Georgia woman admits participation in scheme to obtain fraudulent reimbursements for medical equipment and genetic testing
SAVANNAH, GA: A Georgia woman has admitted taking part in a nationwide telemedicine kickback scheme that led to fraudulent Medicare reimbursements for durable medical equipment and genetic testing.
Robin Darnell, known to some of her co-conspirators as “Nurse Robin,” 57, of Dallas, Ga., pled guilty in U.S. District Court to an Information charging her with one count of Conspiracy, said David H. Estes, Acting U.S. Attorney for the Southern District of Georgia. The plea agreement subjects Darnell to a possible statutory sentence of up to five years in prison and substantial financial penalties and restitution, followed by up to three years of supervised release.
There is no parole in the federal system.
“Telemedicine has played an increasingly important role in providing accessible healthcare, particularly during the pandemic,” said Acting U.S. Attorney Estes. “With our law enforcement partners, we will continue to work diligently to identify and shut down those who would attempt to use technology and deceit to defraud taxpayer funded safety net programs.”
As described in court documents and testimony, Darnell admitted that from June 2018 through September 2020, she and other conspirators took part in a nationwide telemedicine kickback scheme in which she recruited physicians and other medical professionals to sign orders for durable medical equipment and genetic testing. Darnell claimed to have a team of nurses who would contact patients to conduct exams via telemedicine on behalf of the physicians, in exchange for the health care professionals ordering medical equipment and expensive genetic testing for those patients. In fact, Darnell had no such team of nurses, despite claiming otherwise to the physicians she recruited. Darnell processed thousands of orders, which Darnell knew contained medical histories, conditions, diagnoses, or examinations that Darnell knew were false.
Darnell’s conspirators then used these orders to bill Medicare for thousands of dollars each. Medicare beneficiaries were located in the Southern District of Georgia and elsewhere.
“Telemedicine has become a valuable tool for delivering health services in this time of pandemic. However, bad actors are abusing these tools to commit health care fraud,” said Derrick L. Jackson, Special Agent in Charge for the Office of Inspector General of the U.S. Department of Health and Human Services. “When marketing and so-called telehealth services are misused, alleged violators can expect aggressive investigation and swift prosecution.”
“Darnell took advantage of a system that was set up to help healthcare patients get much-needed government assistance during a pandemic,” said Chris Hacker, Special Agent in Charge of FBI Atlanta. “Her actions not only affect those patients, but every citizen whose tax dollars support programs like Medicare. The FBI is determined to hold her accountable and anyone who would commit such fraud.”
The Southern District of Georgia has now charged 33 defendants as part of the nationwide crackdown on fraudulent genetic testing, and prescribing of orthotic braces and pain creams, identifying more than $1.5 billion in losses to Medicare and Medicaid for defendants charged in the Southern District alone.
This investigation is ongoing. As telemedicine becomes an increasing part of our healthcare system, particularly during the COVID-19 pandemic, vigilance in ensuring that fraud and kickbacks do not usurp the legitimate practice of medicine by electronic means is more important than ever. If you are aware of any fraud or kickbacks relating to telemedicine, including COVID-19 fraud, please call the FBI hotline at 1-800-CALL-FBI.
The case was investigated by the FBI and the Health and Human Services Office of the Inspector General, and prosecuted for the United States by Assistant U.S. Attorney Jonathan A. Porter.
News article: https://www.justice.gov/usao-sdga/pr/georgia-woman-admits-participation-scheme-obtain-fraudulent-reimbursements-medical