In late June 2023, the United States Department of Justice (DOJ) announced federal and local charges against 78 defendants in the healthcare space, alleging that they had participated in various fraud schemes totaling $2.5 billion in ill-gotten gains. While the immediate focus in such cases is on exoneration, defendants must also consider the ramifications of criminal allegations for their ability to practice medicine in the future.
Details of the Alleged Fraud Scheme Involve Telemedicine Fraud, Pharmaceutical Fraud, and More
It is important to note that every allegation detailed here is just that—an allegation. It is the burden of the Department of Justice to prove beyond a reasonable doubt that the defendants committed the offenses they stand accused of or convince the defendants to plead guilty.
That being said, the DOJ alleges:
- Telemedicine fraud: 11 defendants face charges of submitting more than $2 billion in fraudulent telemedicine claims. Medicare and other government-affiliated insurers allegedly received fraudulent claims for prescription skin creams, orthotics, and other items and services for which the prescribing doctors received kickbacks and bribes.
- Pharmaceutical fraud: Ten defendants face criminal allegations that they submitted more than $370 million worth of fraudulent claims. Allegations include that one company purchased HIV medication through an illegitimate buyer at a steep discount, rebranded the medication, then resold the medication at a substantial markup.
- Illicit opioid distribution: Defendants allegedly billed insurers falsely for the distribution of opioids and provided patients opioids unnecessarily and dangerously.
- Other forms of fraud: Other criminal allegations involve clinical laboratory testing fraud, cash kickbacks to patient recruiters, and various other types of healthcare fraud.
Many of these charges are extremely serious, potentially carrying prison terms should the defendants fail to exonerate themselves or secure a favorable plea deal.
Medical Professionals Face Few Options When Facing Federal Prosecution
Those who have faced federal legal charges or have watched the right documentaries know that one does not simply clear their name when indicted for a federal offense. The 24 doctors, nurses, and other licensed medical professionals who now face federal or local prosecution may:
- Seek to have a judge dismiss the charges against them
- Fight to secure a not-guilty verdict (but may struggle to shoulder the legal cost of going to trial)
- Agree to a plea that minimizes legal penalties to the greatest possible extent
Perhaps most likely, the DOJ will convince defendants to accept a plea rather than wage a costly legal battle against federal prosecutors with the deepest purse in the legal arena.
After Criminal Proceedings Conclude, the Accused Medical Professionals' Priorities May Become Preserving Their Professional Licenses
Even if those charged in this high-profile case clear their names completely, they may face the threat of losing their professional license. In some respects, being unable to earn a living or fill the professional role you have dedicated your life to maybe even more devastating than a criminal conviction.
If you ever find yourself facing the loss of your license to practice in the healthcare space, the Lento Law Firm Team will wage a vigorous defense on your behalf. Call the Lento Law Firm today at 888-535-3686 or contact us online about your professional license defense needs.