During the 2022 Qui Tam Conference of the Federal Bar Association, DOJ attorneys commented on the dramatic rise in the use of remote health care services during the COVID-19 pandemic, and the difficulty in bringing civil False Claims Act (FCA) actions against fraudulent telehealth schemes. The number of telehealth users increased from around one million unique users between March 2019 to February 2020, to 28 million unique users in the following year. According to DOJ attorneys, this increase in the use of remote health care services also brought a significant increase in fraudulent schemes that often involve the use of sham companies having doctors write unnecessary prescriptions that are billed to Medicare. DOJ attorneys noted that the use of complex agreements and the frequent involvement of cross-border syndicates make it difficult to bring successful civil FCA actions against these schemes.
Though the DOJ has brought criminal charges targeting telehealth schemes in the past year, including in September when charges were announced against 138 defendants, including over 40 medical professionals, for their alleged roles in a $1.4 billion telehealth fraud scheme, these actions have not involved the FCA. However, DOJ attorneys commented that the government is exploring how civil FCA actions can be brought to address telehealth fraud, and experts in health care fraud believe that there will...
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