Health: Big Healthcare Fraud Scheme Busted

The Story:

Old-fashioned Medicare and VA fraud, involving the creation of sham storefronts for the sale of back and knee braces to senior citizen, and the submission of false claims to the VA and Medicare, seldom gets a lot of media attention (it is not exciting to read about), but it sometimes happens on a massive scale. Earlier this year the Department of Justice, the FBI, and other law enforcement agencies collaborated on a multistate raid on malefactors, an operation that they called “Operation Brace Yourself.”


The scheme busted in February was orchestrated by a Florida woman, Kelly Wolfe, through her company, Regency Inc. Wolfe and Regency have agreed to pay more than $20 million in settlement of the federal charges.

The Department of Justice described it as one of the largest healthcare fraud schemes in US history.

The sham stores, hundreds of them, created fraudulent telemedicine orders for “durable medical equipment” supplies, and then submitted claims for reimbursement.  The DMEs were prescribed with minimal if any doctor-patient interaction.

In Pill Form: 

Telemedicine can be misused in this way precisely because the distant nature of the doctor-patient contact is temptingly quick and easy. Given the new post-pandemic prevalence of telemedicine, authorities are concerned analogous scams are expanding, at ever increasing cost to the public.

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