Welcome to Spodek Law Group. Our goal is to give you the reality of federal telemedicine fraud prosecution - not the sanitized version law firm websites present, not the hopeful fiction that your employer will protect you, but the actual truth about what happens when the Department of Justice decides you participated in a telemedicine fraud scheme. We handle federal healthcare fraud defense, and we believe you deserve to understand what you are actually facing.
If you worked for a telemedicine platform during COVID, you probably believed the relaxed regulations meant you were safe. The waivers came through. The payment models seemed fine. Everybody was doing it. Your employer told you the billing was compliant. The attorneys reviewed everything. And here is what nobody told you: the regulations relaxed, but the criminal statutes never changed. The False Claims Act remained exactly the same throughout the pandemic. The Anti-Kickback Statute stayed exactly as written. Wire fraud still carries twenty years. And now the Department of Justice is prosecuting cases from 2020, 2021, 2022 - years after you thought that chapter of your career closed completely.
The 2025 National Health Care Fraud Takedown charged 324 defendants for schemes involving 14.6 billion dollars in alleged fraud. That number more than doubled the prior record of six billion set in 2020. Forty-nine defendants were specifically charged for telemedicine and genetic testing fraud. Individual doctors. Licensed nurses. Physician assistants. Not just platform executives. Providers who thought they were just treating patients during a public health emergency. And the conviction rate when these cases go to trial is above ninety percent. Those numbers should terrify you.
What Nobody Tells You About Telemedicine Investigations
Here is the thing about federal healthcare fraud investigations that most people do not understand until they are already targets. They do not start when you recieve a target letter or a subpoena. They start two to three years earlier. By the time you know you are being investigated, the DOJ has already interviewed your former colleagues, obtained your EMR records through administrative subpoenas, analyzed your billing patterns with their new AI-powered Data Fusion Center, and flipped your employer's executives into cooperating witnesses.
The Department of Justice announced the creation of a Health Care Fraud Data Fusion Center in 2025 specifically to identify fraud patterns using artificial intelligence and machine learning algorithms. They can now analyze millions of Medicare and Medicaid claims automaticaly and flag statistical outliers in real time. Your billing patterns during COVID - when everyone across the country was doing telemedicine because in-person visits were impossible - are being compared against baseline norms from before the pandemic. And if your patterns look different from what prosecutors consider appropriate, if you billed more per patient encounter, if your telehealth visits were shorter than the national average, if your documentation appears templated or repetitive, that is what triggers the algorithm to flag your name.
The Health Care Fraud Strike Force has charged more than 5,800 defendants since 2007, collectively billing over thirty billion dollars to federal healthcare programs. These are not abstract statistics. These are real physicians, real nurses, real healthcare administrators whose careers and families were destroyed. In 2025, the Strike Force expanded into Massachusetts specifically because of what DOJ called the region's "healthcare startup ecosystem." That is Department of Justice language for hunting telehealth companies that raised venture capital and grew rapidly during COVID. If you worked for one of those startups, for one of those platforms that promised to revolutionize healthcare delivery, you are already on their radar whether you know it or not.
Federal investigators move quietly. They do not announce themselves until they are ready. The investigation into your employer likely began with a whistleblower - a former employee who filed a qui tam lawsuit under the False Claims Act. That whistleblower has been working with prosecutors for years. They have turned over documents you did not know existed. They have explained internal practices you thought were confidential. And when the government finally contacts you, they already know the answers to every question they are going to ask.
The COVID Trap: Why Relaxed Regulations Did Not Protect You
This is where it gets really troubling for healthcare providers who worked in telemedicine during the pandemic. During COVID, CMS waived certain telehealth restrictions to facilitate access to care. Geographic requirements relaxed so patients did not need to be in rural areas. Originating site requirements disappeared so patients could receive care from home. Audio-only visits became reimbursable for the first time in many specialties. It felt like the government was saying go ahead, provide care to people who need it, we will figure out the billing requirements later when the emergency is over.
