Telemedicine Fraud Defense
Former DOJ Fraud Section Prosecutors. Nationwide Defense for Telemedicine Company Owners, Telehealth Platform Operators, Physicians, Nurse Practitioners, MSO Executives, and Healthcare Professionals Facing Federal Telemedicine Fraud Investigations and Charges.
Based in Washington, D.C., Armstrong & Bradylyons PLLC defends telemedicine company owners, telehealth platform operators, physicians, nurse practitioners, management services organization (MSO) executives, call center operators, marketers, and healthcare executives in federal telemedicine fraud investigations and cases nationwide.
The firm’s healthcare fraud defense practice is built on nearly a decade of combined experience at the nation’s preeminent healthcare fraud enforcement unit: the Healthcare Fraud Unit of DOJ’s Fraud Section. Scott Armstrong, Drew Bradylyons, and Andrea Savdie tried 17 federal jury trials in healthcare fraud cases at DOJ’s Fraud Section involving over $2.8 billion in alleged false and fraudulent claims to federal healthcare programs. The firm uses that experience to defend individuals in telemedicine fraud cases at every stage: from the first grand jury subpoena, through federal indictment, and at trial.
Telemedicine fraud is one of the most aggressively prosecuted categories of healthcare fraud. DOJ has stated that telemedicine fraud schemes have “exploded” and present “grave fraud risks.” The firm defends individuals in every federal district where DOJ, HHS-OIG, and the DEA bring telemedicine fraud cases.
Armstrong & Bradylyons PLLC defends every telemedicine fraud case from the start as if it will go to trial. That is not a slogan. It is the operating principle of the firm, grounded in 25 federal jury trials in complex fraud cases in federal courts across the country.
Trial experience drives results at every stage. Telemedicine fraud cases are built on platform data, call center records, prescribing patterns, and cooperating witness testimony. They involve allegations that telemedicine encounters were sham consultations, that physician orders were generated without genuine patient relationships, that platforms influenced clinical decision-making to maximize billing, that kickbacks were paid for orders or prescriptions, and that controlled substances were prescribed without legitimate medical purpose. The firm builds the factual record from the first day of engagement: analyzing platform data, retaining clinical experts, identifying and preparing witnesses, and developing a case theory that can withstand the government’s scrutiny.
The firm’s attorneys know how federal prosecutors build healthcare fraud cases because they built them. Scott Armstrong served for nearly a decade at DOJ’s Fraud Section, where he served as lead trial counsel in 16 federal jury trials, including complex healthcare fraud cases involving Medicare, Medicaid, and Tricare. Drew Bradylyons served as Chief of EDVA’s Financial Crimes and Public Corruption Unit and, before that, supervised the Healthcare Fraud Unit’s Miami Strike Force at DOJ’s Fraud Section. That combined experience provides the firm with an unmatched understanding of how federal healthcare fraud cases are investigated, charged, and tried.
The firm relishes the opportunity to try cases. Its willingness to go to trial and its proven skills at trial provide significant leverage in negotiations with federal prosecutors at every stage of a telemedicine fraud case.
Telemedicine fraud is a named enforcement priority of DOJ’s Fraud Section. The government has made it one since well before the pandemic. In 2019, DOJ launched Operation Brace Yourself, charging 24 defendants in telemedicine-driven schemes involving medically unnecessary DME and orthotic braces. That same year, Operation Double Helix charged 35 defendants in telemedicine-driven genetic testing fraud. Combined, these operations involved over $10 billion in alleged fraud. The enforcement has only accelerated since.
DOJ’s 2025 Year in Review stated that the Health Care Fraud Unit has “intensified” its focus on telemedicine schemes “in which telemedicine platforms were exploited to generate false claims, improperly prescribe controlled substances, or bypass necessary clinical oversight.” In the 2025 National Health Care Fraud Takedown, 49 defendants were charged for telemedicine and genetic testing schemes involving $1.17 billion in fraudulent claims to Medicare.
