Advantage Choice Care and Tele Medcare: The Owner Who Signed and Sold Orders

Advantage Choice Care and Tele Medcare’s paid-order telemedicine fraud scheme generated over $136 million in false Medicare claims, of which Medicare paid over $66 million, according to the Justice Department’s announcement about the owner’s criminal case. The owner paid providers to sign unnecessary orders and signed many prescriptions herself. The medical signature was something the business could sell before anyone billed Medicare for the product.

The owner was a licensed nurse practitioner who operated the telemedicine companies between 2017 and 2019. The criminal indictment identifies Advantage Choice Care and Tele Medcare as companies she owned and operated with her husband and, for Tele Medcare, others. She pleaded guilty in March 2024 to conspiracy to commit wire fraud and health care fraud.

A Price Per Beneficiary, Several Products to Sell

The telemedicine order business sold signed orders and prescriptions for approximately $90 per Medicare beneficiary, according to the Justice Department’s announcement. Purported marketing companies paid that price for the orders.

The buyer could acquire orders covering several products for the same person. The marketers often resold the orders to brace suppliers and pharmacies, which then submitted Medicare claims for medically unnecessary equipment and drugs. The business made the signature available for resale, while the supplier or pharmacy turned the order into a claim.

The Owner Also Signed the Prescriptions

The owner ran the business and signed prescriptions herself. The Justice Department’s announcement describes her payments of illegal kickbacks to medical providers for brace orders and drug prescriptions that beneficiaries did not need.

That combination puts practitioner recruitment, payment and the prescription in the same story. The person running the order business also supplied the signature that made its product saleable.

After her arrest and indictment, the owner presented herself as a medical professional legal consultant and wrote books on health care compliance. The Justice Department quoted a warning from one of those books:

The warning describes the very risk her own business created for the practitioners it recruited: someone else turning their medical orders into revenue. The marketers resold the orders to suppliers and pharmacies, which submitted Medicare claims for unnecessary equipment and drugs.

One Beneficiary, Repeated Brace Orders

The Justice Department’s announcement describes pressure on beneficiaries to accept as many braces as possible. Practitioners working for the owner signed orders for four or more orthotics per beneficiary for over 3,000 beneficiaries. Over 40 beneficiaries received orders for ten or more orthotics. Patients faced pressure to accept equipment they did not need, and taxpayers paid the bill.

The indictment’s description of the brace business includes off-the-shelf ankle, knee, back, elbow, wrist and hand braces. It also explains what the downstream claim carried: the beneficiary’s identity, service date and cost, the ordering practitioner’s name and identification number, and the brace supplier’s name and identification number.

Those details connect the clinical side to the billing side. A supplier claim can show whose order it relied on. The order and supporting medical information can show what that practitioner represented about the patient’s need. The patient who was pressed to accept more equipment sits at the beginning of both accounts.

Kickbacks Labeled as Consultation Expenses

The indictment alleged that the owners disguised kickbacks through sham contracts and agreements that labeled payments as medical and consultation expenditures. It also alleged that money reached the network indirectly through nominee companies and bank accounts.

The Justice Department’s announcement describes shell accounts and owners put forward in place of the actual controller. One example involved a member of the owner’s church opening a bank account in the name of a telemedicine company.

That is a concrete reason to look beyond the expense label. The indictment alleged payments for ordering, arranging or recommending braces, while the paperwork described medical or consultation spending. What the purchaser received and who controlled the receiving account explain more than the label on the payment. Alongside the disguised payments, the indictment alleged that the owners and others falsified, fabricated or altered brace orders and other records to support the claims.

The Consultation Went Unbilled

The indictment alleged that the network facilitated brace ordering by charging neither beneficiaries nor Medicare for the purported telemedicine consultations. The resulting orders went to recruiters, brace suppliers and others to support supplier claims.

A search confined to bills for remote visits would miss that alleged revenue model. The consultation produced an order that another business could monetize. The absence of a consultation bill was part of how the owners allegedly facilitated the orders. The superseding indictment involving Video Doctor USA, AffordADoc and Procall likewise alleged that the network sold orders from purported consultations billed to neither beneficiaries nor Medicare.

The broader industry structure helps explain the separation. A telemedicine company can recruit the practitioner, a marketer can supply the beneficiary information and buy the order, and a supplier can submit the claim. The Department of Health and Human Services’ Office of Inspector General describes arrangements linking those roles in its July 2022 Special Fraud Alert. The party paying for the practitioner’s work can be different from the patient or the insurer that would pay for an encounter.

What Evidence Is Needed to Report Fraud?

Our whistleblower experts work with you to connect what you know about paid orders to the resulting Medicare claims. In a business like this one, the person routing prescriptions and the person handling payments may each see a different part of the scheme.

Someone handling order routing may know which marketer received the signed paperwork. Someone handling accounts may know why a consultation payment went to another company’s bank account. A practitioner may know what information was available when the order was signed.

You Saw What the Signature Was Worth

If you saw medical orders bought, routed or paid for behind a consultation label, speak to one of our Whistleblower Experts about how the orders were sold. We build the case with you, bring in telehealth fraud whistleblower lawyers who understand paid-order arrangements, and stay beside you through the pursuit of a recovery. A whistleblower case under the False Claims Act can pay 15% to 30% of what the government recovers.