Four people – David Woroboff of Del Rey, California, George Willard of Brooklyn, Michigan, Randall Mills of Plano, Texas, and Dr. Le Thu, a licensed physician from South Bridge, Massachusetts – have been indicted for their alleged involvement in a telehealth fraud scheme that cost public and private payers a whopping $37 million. They stand accused of one count of conspiracy to commit healthcare fraud and one count of conspiracy to violate the federal Anti-Kickback Statute, as they are believed to have created unnecessary prescriptions and accepted kickback payments in order to carry out their fraudulent activities.
Willard Woroboff and Mills were employed by a telemedicine company, and used their high-ranking positions to generate a high volume of prescriptions for compounded medications and DMEs. In May 2014, these individuals started creating the inaccurate prescriptions without proper communication between the patient and medical provider. Healthcare providers that were associated with the telemedicine company agreed to write the prescriptions, which broke certain state telemedicine laws, in exchange for kickbacks from Woroboff, Willard, and Mills. One of the doctors involved, Thu, was given $35 for each prescription he wrote. The defendants misled Thu and other healthcare providers into writing prescriptions without talking to patients beforehand by falsely claiming that other nurses had already consulted the patients about their medical history and deemed the prescription medically necessary. However, these nurses were based in the Philippines and not licensed to practice in the US, meaning they had not spoken to the patients either. Patient information was provided by marketing company representatives, who also paid the telemedicine company to produce the fraudulent prescriptions. Furthermore, Woroboff and Willard utilized fake phone numbers and addresses for the healthcare providers in order to disguise their fraudulent activities.
If convicted of conspiracy to commit healthcare fraud and conspiracy to violate the federal Anti-Kickback Statute, the defendants in the telemedicine fraud scheme could face up to 10 and 5 years in prison, respectively. In addition, the U.S. Attorney’s Office, the Office of the Inspector General, and the U.S. Department of Labor-Employee Benefits Security Administration are all involved in the investigation and the defendants may be subject to fines of up to $250,000 per count or double the gross profit or loss caused by their offense. This scheme is estimated to have cost private health insurance companies, TRICARE, and Medicare a total of $37 million.