The sentences are severe. The CEO of DMERx, an internet-based platform that generated fraudulent physician orders, was sentenced to 15 years in federal prison for a $1 billion telemedicine fraud conspiracy. A telemedicine company owner was sentenced to seven years for a $56 million Medicare fraud scheme involving kickbacks for orthotic brace orders. Another operator received 10 years for a $174 million telemedicine fraud conspiracy. In November 2025, the founder and clinical president of Done Global were convicted in what DOJ described as its first criminal drug distribution prosecution arising out of telemedicine prescribing. The scheme involved over $100 million and more than 40 million pills of Adderall distributed through a subscription-based telehealth platform.
In 2022, HHS-OIG issued a Special Fraud Alert identifying suspect characteristics of telemedicine arrangements, including limited patient contact, volume-based compensation, and restricted treatment offerings. That alert remains the government’s clearest statement of the red flags it uses to identify telemedicine fraud targets.
Telemedicine flexibilities that allow prescribing controlled substances without a prior in-person visit have been extended through December 31, 2026. The extension reduces care disruption. It does not reduce enforcement risk. Prosecutors can and do focus on whether prescribing practices align with professional standards, whether patient evaluation is adequate, and whether platform design influences clinical judgment.
The firm’s telemedicine fraud defense practice is built on healthcare fraud trial experience, deep knowledge of federal telehealth billing and prescribing regulations, and years of experience investigating and prosecuting complex healthcare fraud cases at DOJ’s Fraud Section. These tools are deployed at every phase of a case.
Establishing Legitimate Telemedicine Encounters and Physician-Patient Relationships
The government’s central theory in telemedicine fraud cases is that physician-patient relationships were nonexistent or insufficient. Prosecutors allege that physicians signed orders without examining, speaking to, or evaluating the patient. The firm builds the factual record to demonstrate that telemedicine encounters were genuine, that clinical evaluations met applicable standards of care, and that physician orders were based on individualized clinical assessment. The firm retains clinical experts to evaluate the quality and sufficiency of telemedicine consultations against the applicable standard of care and CMS telehealth billing requirements.
Defending Telehealth Platform Operators and MSO Executives
DOJ increasingly targets the platforms and management structures behind telemedicine operations, not just the physicians who sign orders. The government alleges that platform design, workflow automation, and financial incentive structures improperly influenced clinical decision-making. The firm defends platform operators and MSO executives by demonstrating that the technology supported, rather than supplanted, independent clinical judgment. The firm analyzes corporate practice of medicine (CPOM) compliance, MSO-physician contractual arrangements, and the separation between administrative and clinical functions.
Challenging the Government’s Per-Order Payment and Referral Theories
The government treats per-order or per-prescription compensation to telemedicine physicians as strong evidence of Anti-Kickback Statute violations. Prosecutors allege that physicians were paid to sign orders, not to evaluate patients. The firm analyzes compensation arrangements against AKS safe harbor regulations, evaluates fair market value, and demonstrates that physician compensation was for legitimate professional services. The firm also defends against allegations that telemedicine companies paid kickbacks to call centers, marketers, or DME suppliers for patient referrals.
Defending Controlled Substance Prescribing Through Telemedicine
Following the Done Global conviction, DOJ has signaled that controlled substance prescribing through telemedicine is a top enforcement priority. The government alleges that telemedicine platforms facilitated prescribing without legitimate medical purpose, without adequate patient evaluation, or in quantities that exceeded clinical need. The firm defends physicians and platform operators by establishing the clinical basis for prescribing decisions, demonstrating compliance with DEA regulations and applicable state prescribing laws, and challenging the government’s characterization of legitimate telemedicine care as illegitimate distribution.
Federal telemedicine fraud investigations target individuals at every level of the operation: from the platform operators who build and control the technology, to the physicians who conduct consultations and sign orders, the call centers that recruit patients, and the downstream companies that bill for the products and services ordered through the platform. Armstrong & Bradylyons PLLC defends these individuals in federal investigations, after indictment, and at trial.
Defense of Telemedicine Company Owners and Platform Operators
The firm defends the founders, owners, and operators of telemedicine companies, telehealth platforms, and digital health companies in federal fraud, Anti-Kickback Statute, controlled substance distribution, and money laundering investigations and prosecutions. Platform operators are primary enforcement targets. Prosecutors pursue owners who allegedly designed platforms to generate fraudulent orders, created workflows that bypassed clinical oversight, paid kickbacks for orders or prescriptions, concealed the true nature of physician compensation, or used technology to eliminate evidence that might trigger Medicare audits. The firm defends platform operators by challenging the government’s evidence of personal knowledge, direction, and intent.