But the kicker is this. Those waivers only affected regulatory compliance with CMS billing rules. They did not touch the criminal statutes at all. The False Claims Act still required that every single claim submitted to Medicare or Medicaid be accurate, medically necessary, and supported by contemporaneous documentation. The Anti-Kickback Statute still made it a federal crime to recieve anything of value in exchange for referrals involving federal healthcare programs. Wire fraud still applied to any scheme to defraud that used electronic communications - which includes every email, every text message, every EHR transmission. You could follow every COVID waiver perfectly and still be committing multiple federal felonies without realizing it.
Think about what that means for a moment. The regulations told you one thing. The criminal law said something completely different. And nobody bothered to explain the difference until years later when prosecutors came knocking. This gap between regulatory compliance and criminal liability is not an accident. It is how the system is designed to operate.
As Todd Spodek has explained to clients facing these charges, the government creates these situations deliberately. They relaxed the regulations because they desperately needed healthcare delivered during a pandemic that was killing thousands of Americans daily. But they kept the criminal statutes in place because they knew - they absolutely knew from decades of experience - that relaxed oversight combined with massive federal spending would create opportunities for fraud. And now, years later, they are prosecuting the conduct they enabled and arguably encouraged.
The question prosecutors ask is never whether you helped patients who needed care. They genuinely do not care about that. What they care about is whether you followed every billing code, every documentation requirement, every state supervision rule, every licensure requirement in every state where your patients were located. And if you did not follow all of those requirements - even if nobody at your employer ever told you those rules applied during COVID - you are criminally exposed.
How They Build Cases Against Individual Providers
Let this sink in for a moment. The executives of the telemedicine platform you worked for have likely already pled guilty to federal charges. They have already signed cooperation agreements with the United States Attorney's Office. They have already named you as the doctor who signed the orders that made the fraudulent billing possible.
This is how federal healthcare fraud prosecution actually works in practice. They start at the top of the organization. They indict the CEO, the Chief Medical Officer, the clinical director, the platform operators who designed the business model. Those people face sentences of ten to twenty years in federal prison. They have families. They have assets the government can seize. They have every possible incentive to cooperate with prosecutors. So they do cooperate. They provide internal documents. They explain how the scheme operated. They identify who knew what and when. They name names. Your name is on that list.
In the Done Global case - which was the first federal prosecution of a telehealth company for illegal drug distribution - the CEO Ruthia He and clinical president David Brody were convicted by a jury in November 2025. The evidence showed they built a company distributing over forty million Adderall pills through a subscription model. They spent forty million dollars on deceptive social media advertising targeting people seeking easy access to stimulants. And when the investigation started? He moved company operations to China. She deleted incriminating documents. She used encrypted messaging apps with disappearing messages. She searched online for countries without extradition treaties with the United States. She was stopped by law enforcement while trying to leave the country.
What happened next? A federal grand jury indicted Done Global itself as a corporation. A Florida medical practice was also charged. And now every single provider who ever signed an order through that platform is potentially exposed to prosecution. Every prescription. Every claim. Every signature.
The EMR documentation is the prosecution's best friend. Spodek Law Group has seen this pattern play out repeatedly in federal healthcare fraud cases. Every three-minute telehealth visit is timestamped and recorded. Every templated note is preserved in the electronic record. Every time you signed an order without conducting a thorough examination, that signature is evidence. The system that was designed to protect you from malpractice lawsuits creates a perfect, immutable audit trail for federal prosecutors who want to prove you rushed through patient encounters to maximize volume.
The Per Patient Payment Model Is an Illegal Kickback
See the problem here? If you were paid per patient, per order, per signature by your telemedicine employer - that payment model itself may constitute an illegal kickback under federal law. This is something most providers never learn until they are already under investigation.
