Provider Licenses at Risk In Crackdown on Telemedicine Fraud

A Maryland OB-GYN was fined $500,000 for defrauding Medicare in a telemarketing scheme. In Florida and Alabama, physicians face prison terms and steep fines for participating in telemedicine schemes that took millions from Medicare. The list goes on.

What we’re seeing here is a new type of fraud that takes advantage of virtual services in which physicians and nurse practitioners are paid for what the orchestrators of the schemes call patient “consultations.” The providers either review patient files with no interaction with the patient, or have a cursory phone conversation with the patient without reviewing their file, and sign pre-populated order forms for tests and equipment, billable to Mediare.

The U.S. Department of Justice contends the practice constitutes fraud and prosecutes the providers involved, whether the providers realize they’re doing something illegal or not. DOJ also automatically notifies the providers’ state medical licensing boards, which in turn issue emergency license suspensions within 48 hours of the unsealing of charges.

Physicians and nurse practitioners likely view the telehealth jobs as legitimate side gigs and are unaware that they could lose their license for it. If you’ve fallen into a telehealth scheme, the Professional License Defense Team at the LLF National Law Firm can help. Call us at 888-535-3686 or send us a message online.

An Alabama Doctor Stepped Up — And the Feds Took Him Down

In a world of physician shortages and long wait times for patients, especially during the Covid-19 pandemic, Dr. Tommie Robinson, a family medicine practitioner in Alabama, probably thought he was helping out — as well as making a little extra money. 

Working with different telehealth companies between 2018 and 2021, Robinson would review patient files and sign his name to pre-filled-out forms ordering durable medical equipment (DME) and genetic tests (for cancer, mostly) that investigators later deemed medically unnecessary. He never examined or spoke with the patients, who were Medicare recipients recruited by a telemarketing company. Genetic testing labs and DME suppliers submitted a total of $2.7 million in claims to Medicare based on Robinson’s signed orders.

Now, Robinson, who was likely paid for every form he signed (rather than by the hour), is preparing to serve 16 months in prison and owes $2.7 million in restitution. The Alabama licensing board has suspended his license.

Telehealth Fraud and Your Medical License

Telemedicine can be a boon for patients fed up with long wait times and faraway in-network facilities. It can also be a nice practice for physicians and nurse practitioners who can’t work in an office or clinical setting, or need a flexible schedule, or could just use a little extra income from time to time. 

But providers need to be careful about what a telehealth company is asking them to do. (One red flag: You’re being paid per order, or consultation, or signature rather than by the hour. The DOJ views this as an illegal kickback under the Anti-Kickback Statute.) Without your license, you won’t be able to practice anywhere in your state. That’s a disaster.

If you’re accused of fraud because of your telehealth work, the LLF National Law Firm’s Professional License Defense Team will make sure your state licensing board follows correct due process in your case, guide you through the investigation and hearings, and help you negotiate the best possible outcome. Send us a message online and tell us about your case, or call us directly at 888-535-3686.