Defense of Physicians and Nurse Practitioners
The firm defends physicians, nurse practitioners, and other licensed medical professionals who face federal charges for signing orders or prescribing through telemedicine platforms. Medical professionals face criminal exposure when the government alleges they signed orders for patients they never examined, approved orders based only on brief phone calls or no patient contact, received per-order or per-prescription kickback payments, or prescribed controlled substances without legitimate medical purpose. The firm defends medical professionals by establishing the clinical basis for their orders and prescribing decisions, demonstrating the adequacy of their patient evaluations, and challenging the government’s characterization of legitimate telemedicine practice as fraudulent conduct.
Defense of MSO Executives and Investors
The firm defends management services organization (MSO) executives, corporate officers, and investors in telemedicine companies. DOJ’s Done Global prosecution established that MSO structures and corporate practice of medicine compliance are now part of the enforcement conversation. The firm defends MSO executives by demonstrating the legitimacy of management arrangements, the separation between administrative and clinical functions, and the absence of improper influence over clinical decision-making.
Defense of Call Center Operators and Marketers
The firm defends call center owners, telemarketing operators, and patient recruiters who face federal charges in telemedicine fraud cases. Call center operators face exposure when the government alleges they recruited patients through deceptive marketing, sold patient leads or signed orders to telemedicine companies or downstream suppliers, or received per-patient or per-lead kickback payments. The firm defends call center operators by challenging the government’s evidence of knowledge, intent, and the nature of the compensation arrangements.
Defense of DME Suppliers, Laboratories, and Pharmacies
The firm defends durable medical equipment suppliers, laboratory owners, and pharmacy operators who face federal charges for their participation in telemedicine fraud schemes. These downstream entities face exposure when the government alleges they paid kickbacks for orders generated through telemedicine platforms, submitted claims for products or services that were medically unnecessary, or billed for items that were never delivered. The firm defends these individuals by challenging the government’s evidence of their knowledge of and participation in the upstream fraud.
Federal telemedicine fraud investigations follow a pattern. Understanding that pattern is the first step to defending against it. Scott Armstrong and Drew Bradylyons built these types of cases as senior prosecutors at DOJ’s Fraud Section. They know how federal investigators identify targets, develop evidence, and present cases to grand juries.
Claims Data Analytics and Prescribing Pattern Analysis
The investigation typically begins with data. HHS-OIG, CMS, the FBI, and the DEA use claims data analytics to identify providers with anomalous billing or prescribing patterns. The government flags telemedicine providers who sign disproportionately high volumes of orders for DME, genetic testing, or controlled substances, whose prescribing patterns diverge from peer averages, who bill for telehealth consultations lasting only minutes, or whose patient populations are geographically dispersed in ways that suggest telemarketing-driven referrals. DOJ has stated that proactive data analytics identified the telemedicine prescribing pattern that led to the Done Global prosecution.
Platform Data and Technology Analysis
Federal investigators increasingly target the technology itself. They analyze platform workflows, automated order-generation processes, scheduling algorithms, and clinical decision-support tools for evidence that the technology influenced or supplanted independent clinical judgment. Investigators examine whether the platform restricted treatment options, auto-populated clinical documentation, generated templated chart notes, or created financial incentives that pressured physicians to approve orders. Electronic health record metadata, login timestamps, and session duration data are critical evidence in these cases.
Physician Compensation and Kickback Tracing
The government traces every payment to telemedicine physicians. Investigators determine whether physicians were paid on a per-order, per-prescription, or per-consultation basis. Per-order and per-prescription compensation is treated as strong evidence of kickback violations under the Anti-Kickback Statute. Investigators also trace payments between telemedicine companies, call centers, DME suppliers, laboratories, and pharmacies to map the full referral chain and identify kickback arrangements at every level.
