You signed orders for a telemedicine company. $100 to $200 per signature. Easy money. The company sent you patient records - sometimes just a name and date of birth - and you signed off on DME orders, genetic tests, prescriptions. You never met the patients. Brief phone consultations at most. Everyone was doing it during COVID when telehealth exploded. The companies kept paying. You kept signing.
That side income is now a federal investigation.
In June 2025, the Department of Justice announced the largest healthcare fraud crackdown in American history. 324 defendants charged across 50 federal districts. $14.6 billion in alleged fraud - more than doubling the prior record of $6 billion set in 2020. 96 licensed medical professionals among the defendants. And the government is using artificial intelligence to find more physicians just like you.
Welcome to Spodek Law Group. We handle federal healthcare fraud defense across the country. If you've received a target letter, if federal agents have contacted you, if your billing records have been subpoenaed, or if the telemedicine company you worked with has been raided - this article explains exactly what your facing and what options exist.
The Largest Healthcare Fraud Crackdown in History
On June 30, 2025, the Department of Justice announced Operation Gold Rush. The numbers are staggering. 324 defendants charged. $14.6 billion in alleged fraud. Twelve State Attorneys General participating alongside federal prosecutors. The government seized $245 million in cash, luxury vehicles, and cryptocurrency.
Operation Gold Rush itself - just one component of the takedown - involved $10.6 billion in fraudulent Medicare claims for urinary catheters and durable medical equipment. 19 defendants. The stolen identities of more then one million Americans. International arrests in Estonia. The DOJ called it the largest loss amount ever charged in a healthcare fraud case.
What made this possible wasn't more investigators. It was artificial intelligence.
The Health Care Fraud Data Fusion Center represents a fundamental shift in how the government detects fraud. Real-time analytics. Cloud computing. Machine learning algorithms that identify anomalous billing patterns before anyone files a complaint. In Operation Gold Rush, the system detected the scheme and blocked $4.41 billion in payments that were scheduled to be issued to Medicare providers. The algorithm caught them.
The government dosent wait for whistleblowers anymore. The system flags telehealth spikes, cross-state billing activity, unusual prescription patterns. If your signing orders for patients in states where you've never practiced, the algorithm knows. If your brace order volume suddenly increased 500% during the pandemic, the algorithm knows. The Data Fusion Center is watching your billing patterns right now.
49 defendants in the 2025 takedown were charged specifically for telemedicine and genetic testing fraud. $1.17 billion in fraudulent claims. DME braces, cancer genetic tests, controlled substances. The patterns are known. The schemes are catalogued. And prosecutors are actively looking for the next cases.
Why Physicians Are the Primary Targets
Most people assume physicians are witnesses in these cases. Minor participants at worst. The telemedicine company ran the scheme. The marketing company found the patients through those Medicare beneficiary leads. The billing company submitted the claims. The physician just signed some orders - they didnt even see the money except for there per-signature payments.
Thats not how the government sees it. Your signature is the key to the entire prosecution.
Without a physician signature, theres no order. Without an order, theres no claim. Without a claim, theres no fraud. Prosecutors dont view physicians as accessories to telemedicine fraud. They view physicians as the essential element that makes the entire scheme possible. Your the one who held the medical license. Your the one who authenticated the orders. Your the one whos signature appeared on claims submitted to Medicare.
Consider Dr. Sophie Toya. Michigan. She signed 7,900 orthotic braces in six months. Thats more then 40 per day. 2,600 elderly and disabled Medicare patients recieved braces based on her orders. She was paid aproximately $120,000 by telemedicine companies. The scheme generated $6.3 million in false claims.
She was just signing orders. Brief conversations with patients - sometimes no conversation at all. The telemedicine companies paid her per signature. She thought she was providing a service, reviewing records and approving medically appropriate equipment. The government called it a signature factory. A federal jury convicted her of health care fraud and false statements. Four years federal prison. $3.6 million in restitution. Forfeiture of the $120,000 she recieved.
The COVID-19 pandemic created an opportunity that many physicians thought was legitimate. CMS expanded telehealth access dramatically so patients could recieve care remotely without traveling to medical facilities. Telemedicine exploded. And some physicians took advantage of those expanded rules. The DOJ charged 14 people for specifically exploiting COVID-19 telehealth flexibility for $143 million in fraud.
