Columbus, South Carolina- On 7th October 2020, U.S. Attorney for the Southern District of Georgia Bobby L. Christine, and U.S. Attorney for the District of South Carolina Peter M. McCoy, Jr., announced that over forty people were facing federal indictments for their participation in an extensive health care fraud plot across Georgia and South Carolina resulting in hundreds of millions of USD in fraudulent charging. The indictments marked the 3rd countrywide string of telemedicine fraud prosecutions, which started as a result of the investigative attempts out of the South Carolina District.
Georgia’s Southern District and the District of South Carolina had been at the forefront of fighting health care fraud all over the nation and the world. Participating in three crucial countrywide operations, Double Helix, Operation Brace Yourself, and Rubber Stamp, the Districts had acquired sentencing of proprietors of international telemarketing institutions; proprietors of genetic testing facilities; proprietors of chemists’ proprietors of medical supply enterprises; CEOs of trade enterprises; physicians; nurses; and compliance officers. Working together with the Department of Justice’s Health Care Fraud Task Force and other federal districts, trials were brought in more than twenty districts all over the nation, resulting in more than 175 persons being indicted and/or sentenced, with more than a billion USD in remuneration. Besides, the Centers for Medicaid and Medicare Services/ Center for Program Integrity individually took the highest amount of negative administrative initiative as a consequence of one administrative health care fraud investigative action in history in canceling the Medicare billing privileges of more than 250 medical experts for their role in the telemedicine plots.
In South Carolina District, five persons were indicted in the previous week in a kickback conspiracy and telemedicine-based health care fraud, involving over 100 million USD in fraudulent charging in South Carolina. The persons were all medical professionals- one nurse and four physicians- who issued prescriptions over a web-based platform, frequently without meeting or seeing the patients. Further, indictments were filed against 8 persons and one organization related to kickback conspiracy and health care fraud that utilized fraudulent telemedicine and offshore call facilities to charge hundreds of millions of USDs for durable medical items that were medically unnecessary. These indictments added to the number of persons earlier indicted.
In the Southern District of Georgia, 4 persons were indicted in the previous week for kickback and telemedicine-based fraud plots, adding to the twenty-six suspects earlier indicted. The 4 new suspects, 3 of whom were medical experts, were purported to have participated in the telemedicine-based fraud plot, which now accumulatively summed to more than 1.4 million USD in fraudulent allegations for defendants indicted in the Southern District of Georgia alone. Among the new suspects indicted, an ex-compliance officer was indicted with conspiracy to perpetrate health care fraud for her participation as part of an enterprise that linked different parties via an online-based platform where records of patients would be uploaded, prescriptions would be issued electronically by medical experts, and the parcel with the issued prescriptions could then be purchased by durable medical equipment enterprises for final charging to Medicare and various programs.
U.S. Attorney McCoy said that those who robbed from federal health care systems were taking funds from the citizens, and that was wrong. He added that together with other law enforcement liaisons and his coworkers in the Southern District of Georgia, they would work relentlessly to pinpoint and prosecute those who sought to hurt the taxpayers of Georgia and South Carolina. He further added that they had ensured that millions of USDs were recovered, or would be recovered, to those crucial health care systems.
U.S. Attorney Christine said that the intentional, methodological, and coordinated string of prosecution and investigations in the Southern District demonstrated the proceeding, comprehensive team effort with the law enforcement liaisons to safeguard the citizens’ safety nets systems from robbery and fraud. She added that the message should be clear to unethical providers that they would find themselves in trouble if they attempted to unlawfully enrich themselves from the systems.
Special Agent in Charge of the FBI (Federal Bureau of Investigation) in Columbia, South Carolina Jody Norris said that thousands of taxpayers had their health endangered and private information traded, while the illicit companies reaped out the USDs. She added that the FBI, collaborating together with law enforcement liaisons, had terminated the criminal links and would remain committed to looking for and ending others.
Special Agent in Charge of the FBI in Atlanta Chris Hacker said that fraudulent charging plots costed each citizen and health care programs, and when it preyed on systems like Medicare that helped the poor and elderly, it potentially endangered their health care requirements. He added that his collaboration within law enforcement was crucial in revealing such abuse by persons driven by inconsiderate gluttony and would remain committed to uncovering it.
