New York physician indicted in $10M telemedicine fraud scheme

A New York orthopedic surgeon is facing federal charges for his alleged role in a fraud scheme involving the submission of false claims to Medicare and Medicare Part D plans, the U.S. Justice Department said April 21.

Prosecutors allege that Elemer Raffai, MD, and others submitted about $10 million in fraudulent claims for durable medical equipment. Medicaid paid more than $4 million of those claims. 

Dr. Raffai practiced telemedicine with the AffordADoc Network and other telemedicine companies that paid him for each consultation with a beneficiary, the Justice Department alleges. Between July 2016 and June 2017, Dr. Raffai allegedly signed prescriptions and order forms via telemedicine services for durable medical equipment, including orthotic braces, that was not medically necessary. 

The Justice Department alleges Dr. Raffai submitted the claims based solely on short telephone conversations for beneficiaries he had not physically examined and evaluated. He was allegedly paid in bribes and kickbacks. 

If convicted, Dr. Raffai faces up to 10 years in prison.

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