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108 Iowa L. Rev. 69 (2022-2023)
Telemedicine Scams

handle is hein.journals/ilr108 and id is 81 raw text is: Telemedicine Scams Katrice Bridges Copeland* ABSTRACT: Telemedicine emerged as a lifeline during the COVID-19 pandemic. Although the technology existed long before the pandemic, its use was limited due to strict government regulations that limited reimbursement for telemedicine visits. In response to the pandemic, the Government waived many of its restrictions for the duration of the Public Health Emergency. These changes fueled the growth of telemedicine. The problem, however, is that telemedicine makes it easier to conduct fraud on a large scale because without in-person visits, medical providers can reach many more beneficiaries in a short period of time. Thus, the size and scale of typical health care fraud schemes, such as sending medically unnecessary durable medical equipment, is magnified. This type offraud has been on the rise since 2016, and, with the relaxed rules for telemedicine reimbursement during the pandemic, there is a serious concern that there will be a sharp increase in telemedicine fraud. This Article examines the fraudulent practices in the telemedicine industry and the conditions that permit them to flourish. This Article critically assesses the changes to telemedicine coverage and their relationship to fraud. It examines the fraudulent practices through the lens of the fraud triangle to determine why telemedicine fraud occurs. After assessing the causes of telemedicine fraud, this Article argues that there is no need for additional criminal statutes to address telemedicine fraud. As the typical telemedicine scam involves the payment of kickbacks and billing for medically unnecessary treatment and services, the existing fraud laws such as the Anti-Kickback statute and the False Claims Act are sufficiently capacious to address the criminality involved in these cases. This Article also argues that in lieu of additional criminal statutes, the Government should focus on additional * Professor of Law, Penn State Law, University Park, PA. B.S., University of Illinois; J.D., University of Michigan Law School. For helpful comments on this project, I thank Lucy Hodder, Valarie Blake, Deborah Farringer, Kristin Madison, Laura Hoffman, Carl Coleman,John Jacobi, Adam Muchmore, Tara Ragone, and Michal Buchhandler-Raphael. I would also like to thank the participants of the 44th Annual Health Law Professors Conference and Seton Hall's Sixth Annual Health Law Works-in-Progress Retreat. I am grateful to Sierra Zellner, Penn State Law class of 2022, for research assistance. 69

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