Healthcare Policy News

DOJ Busts $1.2B Telemedicine Fraud Ring, CDC Recommends Novavax

Department of Justice (DOJ) officials charged 36 defendants in a telemedicine fraud scheme that generated $1.2 billion in fraudulent payments, and the CDC recommended Novavax for use in adults.

doj busts telehealth fraud scheme while fda approves new covid vaccine

Source: Getty Images

By Hayden Schmidt

- DOJ officials are prosecuting 36 individuals linked to a telemedicine fraud ring that generated over a billion dollars in faulty Medicare claims. The defendants working throughout the United States now face prison time and fines for their involvement in the scheme.

Meanwhile, the CDC has included a new vaccine in its recommended vaccination list and the first vaccine approved in the US that does not use mRNA technology. Novavax, manufactured in North Carolina, boasts a high efficacy and promising side-effect profile, and it comes to the market at a time when cases are rising throughout the nation.
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The VA has delayed its Cerner EHR implementation in Idaho after accumulating reports of patient safety failures and rising costs. A week before the postponement, the VA Office of the Inspector General (OIG) produced a report that found at least 149 cases of patient harm caused by the EHR in Spokane, Washington. Negative OIG reports about the EHR software rollout have escalated for two years, culminating in Idaho’s postponement. Another blow to the project came last week when VA officials estimated a $51 billion price tag for the system, revealing that it was about $40 billion over budget. READ MORE.

DOJ Finds $1.2B in Telemedicine Fraud

The DOJ charged 36 defendants after they received kickbacks for genetic testing and medical equipment, resulting in $1.2 billion in losses. The scheme was conducted by providers at a telemedicine firm who ordered unnecessary tests in exchange for hefty payments from laboratories and medical equipment vendors. One clinical lab used marketers to pay telemedicine companies more than $16 million in exchange for unnecessary testing orders that were then used to generate $174 million in false claims to Medicare. READ MORE.

CDC Recommends Novavax Coronavirus Vaccine

After the FDA issued an Emergency Use Authorization for the Novavax COVID vaccine, CDC officials acted quickly and added the vaccine to its recommended list of adult vaccines. Novavax is a two-dose series with 90.4% efficacy and limited adverse side effects.

“If you have been waiting for a COVID-19 vaccine built on a different technology than those previously available, now is the time to join the millions of Americans who have been vaccinated. With COVID-19 cases on the rise again across parts of the country, vaccination is critical to help protect against the complications of severe COVID-19 disease,” said CDC DC Director Rochelle Walensky, MD, MPH, in a recent press release.  READ MORE.

DOJ Seizes $500k from Maui Ransomware

In a recent press release, DOJ officials shared details of a successful operation where they seized half a million dollars from North Korean-backed ransomware actors. The perpetrators had successfully obtained multiple ransoms from US healthcare providers before their seizure by an FBI-led operation. FBI officials credited the swift action taken by provider organizations with their ability to track and seize stolen assets. READ MORE.

BJC HealthCare to Boost Cybersecurity as Part of Settlement

BJC HealthCare, the victim of a 2020 phishing attack that affected 288,000 individuals across 19 hospitals, agreed to dedicate $2.7 million to multifactor authentication and other security measures as a part of a legal settlement. Five separate class-action lawsuits slammed BJC after the breach and its subsequent failure to secure protected health information. READ MORE.

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