In what highlights a continued crackdown on Medicare fraud, the U.S. Attorney for the Western District of Michigan, Mark Totten, has heralded the latest convictions and settlements involving physicians in telemedicine schemes.TheU.S. Department of Justicereported thatthese schemes have seen doctors ordering unnecessary medical equipment, costing the Medicare program millions of dollars.
In the second wave of enforcement for Operation Happy Clickers, two doctors pleaded guilty to making false statements about healthcare matters, admitting to promptly authorizing medical orders for patients they had never seen. Over the last five years, fraudsters have operated nationwide telemarketing schemes to defraud the Medicare Program of billions of dollars by preying on older adults to solicit orders for medically unnecessary braces and genetic testing, Totten said, per theDepartment of Justicepress release. This growing issue has prompted authorities to more aggressively pursue those who violate the law.
Among those convicted, Dr. Theresa Kordish of Kalamazoo, MI, and Dr. Utibe Effiong, formerly of Mt. Pleasant, MI, acknowledged approving orders without appropriate review. Dr. Kordish agreed to settle for $50,000, while Dr. Effiong will pay $150,000. Three other physicians reached civil settlements without criminal charges, ranging from $80,000 to nearly $300,000.
The larger telemedicine scam involved medical supply companies and genetics testing labs that filled out fraudulent orders, which physicians approved without seeing patients. The FBI s Special Agent in Charge in Michigan, Cheyvoryea Gibson, said in a statement detailed by theU.S. Department of Justice, By preying on the elderly and defrauding Medicare, these individuals betrayed their oath to uphold the highest standards of care and ethics; in turn, they exploited a vulnerable population for personal gain. These fraudulent activities have underscored a systemic issue within telemedicine operations nationwide.
Since the operation’s inception, federal efforts have recovered over $1 million for the Medicare program, with the latest enforcement actions by the U.S. Attorney’s Office for the Western District of Michigan being coordinated with HHS-OIG and the FBI. Additional restitution is expected following criminal sentencing scheduled for the convicted doctors in early 2025. The collective efforts reflect a stance of zero tolerance for healthcare fraud, helping preserve the Medicare system’s integrity. Civil settlements mentioned are part of allegations and do not equate to an admission of liability.
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