A federal court in Brooklyn recently arraigned a New York anesthesiologist for health care fraud. The government has accused the physician of failing to provide services for telemedicine as billed.
Is the government unfairly focusing on telemedicine?
It is unclear. The government does clarify within the indictment that telemedicine provides a tool to connect patients and physicians. This appears to show the government recognized the value of the telemedicine practice when used wisely.
What were the allegations?
The prosecution’s allegations include fraudulently billing government and private insurance companies. The indictment also states the physician would allegedly receive illegal kickbacks in exchange for each telemedicine encounter. The anesthesiologist is also accused of prescribing medication and medical devices that were medically unnecessary in exchange for monetary rewards.
The allegations are serious. The prosecution has accused the physician of working with a group of other medical professionals that, combined, submitted over $7 million in illegal claims to Medicare.
What can other anesthesiologists learn from this case?
The case is another example of charges brought against physicians due to evidence gathered through investigations by the Federal Bureau of Investigation (FBI), Health and Human Services Office of Inspector General, Office of Investigations (HHS OIG) and brought forward by the Medicare Fraud Strike Force. Although telemedicine itself is not a specific focus, the group has proven itself a fierce opponent against Medicare fraud.
As such, anesthesiologists are wise to review their best practices to ensure they are in line with applicable rules and regulations. Such proactive measures can help to identify issues and make changes before the issues grow into a larger, potentially illegal, problem.