Patient and Physician Interviews
Federal agents interview patients to determine whether they actually spoke with a physician, whether they understood what they were agreeing to, and whether they received the products or services that were ordered on their behalf. Agents also interview physicians who worked on the platform to determine whether they conducted genuine clinical evaluations, whether they felt pressured to approve orders, and whether they understood the financial relationships underlying the platform. Physician cooperators are a cornerstone of telemedicine fraud prosecutions.
Call Center and Marketing Records
The government analyzes call center scripts, recorded calls, marketing materials, and lead-generation records. Investigators examine whether call center operators used deceptive marketing to recruit patients, whether patients were told their insurance would cover free products, and whether call center operators sold patient leads or signed orders to telemedicine companies or downstream suppliers. Call recordings are powerful trial evidence.
HHS-OIG Special Fraud Alert Red Flags
In 2022, HHS-OIG issued a Special Fraud Alert identifying characteristics of telemedicine arrangements that may implicate the Anti-Kickback Statute. The alert identifies the following red flags: patients identified or recruited by the telemedicine company, practitioners compensated based on the number of items or services ordered, limited or no patient interaction, restricted offerings of products or services, and limited follow-up with patients. These red flags are the government’s published roadmap for identifying telemedicine fraud targets.
Search Warrants and Electronic Evidence
Federal agents routinely seek and execute search warrants for cell phones, laptops, servers, and cloud-based accounts in telemedicine fraud investigations. These warrants target platform source code, call recordings, internal communications, financial records, and physician compensation data. Federal agents obtain cloud warrants under 18 U.S.C. § 2703 of the Stored Communications Act. In the DMERx prosecution, investigators recovered evidence that the defendants eliminated “dangerous words” from physician orders and created randomized chart note narratives to avoid triggering Medicare audits.
Federal telemedicine fraud prosecutions draw on several criminal statutes. Telemedicine cases are distinctive because they can invoke both traditional healthcare fraud statutes and controlled substance distribution charges. The government charges aggressively and stacks counts.
Healthcare Fraud (18 U.S.C. § 1347)
The primary charging statute in telemedicine fraud cases. Healthcare fraud makes it a federal crime to knowingly and willfully execute a scheme to defraud any healthcare benefit program. In telemedicine cases, this statute targets billing for consultations that were not genuine medical encounters, generating orders for products or services that were medically unnecessary, and submitting claims based on fraudulent physician orders. The penalty is up to 10 years of imprisonment per count. If the fraud results in serious bodily injury, the maximum increases to 20 years. If it results in death, a life sentence is possible.
Controlled Substances Act (21 U.S.C. § 841)
Following the Done Global prosecution, controlled substance distribution charges are an expanding enforcement vector in telemedicine fraud cases. 21 U.S.C. § 841 prohibits distributing or dispensing controlled substances except as authorized by a valid prescription issued for a legitimate medical purpose by a practitioner acting in the usual course of professional practice. When the government alleges that telemedicine prescribing lacked legitimate medical purpose, it charges distribution rather than healthcare fraud. Distribution of Schedule II controlled substances carries up to 20 years per count.
Wire Fraud (18 U.S.C. § 1343)
The government frequently charges wire fraud in telemedicine cases. Telemedicine operations are inherently wire-dependent: the consultations occur over electronic communications, the orders are transmitted electronically, and the claims are submitted electronically. Wire fraud carries a maximum penalty of 20 years of imprisonment per count.
Anti-Kickback Statute (42 U.S.C. § 1320a-7b)
The Anti-Kickback Statute is at the center of most telemedicine fraud prosecutions. It prohibits offering, paying, soliciting, or receiving anything of value to induce or reward referrals for services covered by federal healthcare programs. In telemedicine cases, prosecutors target per-order payments to physicians, payments to call centers for patient leads, payments between telemedicine companies and DME suppliers or laboratories, and kickbacks disguised as consulting fees or platform access charges. Violations carry up to 10 years of imprisonment per violation.
Money Laundering (18 U.S.C. §§ 1956, 1957)
Money laundering charges are common in large-scale telemedicine fraud prosecutions. The government charges money laundering when it alleges that defendants conducted financial transactions involving fraud proceeds with the intent to conceal or promote the underlying scheme. Money laundering carries up to 20 years of imprisonment per count.
