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Washington State News

DOCTOR AGREES TO PAY $95,000 TO SETTLE ALLEGATIONS OF HEALTH CARE FRAUD

Spokane, WA – Physician Daniel Case has agreed to pay $95,000 to resolve allegations that he participated in a kick-back scheme and ordered medically unnecessary durable medical equipment that Case caused to be billed to Medicare, Medicaid, and other federal health care programs, announced Vanessa R. Waldref, the United States Attorney for the Eastern District of Washington.

Between October 2018 and April 2019, Case worked with RediDoc LLC (Redidoc).  RediDoc employed telemarketing companies to call federal health care program beneficiaries, including Medicare beneficiaries, and speak with them about obtaining durable medical equipment at no cost.  Portions of these calls were recorded and provided to physicians, like Dr. Case, along with pre-filled prescriptions for durable medical equipment.  The physicians would review the recordings and sign orders for durable medical equipment, which were then billed to federal health care programs, including Medicare.  The physicians, including Dr. Case, were paid for each order they signed prescribing durable medical equipment.

The owners of RediDoc were charged with various federal offenses in September 2020, including conspiracy to violate the federal anti-kickback statute, based upon the fact that the payments to physicians were remuneration intended to induce the physician to sign durable medical equipment orders, including orders that were not medically necessary. The owners of RediDoc both pled guilty to this conspiracy, admitting that RediDoc provided kickbacks to physicians, such as Dr. Case, to induce them to sign durable medical equipment orders.

While employed with RediDoc, Dr. Case expressed in a November 14, 2018, email his “concern” regarding the “legitimacy of what I am doing.” Nevertheless Dr. Case continued to work with RediDoc and signed durable medical equipment orders for patients until April 2019.  During his time working with RediDoc, Dr. Case signed numerous orders that were not medically necessary.  For example, Dr. Case signed an order on January 18, 2019, prescribing right and left knee braces to a woman who had and above-the-knee amputation of her right leg.  As another example, Dr. Case signed three durable medical equipment orders on January 9, 2019, for a patient who had died on January 7, 2019.  While working with RediDoc, Case signed orders that resulted in Medicare payments of $3,358,221.57.  During the same time, RediDoc paid Case approximately $66,727.00 for orders he signed.

“Kickback schemes incentivize physicians to place financial gain over patient care,” said United States Attorney Waldref.  “RediDoc relied upon the willing participation of doctors around the country to sign orders prescribing equipment or medication for payment.  These schemes compromise the medical decision making of physicians, resulting in the payment of public money for services that are not medically necessary for the patients, such as the braces Dr. Case ordered for patients here.  This settlement is a signal to physicians that they will be held accountable for engaging in kickback schemes, and that they stand to lose more in the long run than will be gained in the short term by participating in an unlawful practice.”

“Doctors that participate in telemedicine kickback schemes for personal financial gain corrupt the provider-patient relationship and undermine the integrity of taxpayer-funded health care programs” said Special Agent in Charge Steven J. Ryan with the Department of Health and Human Services, Office of the Inspector General (HHS-OIG).  “This settlement demonstrates HHS-OIG’s ongoing commitment to protecting federal health care programs and ensuring that providers focus on providing medically necessary care.”

The settlement was the result of a investigation conducted by the U.S. Attorney’s Office for the Eastern District of Washington and the U.S. Department of Health and Human Services, Office of Inspector General, Seattle Field Office.  Assistant United States Attorney Jeremy Kelley of the Eastern District of Washington handled this matter on behalf of the United States.