Big Sky, Big Fraud? Telemedicine Schemes Reach Montana

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Amid the latest major telehealth takedown last month, DOJ announced new cases in the common locales. Districts in Florida, New Jersey, and other large jurisdictions figured prominently in the announcement. But less noticed was new prosecutions in out-of-the-way districts like Montana, illustrating the reach of telehealth, its location-independence, and the equally widespread enforcement focus on the industry.

In a September 3, 2020 indictment, the government charged Mark Hill with healthcare fraud, 18 USC 1347 and conspiracy to commit healthcare fraud, 18 USC 1349. Hill, a Montana-based nurse practitioner, is alleged to have worked with Integrated Support Network (ISP), a telemedicine company owned by Willie McNeal. (McNeal was separately charged on related charges last year in Tampa, FL). According to the indictment, unnamed DME companies paid telemarketing companies for completed prescriptions for various types of orthotic braces. Those telemarketing companies would obtain Medicare beneficiary information, prepare a DME order, and then forward the near-completed orders to ISP, In turn, ISP contracted with healthcare providers like Hill who would—after a short call or without any communication at all—sign the orders for a fee. ISP then returned signed orders to the telemarketing companies for its fee, and the telemarketers returned the now-completed orders to the DME companies for its fixed fee. Finally, the DME companies completed the process by submitting the fraudulent claims to Medicare for reimbursement.

Hill is alleged to have helped cause over $10 million in false claims submitted to Medicare. What’s unique about Hill’s case? Not much. It follows a typical pattern of so-called telemedicine schemes. But the new indictment shows that telemedicine enforcement is active across the country and providers and telemedicine executives should be on notice—even those in places like Cut Bank, Montana (pop. 3,022).

Ty Howard

Ty Howard

Ty Howard is an attorney specializing in internal investigations, government enforcement, and white-collar criminal defense. A former federal and state prosecutor, Ty focuses his practice on helping businesses and individuals in highly regulated industries navigate government investigations, civil and criminal litigation, and compliance issues.

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