False Claims Act (31 U.S.C. §§ 3729–3733)
The False Claims Act is the government’s primary civil enforcement tool. In telemedicine cases, the FCA targets claims generated through fraudulent telemedicine encounters and claims tainted by kickback relationships. Civil FCA enforcement in healthcare hit a historic high in FY 2025: over $6.8 billion in settlements. Many telemedicine investigations run parallel criminal and civil tracks.
Federal Program Exclusion and Collateral Consequences
Beyond incarceration and fines, a conviction or settlement triggers mandatory exclusion from Medicare, Medicaid, and all federal healthcare programs under the authority of HHS-OIG. For physicians and licensed professionals, exclusion effectively ends a career. DEA registration may be revoked if the case involves controlled substance prescribing. State licensing boards may initiate independent disciplinary proceedings.
What Types of Telemedicine Fraud Does the Government Prosecute?
Federal prosecutors target several categories of telemedicine fraud. The most common are generating fraudulent physician orders for DME, genetic testing, or prescriptions through sham telemedicine consultations, billing for telehealth encounters that did not involve genuine clinical evaluation, paying physicians on a per-order or per-prescription basis, paying kickbacks to call centers for patient leads, prescribing controlled substances without legitimate medical purpose through telehealth platforms, and using platform technology to bypass clinical oversight.
DOJ’s 2025 Year in Review described telemedicine fraud schemes as presenting “grave fraud risks” and stated that the Health Care Fraud Unit has “intensified” its enforcement focus on telemedicine. In the 2025 Takedown, 49 defendants were charged for telemedicine and genetic testing schemes involving $1.17 billion in fraudulent claims.
What Are the Penalties for a Federal Telemedicine Fraud Conviction?
The penalties are among the most severe in healthcare fraud. Healthcare fraud carries up to 10 years per count. Wire fraud carries up to 20 years per count. Controlled substance distribution carries up to 20 years per count. Money laundering carries up to 20 years per count. Anti-Kickback Statute violations carry up to 10 years per violation.
The CEO of DMERx was sentenced to 15 years for a $1 billion telemedicine fraud conspiracy. A telemedicine company owner received seven years for a $56 million scheme. Another operator received 10 years for a $174 million conspiracy. The Done Global founder faces sentencing after conviction in November 2025 for a $100 million controlled substance distribution scheme.
What Is the HHS-OIG Special Fraud Alert for Telemedicine?
In 2022, HHS-OIG issued a Special Fraud Alert identifying characteristics of telemedicine arrangements that may implicate the Anti-Kickback Statute. The alert identifies the following red flags: patients identified or recruited by the telemedicine company rather than seeking care on their own, practitioners compensated based on the number of items or services ordered, limited or no meaningful contact between the practitioner and patient, offerings restricted to a narrow set of products or services, and little or no follow-up with patients after the telemedicine encounter.
These red flags are the government’s published roadmap for identifying telemedicine fraud targets. Telemedicine providers whose arrangements exhibit these characteristics face heightened enforcement risk.
What Did the Done Global Prosecution Establish for Telemedicine Enforcement?
In November 2025, a federal jury convicted the founder and clinical president of Done Global, a subscription-based telehealth platform focused on ADHD treatment. DOJ described it as the first criminal drug distribution prosecution arising from telemedicine prescribing practices. The scheme involved over $100 million and more than 40 million pills of Adderall and other stimulants.
The Done Global prosecution established several important precedents. DOJ used corporate practice of medicine (CPOM) principles as part of its evidentiary framework under the Controlled Substances Act. The government argued that the platform’s business model improperly influenced clinical decision-making. MSO structure, financial incentives, and technology design were all part of the government’s theory. Telemedicine platform operators, MSO executives, and investors should treat Done Global as a signal of where enforcement is headed.
What Defenses Are Available in a Federal Telemedicine Fraud Case?
The available defenses depend on the specific allegations. Common defenses include the following:
Legitimate clinical encounters. Presenting evidence that telemedicine consultations involved genuine patient evaluation consistent with the applicable standard of care.
Independent clinical judgment. Demonstrating that physician ordering and prescribing decisions were made independently, not influenced by platform design or financial incentives.
Safe harbor compliance. Demonstrating that compensation arrangements fell within recognized AKS safe harbors.
