Earlier this month, the Department of Justice (DOJ) announced that the owners of two telemedicine companies were charged with one count of conspiracy to defraud the United States and to pay and receive health care kickbacks, one count of conspiracy to commit health care fraud and wire fraud, three counts of receiving health care kickbacks, and one count of conspiracy to commit money laundering.
Reinaldo Wilson and Jean Wilson, a husband and wife duo from Richmond Hill, Georgia, own purported telemedicine companies Advantage Choice Care LLC (ACC) and Tele Medcare, LLC. The Wilsons, through their telemedicine companies, allegedly orchestrated a nationwide scheme to receive kickbacks and bribes in exchange for ordering medically unnecessary orthotic braces for Medicare beneficiaries.
The indictment alleges that Mr. and Mrs. Wilson owned and operated ACC and Tele Medcare, which had locations in Bayonne, New Jersey; Boca Raton, Florida; and Richmond Hill, Georgia. The indictment further alleges that the Wilsons agreed to solicit and receive illegal kickbacks and bribes from patient recruiters, pharmacies, brace suppliers and others in exchange for the arranging for doctors to order medically unnecessary braces for beneficiaries of Medicare from approximately March 2017 through April 2019. Additionally, in order to get those orders that were transmitted in exchange for kickbacks and bribes, the Wilsons – through ACC and Tele Medcare – recruited and hired healthcare providers to order braces for Medicare beneficiaries. Mr. and Mrs. Wilson also allegedly paid illegal kickbacks and bribes to healthcare providers to order braces for Medicare beneficiaries that were medically unnecessary, ineligible for Medicare reimbursement and/or not provided as represented.
The indictment further alleges that Reinaldo Wilson, Jean Wilson, and others transferred the brace orders to co-conspirator brace suppliers to support more than $56 million in false and fraudulent claims to Medicare that were submitted by brace suppliers and that Medicare paid these brace suppliers in excess of $28 million for these claims.
Further, to the money laundering charge, the indictment alleges that between approximately March 2017 and April 2019, Reinaldo Wilson and Jean Wilson agreed to engage in monetary transactions of criminally derived property in amounts greater than $10,000.
The Wilsons were arrested on February 5, 2020. Mr. Wilson was held pending a bail hearing scheduled for February 11, 2020, while Ms. Wilson was released and was set to appear for a bail hearing the same date.
The indictment of Reinaldo Wilson and Jean Wilson has references throughout it to “others” that seemed to act in concert with the Wilsons in their alleged activity. We will have to watch and see if any additional indictments will come out of this situation.
Telemedicine, as a growing field that has not yet been terribly regulated, has entered a new phase. It will be interesting to watch this case progress through the courts, as well as see if the DOJ will turn its focus to other telemedicine companies.