More than half a dozen people, including several doctors and a former nursing professor at the Medical University of South Carolina, have been charged by federal prosecutors with taking part in schemes that used overseas call centers, telemedicine companies and a network of physicians to submit fraudulent Medicare claims.
The new criminal charges stem from an earlier investigation into more than $1 billion in Medicare fraud, which the U.S. Attorney’s Office in South Carolina dubbed “Operation Brace Yourself.”
That previous probe looked into how medical equipment companies were partnering with overseas call centers to persuade Medicare recipients to order back, leg or wrist braces. They then used doctors and telemedicine companies to write prescriptions for those products without the physicians ever examining the patients or determining whether the braces were medically necessary.
More than 24 people were charged in that initial investigation, including Andrew Chmiel, a Mount Pleasant resident who owned several companies that prosecutors say profited off the scheme.
The newer cases, which were filed in federal court late last month, describe similar networks involving telemarketers, telemedicine companies and physicians, but this time the allegations went beyond medical braces. Some of the allegedly bogus prescriptions were for genetic testing.
“Those who steal from federal health care programs are taking money from the pockets of taxpayers,” Peter McCoy, the U.S. Attorney for South Carolina, said in a statement. “This is reprehensible.”
Four of the defendants charged in South Carolina are or were medical providers in the state.
Three of them, Alyssa Degnan, Fatimah Jah and Jeffrey Hoffman, are licensed physicians. The other, Kathryn Van Ravenstein, is a licensed nurse practitioner with a doctorate who until recently was an assistant professor at MUSC’s College of Nursing.
All four face similar charges. Prosecutors said they were paid to write prescriptions for Medicare recipients, often without “speaking to, examining, or following up with” those patients. The only information they went off of were documents provided by the telemedicine company they were doing business with, according to law enforcement authorities.
The prescriptions they signed contributed to more than $100 million in fraudulent charges to Medicare in South Carolina, the U.S. Attorney’s Office said.
Hoffman and Van Ravenstein have signed plea agreements. The charges they intend to plead guilty to could carry up to five years in prison, another three years of supervised release and a $250,000 fine.
A judge could also order them to pay restitution. Also, prosecutors could recommend lighter sentences as a result of them pleading guilty.
MUSC had no connection to the criminal allegations filed against Van Ravenstein. Heather Woolwine, a spokeswoman for MUSC, said the hospital and college “severed” their connections with her as a result of the charges and her guilty plea.
The Post and Courier attempted to contact Degnan, Jah, Hoffman and Van Ravenstein, either directly or through their attorneys.
Walt Cartin, who represents Degnan, said his client has fully cooperated with the prosecutors and assisted the government in their investigation into the telemedicine companies that took part in the alleged scheme.
“Dr. Degnan approached the government and self-reported her conduct and her role in the charged offense before the government ever identified her as a target,” Cartin said.
The others facing felony charges in South Carolina either owned or operated businesses that prosecutors said profited off the sales.
Prosecutors said David Tsui ran a company called Comfortland Medical Inc. that shipped wrist braces and other “durable medical equipment” that was eventually billed to Medicare.
Also, Jeff Charnock and Steve Lowell ran several other companies that operated in a similar fashion, billing Medicare for unnecessary prescriptions, the government alleged.
The Post and Courier also attempted to contact Tsui, Charnock and Lowell through their attorneys. Tsui and Lowell have already signed plea agreements, according to court records.
Bill Nettles, Lowell’s defense attorney, said his client also cooperated.
“At a time when it seems passé to take accountability for your actions, Steve Lowell has taken responsibility and has done everything in his ability to make it right,” said Nettles, who served as the U.S. Attorney in South Carolina from 2010 to 2015.
Reach Andrew Brown at 843-708-1830 or follow him on Twitter @andy_ed_brown.