At the last minute, President Donald Trump granted pardons to several individuals convicted in huge Medicare swindles that prosecutors alleged often harmed or endangered elderly and infirm patients while fleecing taxpayers.
The Justice Department has thus far declined to take over the case, which alleges wrongdoing by Seattle-based nonprofit health plan, Group Health, but said in a June 21 court filing that “an active investigation is ongoing.”
The progress in artificial intelligence (AI) is reshaping patient care, across various dimensions, from facilitating faster discharge to curating treatment plans and suggesting lifestyle changes.
While prescriptions for durable medical equipment, such as orthotic braces or wheelchairs, have long been a staple of Medicare fraud schemes, the manipulation of telemedicine is relatively new.
Suspects in the case include executives at five telemedicine companies, the owners of dozens of durable medical equipment (DME) companies and three licensed medical professionals.
After an eight-week trial, Philip Esformes was found guilty for his role in a fraud scheme that involved more than $1.3 billion in fraudulent claims to Medicare and Medicaid for services that weren't provided, weren't medically necessary or were procured through the payment of kickbacks.
According to the DOJ, this is the ninth consecutive year that the organizations' civil healthcare fraud settlements and judgments have exceeded $2 billion.
The future looks bright for the integrated specialty pharmacy model – for health systems, providers, and most importantly, for patients.