Telemedicine Fraud and Kickback Cases

By Sarah Wirskye - On

Telemedicine has been growing over the last several years, and COVID-19 has accelerated that growth. Several provisions in the CARES Act relaxed telemedicine rules.  In addition to the CARES Act, there have been many other legislative and policy changes on both the national and state levels.

For example, in March 2020, HHS OIG issued a policy statement that allows practitioners to reduce or waive patient responsibility amounts for telemedicine during the COVID-19 public health emergency. ( Doing so otherwise could potentially run afoul of the anti-kickback statute (AKS). See  However, providers should recognize that this policy does not make them immune to the AKS. There could be other issues that implicate potential violations, including the AKS.

For example, a Georgia telemedicine company owner, Charlene Frame, recently plead guilty to a telemedicine fraud conspiracy.  Frame pled guilty for conspiring to pay medical providers, such as physicians and nurse practitioners, in exchange for obtaining orders for durable medical equipment.

Similarly, in the Northern District of Texas, a doctor was indicted for receiving kickbacks for writing compounding drug prescriptions for telemedicine patients.  The government’s position was that payments he received for alleged consulting services were really disguised kickback payments.  The government further argued that the prescribing physician had no physician/patient relationship and that the physician only performed a cursory consultation via telephone. The physician disputed these allegations at trial and asserted that the payments were not in exchange for the prescriptions, and the prescriptions were for patients utilizing telemedicine. At trial, the jury was deadlocked on the charges against the defendant and he is scheduled to be retried.

The Texas prosecution is particularly instructive because it includes not only typical AKS issues but also alleges services not provided when they were arguably provided via telemedicine.  Providers need to ensure that their documentation when providing such services is just as robust as if the patient was being treated in person.

In conclusion, there is greater willingness to utilize telemedicine by patients and providers, and legislative changes have been more accepting of the practice as well.  However, because of the increased use of telemedicine, providers should be vigilant with their practices.  As stated earlier, this includes thoroughly documenting all patient encounters and being mindful of any remuneration arrangements that could be suspect under the AKS or other bribery statutes. Because of its growth, telemedicine is likely to be under increased scrutiny by the government.

Leave a Comment