The Anti-Kickback Statute makes it a federal crime to knowingly and willfully recieve anything of value in exchange for referrals involving federal healthcare programs like Medicare and Medicaid. When a telemedicine platform pays you based on volume - based on how many orders you sign, how many patients you see per hour, how many prescriptions you authorize - that is precisely the payment structure the statute was designed to prohibit. You were being paid to sign. The more you signed, the more you got paid. That is the definition of a kickback in federal court.
It does not matter that the platform called it compensation for professional services rendered. It does not matter that you actually examined patients before signing. It does not matter that you believed you were providing legitimate medical care. What matters to prosecutors is the structure of the arrangement. Value tied to volume equals a kickback. And every kickback is a separate federal felony carrying up to ten years in prison per instance. If you signed a thousand orders over a year, that is potentially a thousand separate counts.
The Department of Justice knows exactly how these platforms structured their provider payment models. They have the contracts you signed. They have every payment record. They can calculate precisely how much you were paid per patient encounter. And they will argue that this payment structure proves you had a financial incentive to sign orders you should not have signed, to approve treatments you should have questioned, to bill for services that were not medically necessary.
This is one of those hidden connections nobody explains until it is too late to do anything about it. You thought you were being paid fairly for your professional services and clinical judgment. The DOJ will argue you were being paid for your signature on a federal healthcare claim, and that your signature was for sale to the highest bidder.
Done Global: The Case That Changed Everything
Listen carefully. The Done Global prosecution fundamentally changed the landscape for telemedicine fraud enforcement. This was the first time in history that the DOJ criminally prosecuted a telehealth company as a corporate entity - not just the individual executives, but the actual company itself.
Ruthia He, the founder and CEO of Done Global, and David Brody, the clinical president, were convicted by a federal jury in San Francisco in November 2025. The charges included conspiracy to distribute controlled substances, substantive counts of distribution of controlled substances, and conspiracy to commit healthcare fraud. He was additionally convicted of conspiring to obstruct justice by trying to destroy evidence and flee the country. Both defendants face maximum sentences of twenty years in federal prison when they are sentenced in February.
The government proved at trial that Done Global's entire business model was designed to provide easy access to Adderall and other Schedule II stimulants in exchange for monthly subscription fees. Subscribers paid to get drugs, not to get healthcare. The company spent forty million dollars on social media advertisements targeting people who wanted stimulants without the hassle of legitimate medical evaluation. They distributed over forty million pills of controlled substances across the country.
The company paid providers to sign off on orders based on minimal patient contact, often just a few minutes of audio-only conversation. Those providers are now exposed. If you ever signed an order for a platform that pressured you to move fast, that incentivized volume over thoroughness, that discouraged you from questioning patient claims - you should be very concerned about what comes next.
As Todd Spodek has told clients facing similar situations, the DOJ prosecutes the most egregious cases first to establish precedent and develop expertise. Done Global was the example case, the one they used to prove their legal theories and train their prosecutors. Now they have precedent. Now they have a playbook. Now they have experience. And they are going to use all of those tools on every similar platform that operated during COVID. The only question is timing.
What Fifteen Years in Prison Actually Looks Like
Notice the pattern emerging here. The harshest sentence in recent telemedicine fraud cases was fifteen years in federal prison. The operator of the DMERx platform was sentenced to fifteen years and ordered to pay over 452 million dollars in restitution for a scheme that billed more than one billion dollars to Medicare through fraudulent durable medical equipment claims facilitated by telemedicine orders.
Fifteen years. Not fifteen months. Fifteen years in federal prison. That is the sentence the government considers appropriate for running a telemedicine fraud scheme at scale. You will be in your fifties or sixties when you get out. Your children will be grown. Your marriage will almost certainly be over. Your medical license will be permanently revoked. Your assets will be gone. Everything you worked your entire career to build will be destroyed.
But it was not just the platform operator who faced prosecution. The doctors who signed orders through DMERx were prosecuted individually as well. A Michigan doctor received four years in federal prison for a 6.3 million dollar scheme involving unnecessary orthotic braces. An Alabama doctor pled guilty to a six million dollar scheme and was prosecuted in Boston federal court - not in Alabama where he practiced, but in Massachusetts where federal prosecutors thought they could get the best outcome. A Massachusetts doctor agreed to plead guilty to participating in a 35.5 million dollar scheme.