Regulatory ambiguity. Establishing that evolving CMS, DEA, and state telehealth regulations created genuine ambiguity about permissible billing and prescribing practices.
Cross-examining cooperators. Attacking the credibility of cooperating witnesses who have plea agreements and sentencing incentives to implicate others.
Scott Armstrong and Drew Bradylyons leverage their significant federal trial experience as former prosecutors to anticipate the government’s trial strategy and develop an aggressive, evidence-based defense.
What Triggers a Federal Telemedicine Fraud Investigation?
Federal telemedicine fraud investigations are typically triggered by CMS claims data analytics identifying billing or prescribing outliers, HHS-OIG audits, DEA analysis of prescribing patterns for controlled substances, qui tam whistleblower complaints filed by former employees or physicians under the False Claims Act, complaints from patients, and referrals from downstream entities that suspect fraud in orders they received.
Common red flags include unusually high order volume per physician, telehealth consultation durations that are too short for meaningful clinical evaluation, prescribing patterns that diverge from peer averages, per-order or per-prescription physician compensation, and geographically dispersed patient populations.
Can a Physician Be Charged for Signing Orders Through a Telemedicine Platform?
Yes. Physicians are regularly charged in telemedicine fraud cases. In the 2025 Takedown, 96 of the 324 defendants were licensed medical professionals. In Operation Brace Yourself, physicians who signed orders for orthotic braces without examining patients were charged and convicted. In Operation Happy Clickers, nurse practitioners who approved orders without reading them faced criminal and civil enforcement.
The government treats physicians who sign high volumes of orders through telemedicine platforms without genuine clinical evaluation as active participants in the fraud scheme. Per-order compensation is treated as a kickback. An experienced defense attorney establishes the clinical basis for the physician’s orders and challenges the government’s characterization of legitimate telehealth practice as fraudulent rubber-stamping.
How Do Telemedicine Flexibilities Affect Federal Fraud Exposure?
During the COVID-19 public health emergency, CMS expanded telehealth coverage and relaxed certain billing and prescribing requirements. HHS and DEA have extended telemedicine flexibilities for controlled substance prescribing through December 31, 2026, allowing prescribing without a prior in-person visit.
The flexibilities reduce regulatory barriers. They do not reduce enforcement risk. DOJ has stated that the expansion of telehealth services created “grave fraud risks.” Prosecutors focus on whether prescribing practices align with professional standards regardless of whether the regulatory framework permits telemedicine delivery. The Done Global prosecution was brought under the Controlled Substances Act, not under CMS billing rules. The regulatory environment is permissive. The enforcement environment is not.
What Is Operation Brace Yourself?
Operation Brace Yourself was a coordinated DOJ enforcement action launched in April 2019. It charged 24 defendants, including executives of five telemedicine companies, owners of dozens of DME companies, and licensed medical professionals. The operation targeted schemes in which telemedicine companies paid physicians to sign orders for medically unnecessary orthotic braces, and DME companies paid kickbacks for the signed orders.
Operation Brace Yourself established the enforcement template that DOJ continues to use: trace the referral chain from telemarketer to telemedicine company to physician to downstream supplier, and charge everyone in the chain. It resulted in over $1.2 billion in alleged fraud and set the stage for the subsequent telemedicine enforcement actions that have now exceeded $10 billion in cumulative alleged losses.
Does Armstrong & Bradylyons Handle Telemedicine Fraud Cases Nationwide?
Yes. Armstrong & Bradylyons PLLC defends individuals in federal telemedicine fraud investigations and prosecutions nationwide. The firm can practice in every federal district court in the country.
Telemedicine fraud enforcement is active in Strike Force districts including the Southern District of Florida, the Northern District of California, the Southern District of New York, the Eastern District of New York, the Central District of California, the District of New Jersey, and the Southern District of Texas. Telemedicine fraud prosecutions also originate from U.S. Attorney’s Offices in districts beyond the Strike Force footprint.
Scott Armstrong and Drew Bradylyons have tried healthcare fraud cases and handled investigations in federal courts throughout the country during their combined 25-year DOJ career. The firm is based in Washington, D.C. and represents clients in every jurisdiction where DOJ, HHS-OIG, and DEA investigate and prosecute telemedicine fraud cases.