Special Agent-in-Charge of the U.S. HHS-OIG (Department of Health and Human Services- Office of Inspector General) Atlanta Region, Derrick L. Jackson said that telemedicine had become an important tool for rendering health services in the wake of the Coronavirus, but bad individuals were misusing the tool to perpetrate health care fraud. He added that when the so-called telemedicine and marketing services were abused, purported offenders should expect an intense investigation and fast prosecution.
Resident Agent Glen M. Kessler in Charge of the U.S. Secret Service in Savannah, Georgia, said that cases of such intensity could only be handled using a method that acknowledged that the most fruitful way to combat huge criminal links was by combining the resources, expertise, and strengths of the federal agencies. He added that the country’s health care programs could not permit kickbacks to doctors and chemists while criminals filled their coffers with citizen financed health care money.
At its center, the federal lawsuit claimed that the criminal links targeted by the investigations involved enterprises and persons that obtained patient information and bartered it to one or several DME (Durable Medical Equipment) providers, labs, or chemists. Patients were frequently lured into the plot by a global telemarketing network. As per the documents, the perpetrators’ promise of frequent unnecessary durable medical equipment, diagnostic and generic testing, and drugs deluded patients and held up their opportunity to seek necessary remedy for medical ailments. As part of the plot, telemedicine administrators purportedly remitted physicians and nurses to request for unrequired durable medical equipment, diagnostic and genetic testing, and pain relievers, either without any interaction with the patient or with only a small phone call discussion with the patients they had never seen or met. The lawsuit claimed that durable medical equipment enterprises, genetic examination labs, and chemists bought those orders in trade for illicit bribes and kickbacks and presented falsified and fraudulent allegations to Medicare and other government programs.
The matters were investigated by agents of the HHS-OIG, Secret Service, and the FBI; specifically, Special Agents Randy Dye, Karen Corbett, Dave Graupner, Su Kim, Matt Britsch, Ryan Schubert, T.J. Smith, and Neil Powell. The matters were prosecuted by Assistant U.S. Attorneys with the South Carolina District Will Lewis, Jim May, and Derek A. Shoemake; Assistant U.S. Attorneys with the Southern District of Georgia Jonathan Porter and Tom Clarkson; and Trial Attorney Catherine Wagner and Assistant Chief Jacob Foster with the Department of Justice’s Health Care Fraud Strike Force.
The claims in the cases were only allegations of a crime, and the suspects were presumed innocent until or unless proven guilty.
Breaching the False Claim Statute, the Anti-Kickback Act, and the Controlled Substance Act is severely punished by the law. Additionally, scheming to execute health care fraud such as defrauding taxpayer-funded health care programs, including TRICARE, Medicaid, or Medicare programs, is a severe crime. Any person who commits these crimes breaks the law and is severely penalized if found guilty of the accusations. Once charged with these offenses, you should seek the best legal advice or representation to safeguard and pursue your rights. Hire our qualified team of top-rated defense and criminal attorneys if you want the best legal representation and assistance, which will result in achieving positive results for your matter. At Health Care Fraud Group, we have an experienced team of lawyers with tremendous experience in handling Health Care Fraud related cases related to the Federal Health Care Program; they are highly knowledgeable about civil and federal issues. The defense lawyers are well recognized across the U.S. due to their excellent and outstanding work and professionalism when handling health care fraud cases and inquiries. Our lawyers are well equipped with previous knowledge of each aspect of Health Care fraud defense, medical, and legal issues.
Our offices function 24/7 since they are always open, and we are well prepared and ready to start your defense immediately. Our law firm is the most sought-after because we are continually updating our practices and knowledge to act swiftly in your issue without the requirement of constant legal consultations. We offer a quick and safe evaluation of your case and work quickly to collect, acquire, and assemble the required and key particulars concerning your matter in the government’s investigations. Once hired, we will help you and your team come up with the right and best decision. Our highly skilled team of attorneys will support and guide you when required in anything you may want to know and further train your team to effectively assist in your criminal defense; because there are several crucial mistakes, you must evade when facing a health care fraud investigation.
Additionally, we will offer you and your team with detailed legal assistance and defense in cases and inquiries that are in charge and even those in other institutions or firms that cover the IRS and the FBI, and investigations and matters that are under the jurisdiction of the CMS, DOJ, DHHS, OIG, and DEA. Besides, we will investigate potential health care fraud and help keep both you and your career safe. Our highly qualified attorneys at the HCFG are conversant and clearly understand the need to prove innocence after the accusation of any crime. For any legal representation, advice, or support you may need, contact us at 888-402-4054.