The irony is that Done Global looked completley legitimate. The platform looked legitimate. The prescriptions for Adderall looked legitimate. Millions of patients used the service. The CEO and clinical president are now convicted of conspiracy to distribute controlled substances, health care fraud, and obstruction of justice. $100 million scheme. The DOJ called it a first-of-its-kind telemedicine criminal prosecution. And it wont be the last.
The Math That Destroys Medical Careers
The per-order payment seems small. $100. $200. $300 per signature. You signed 50 orders a week for two years. Maybe $500,000 total. Nice supplement to your practice income.
Every single one of those payments is a potential Anti-Kickback Statute violation. Ten years per violation.
The Anti-Kickback Statute prohibits offering, paying, soliciting, or recieving anything of value in exchange for referrals or for generating business involving items or services payable by federal healthcare programs. Per-order payments from telemedicine companies are textbook kickbacks. The statute dosent care that you thought it was legal. The statute dosent care that everyone else was doing it. The statute only cares that you recieved payment tied to orders.
One telemedicine signature can trigger multiple federal charges:
1. Anti-Kickback Statute - 10 years per violation
2. Health Care Fraud - 10 years
3. Wire Fraud - 20 years
4. False Statements - 5 years
5. Money Laundering - 20 years
A physician who signed 1,000 orders over two years faces theoretical exposure measured in centuries. Prosecutors dont usually seek maximum consecutive sentences. But they use charge stacking as leverage. In practice, mid-level physician participants in telemedicine fraud schemes are recieving 4 to 10 years federal prison. Dr. John Manning: 3 years for $812,000 in kickbacks signing genetic testing orders. Colby Joyner, a physician assistant in North Carolina: 6 years for a $10 million genetic testing scheme. A North Texas doctor: 10 years and 1 month for a $54 million Medicare fraud operation.
The amount of the kickback dosent determine your exposure. The number of orders does.
Every signature is a seperate potential violation. If you signed 5,000 orders over three years, prosecutors see 5,000 potential Anti-Kickback counts. The civil penalties are equally devastating - $100,000 per kickback plus treble damages under the Civil Monetary Penalties Law. And thats before the state medical board reviews your conduct for license revocation.
What to Do If You're Under Investigation
The instinct is to explain. You didnt know the telemedicine company was fraudulent. You thought these were real patients with genuine medical needs. You reviewed the records carefully. You were just doing your job.
Every explanation becomes evidence. "I didn't know" becomes willful blindness. Cooperation without counsel has destroyed more physician defendants than any investigative technique the government uses.
Federal agents are trained to elicit statements that sound like explanations but read like confessions. When you say "I never met the patients in person, I just reviewed their records," you're confirming no physician-patient relationship existed. When you say "I didn't know the company was billing Medicare," you're establishing you failed to investigate what happened with your signed orders. When you say "everyone was doing it during COVID," you're admitting knowledge of widespread irregularities.
If you're under investigation or concerned you might be:
- Do not speak to federal agents without a defense attorney present
- Do not provide documents, records, or computer access voluntarily
- Do not contact other physicians who may have worked with the same telemedicine company
- Do not delete any emails, text messages, or electronic records
- Contact a federal healthcare fraud defense attorney immediately
Todd Spodek has represented physicians in federal healthcare fraud investigations, including telemedicine cases. He understands the difference between being a target, a subject, and a witness - and he knows how quickly that status can change based on what you say in those first conversations with investigators.
When You're Ready
If you're a physician facing a federal telemedicine fraud investigation, or if you've recieved a subpoena or target letter related to a telemedicine company you worked with, Spodek Law Group can help you understand where you stand and what options exist.
The consultation is free. There's no obligation. What you'll get is an honest assessment. Are you a target or a witness? What does the government likely have? What are realistic outcomes - not best-case fantasies, but actual possibilities based on how these cases are being prosecuted in 2025 and 2026?
Call us at 212-300-5196. The government has artificial intelligence identifying billing patterns. The government has Data Fusion Centers coordinating across agencies. The government has resources you can not match. What you can have is experienced federal defense counsel who's handled these cases before.
The earlier you have representation, the more leverage exists. Before the indictment. Before the arrest. Before your name appears in a DOJ press release alongside 323 other defendants.
We're here when you need us.
