Telehealth Doctor Kickback Settlement: Orders Without a Patient Relationship

A physician from Batavia, Ohio, paid $720,000 in a telehealth doctor kickback settlement over allegations that staffing agencies and telehealth companies paid him for medically unnecessary Medicare orders. The government alleged that he ordered braces and genetic tests for beneficiaries with whom he had no physician-patient relationship and often never spoke. The alleged arrangement paid for the doctor’s orders while leaving the patient out of the conversation.

The U.S. Attorney’s Office for the Western District of Kentucky announced the civil settlement on October 20, 2022. Its account puts temporary physician staffing agencies inside the alleged transaction: they helped connect a doctor’s ordering authority to goods and services billed to Medicare. For someone who knows the staffing contracts, the payments or the order workflow, that connection is the heart of the case. The physician also agreed to additional payments contingent on his income over the following five years and a fifteen-year exclusion from federal health care programs as part of the civil settlement.

The Orders Behind the Medicare Claims

The government alleged that the physician knowingly worked with others to generate false Medicare claims between December 5, 2016, and June 20, 2019. The alleged financial arrangements covered both durable medical equipment and genetic testing. The doctor allegedly received illegal kickbacks in exchange for ordering items and services he knew were medically unnecessary. Medicare and the taxpayers behind it were the targets of those claims. The orders carried beneficiaries’ names, often without those patients ever speaking to the doctor who authorized them.

The equipment included braces for knees, ankles, shoulders, backs and necks. The genetic tests looked for inherited variants associated with a high to moderate increased risk of cancer.

Why a Staffing Payment Can Matter to Medicare

A telehealth order can produce revenue for another business even when the ordering practitioner never bills Medicare for a visit. In its July 20, 2022 Special Fraud Alert, the Department of Health and Human Services Office of Inspector General described arrangements involving patient recruitment, practitioners paid for reviews or signatures, and orders transferred to businesses that bill federal healthcare programs.

The agency described compensation labeled as payment for a review, audit, consultation or assessment of medical charts. Those labels describe work. The payment terms reveal what the business rewards: reviewing a file, approving an order or supplying a signature that allows the next company to bill.

That distinction matters to a staffing employee who sees contracts and invoices but never sees the supplier’s Medicare claim. A recruiter, the ordering practitioner and the business billing for the equipment can each see a different part of the same transaction. Understanding what the staffing customer purchases helps connect those parts. In a separate settlement agreement, Jackson & Coker LocumTenens admitted facts about fees tied to approved orders, although the staffing company did not itself bill Medicare.

Braces, Genetic Tests and the Missing Clinical Work

The equipment and cancer-risk tests in this case carried the same alleged defect: a physician’s authorization without a physician-patient relationship. The inspector general’s alert identifies insufficient patient contact or information, compensation tied to order volume, a restricted product menu and absent follow-up among the features of suspect telemedicine arrangements. Its account starts with recruitment through offers of free or low-cost items and follows the orders to businesses billing federal programs.

That sequence matters in a business selling a single product or product class. When a clinician receives information collected to sell a brace or a test, the question is what medical judgment went into choosing it. The Ohio settlement centers on that gap: the government alleged that the physician knew the goods and services were unnecessary.

A separate civil settlement involving a physician working through RediDoc makes that gap concrete. The Justice Department described a doctor reviewing recorded telemarketing calls and prefilled prescriptions, receiving payment per signed order and continuing after expressing doubts about the work. One example was an order for braces for both knees for a woman whose right leg had been amputated above the knee. The patient’s condition and the product ordered told different stories.

What Evidence Is Needed to Prove Fraud?

For an arrangement like this, the useful evidence connects the staffing payment to the signed order, the patient’s actual contact with the clinician and the Medicare claim that followed. That connection is what we build with you. A staffing contract may explain what triggered payment while the patient history tells a different story about what the clinician did.

A 2024 Rutgers University Law Review analysis, Plausible Cause: Connecting the FCA and AKS in the Context of Health Care Fraud, makes a useful point about who can see that connection. It argues that businesses hold their own records, understand their billing processes and may have internal analyses that are especially useful in explaining the relationship between payments and claims. An insider who understands the staffing arrangement can bring meaning to transactions that look disconnected from outside the business.

We work with that knowledge: why the agency was paid, what the clinician was expected to approve, and how the order reached the company billing Medicare. A whistleblower case under the False Claims Act can pay 15% to 30% of what the government recovers.

You Know What the Staffing Fee Bought

If you know how a staffing or telehealth company paid clinicians for unnecessary orders, speak with our whistleblower experts about what those payments bought. We build the case with you, bring in telehealth fraud whistleblower lawyers who understand paid-order schemes, and stay beside you as the case moves from your account of the business to the pursuit of a government recovery.