defendant charged by the SDGA in an estimated $410 million telehealth fraud scheme—the largest fraud scheme ever prosecuted in the history of the Southern District of Georgia. As this case evidences, the Southern District of Georgia is not targeting fraudsters solely located within the Southern District borders or even those solely within Georgia. A significant number of the defendants are from out of state—California DME operators, Florida DME owners, Florida patient brokers, and more. Just because a telehealth provider is located outside of the Southern District, does not mean they are outside the grasp of the U.S. Attorney’s Office.

Acting Assistant Attorney General Brian C. Rabbitt recently acknowledged the high amount of health care fraud prosecutions nationwide and warned that they will “grow significantly before year’s end.” Whether this is due to COVID-19 related fraud, DME, or cancer genomic tests, one thing is certain—telehealth will be at the forefront of many of those charges. Unsurprisingly, the Southern District of Georgia has already begun to lead this newest round of charges as today’s DOJ announcement evidences. One of the newly announced defendants, a nurse practitioner, was indicted a few weeks ago for conspiracy to commit health care fraud and other offenses due to her alleged role in a multi-million dollar DME fraud scheme, all orchestrated over telemedicine platforms.  

This newest takedown is just one of many to come. There will be no shortage of telemedicine related health care fraud enforcement actions this fall, particularly in Georgia. All health care providers, practitioners, and entities engaging or assisting with telemedicine services should consult with counsel to ensure compliance with applicable laws and regulations. Similarly, those same telemedicine entities or individuals who suspect or learn of an investigation should hire counsel immediately. 

DISCLAIMER: Because of the generality of this update, the information provided herein may not be applicable in all situations and should not be acted upon without specific legal advice based on particular situations.

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