These are real doctors with real families and real careers who made the same assumptions you might be making right now. They thought they were doing their jobs. Following protocols. Providing care. Signing orders that seemed legitimate. And then years later, every single one of those signatures became a federal count on a criminal indictment.
The sentencing guidelines for healthcare fraud are brutal and unforgiving. The loss amount drives the calculation of your sentence range. If the scheme you participated in - even if you participated unknowingly, even if you were just one of dozens of providers - involved millions of dollars in allegedly fraudulent billing, you are looking at years of imprisonment in a federal facility. And unlike state prison, federal prison means serving at least eighty-five percent of your sentence before you are eligible for any form of release. There is no early parole in the federal system.
The Ninety Percent Conviction Rate Reality
You might be thinking you could fight this in court. Explain to a jury that you were just doing your job. That you were following your employer's protocols as instructed. That you actually helped real patients who needed care. That you never intended to defraud anyone.
Here is the brutal reality nobody wants to tell you. When IRS Criminal Investigation is involved in healthcare fraud cases - and they almost always are because these cases involve tax implications - the federal conviction rate is approximately ninety percent. Nine out of every ten defendants who go to trial are convicted on at least some charges. And in healthcare fraud cases specifically, the Fraud Section has averaged thirty-six trial convictions annually in recent years, nearly matching their all-time record.
The reason the conviction rate is so extraordinarily high is simple and terrifying. By the time prosecutors charge you, they have already won. They have built the case against you for years before you knew you were a target. They have flipped every cooperator who could hurt you. They have analyzed every document, every EMR note, every billing record. They have interviewed every witness. They only bring cases they know they can prove beyond a reasonable doubt to a jury.
Going to trial means risking what defense attorneys call the trial penalty - a significantly longer sentence for making the government prove its case instead of accepting responsibility by pleading guilty. Judges take this into account at sentencing. Prosecutors recommend harsher sentences for defendants who went to trial and lost. Most defendants plead guilty as a result. Not because they believe they are guilty, necessarily, but because the math simply does not work any other way.
And even if you beat the criminal case - even if you are one of the ten percent who prevails at trial after years of litigation - you are bankrupt from attorney fees that can easily exceed half a million dollars, your medical license is suspended pending investigation by your state board, your hospital privileges are gone, your malpractice insurance is canceled, your career is effectively destroyed, and your reputation is permanently damaged by years of public court proceedings. Sometimes the process itself is the punishment, regardless of the ultimate outcome.
If You Are Reading This, Here Is What To Do Next
What actually happens from this point forward depends entirely on what you do right now, today. This is the only thing you can still control in this situation: the decisions you make in the next forty-eight to seventy-two hours.
If you have received a target letter from a United States Attorney's Office, if you have been served with a grand jury subpoena for documents or testimony, if you have received an audit notice from Medicare or a state Medicaid program, or even if you have just noticed unusual inquiries from a former employer about your time there - you need to act immediately. Do not speak with federal agents or investigators until you have consulted with an attorney who specifically handles federal healthcare fraud defense. Anything you say can and will be used against you. Anything you fail to say can be used against you too.
At Spodek Law Group, we represent healthcare providers facing federal fraud charges and investigations. We understand the critical difference between someone who intentionally participated in a fraud scheme and someone who got swept up in an investigation of their employer's business practices. We know how to negotiate with federal prosecutors before charges are filed, when the most options are still available. We know how to protect your interests while there is still time to protect them effectively.
The clock on your case started when federal agents began building it against you - years ago, probably. But your window for taking meaningful action started when you first learned about this situation. That window is closing with every day that passes.
Call us at 212-300-5196. The initial consultation costs you nothing. Not calling when you have concerns costs you everything you have worked to build.
The government had years to prepare their case. You have days to prepare yours. Use them wisely.
