Physician Indicted in $10 Million Telemedicine Healthcare Fraud Scheme

An indictment was unsealed in federal court in Brooklyn charging Elemer Raffai, an orthopedic surgeon, with healthcare fraud in connection with a $10 million scheme involving the submission of false and fraudulent claims to Medicare and Medicare Part D plans. According to the indictment, Dr. Raffai purported to practice telemedicine with the AffordADoc Network and other telemedicine companies that paid the defendant for each consultation with a beneficiary. Between July 2016 and June 2017, Dr. Raffai allegedly participated in a healthcare fraud scheme in which he signed prescriptions and order forms via purported telemedicine services for durable medical equipment (DME), including orthotic braces, that were not medically necessary. Dr. Raffai caused the submission of these claims based solely on a short telephone conversation for beneficiaries he had not physically examined and evaluated, and that were induced, in part, by the payments of bribes and kickbacks. Dr. Raffai was paid by telemedicine companies approximately $25 or $30 per patient consultation. The indictment further alleges that Dr. Raffai, together with others, submitted or caused the submission of approximately $10 million in false and fraudulent claims to Medicare for DME on behalf of beneficiaries who were residents of the Eastern District of New York, and Medicare paid more than $4 million on those claims.

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