Telemedicine Fraud Defense Lawyer
Protecting Medical Professionals and Healthcare Entities Facing Federal Fraud Allegations
In the wake of rapid expansion in digital healthcare services, telemedicine fraud investigations have become a major focus for federal law enforcement. Medical professionals and healthcare companies across New York City are now finding themselves under scrutiny from agencies like the Department of Justice (DOJ), Centers for Medicare & Medicaid Services (CMS), and the Office of Inspector General (OIG)—often with devastating consequences.
At Sosinsky Law, we represent physicians, nurse practitioners, telehealth startups, billing managers, and healthcare business owners who are facing federal allegations related to telemedicine fraud. With extensive experience in defending clients charged with Medicare and Medicaid fraud, kickback violations, and billing irregularities, we understand the legal and regulatory challenges unique to digital medicine—and how to build a powerful defense against government overreach.
If you’ve received a subpoena, target letter, or audit notice, or if you suspect you’re under investigation for your involvement in a telemedicine operation, do not speak with federal agents until you’ve consulted with an experienced healthcare fraud attorney. Sosinsky Law is here to help protect your career, your license, and your freedom.
What Is Telemedicine Fraud?
Telemedicine fraud refers to any criminal or civil violation of healthcare laws committed through digital healthcare services or platforms. With the rise of virtual consultations, remote diagnostics, and digital prescriptions, the DOJ and HHS have increased enforcement actions targeting alleged fraud involving:
- Medicare and Medicaid reimbursement claims for services not actually rendered
- Kickbacks or referral fees paid to telemedicine marketers or patient recruiters
- False or unnecessary prescriptions, especially for durable medical equipment (DME) or controlled substances
- Identity theft or misuse of beneficiary information to submit fraudulent claims
- Misrepresenting patient interactions, such as billing for comprehensive exams based on limited virtual contact
Although the intent of telemedicine is to increase access to care, it has also become a flashpoint for federal prosecutors, particularly when claims are submitted at high volume or in partnership with marketing companies.
Why Telemedicine Providers Are Being Targeted
The government has zeroed in on telehealth models that rely on third-party lead generators, overseas call centers, or “hub-and-spoke” structures where licensed professionals are paid to review patient intake forms and prescribe treatments or devices with minimal direct contact. These models have been criticized for prioritizing volume over patient care, leading to accusations of fraud.
Federal agencies focus on telemedicine fraud through:
- Data mining of high-billing providers or suspect CPT codes
- Qui tam (whistleblower) lawsuits under the False Claims Act
- Joint federal task forces, including the DOJ, FBI, and HHS-OIG
- Operation “Telehealth Takedown” initiatives, where multiple defendants are charged simultaneously
If you or your practice is associated with a high-volume telehealth model—especially in areas like DME, genetic testing, mental health services, or prescription medication—you may be at risk.
Criminal Charges Commonly Associated with Telemedicine Fraud
Telemedicine fraud allegations are often tied to a combination of federal criminal statutes, including:
- Healthcare Fraud (18 U.S.C. § 1347)
- False Statements Relating to Health Care Matters (18 U.S.C. § 1035)
- Wire Fraud (18 U.S.C. § 1343)
- Conspiracy to Commit Healthcare Fraud (18 U.S.C. § 1349)
- Anti-Kickback Statute (42 U.S.C. § 1320a–7b(b))
- False Claims Act (civil and criminal provisions)
These statutes carry severe penalties, including prison sentences of up to 10 years per count, multi-million-dollar fines, exclusion from Medicare and Medicaid programs, asset forfeiture, and permanent damage to your professional reputation.
Common Scenarios That Trigger Investigations
- A medical provider bills Medicare for a telehealth visit, but there was no real-time interaction with the patient.
- A telehealth company pays doctors flat fees to approve prescriptions or equipment orders based solely on intake forms.
- A provider is named in a qui tam lawsuit for allegedly authorizing prescriptions without full clinical review.
- A physician unknowingly enters into a marketing arrangement that violates the Anti-Kickback Statute.
- A telehealth platform submits claims for services that were never provided or medically unnecessary.
At Sosinsky Law, we have defended clients in these exact situations and understand how to separate lawful practice from prosecutorial overreach.
How Sosinsky Law Defends Telemedicine Fraud Cases
Telemedicine fraud cases are often factually and legally complex. They require not only an understanding of criminal law but also of CPT billing codes, telehealth regulations, documentation requirements, and EMR audit trails. Our experience representing healthcare professionals allows us to create multi-layered defenses grounded in both law and medicine.
Our Defense Strategies Include:
1. Challenging Intent and Knowledge
Many cases hinge on proving that the provider knowingly and willfully committed fraud. We work to demonstrate that any billing issues resulted from administrative oversight, EMR software defaults, or contractor error, not criminal intent.
2. Proving Medical Necessity and Provider-Patient Interaction
We use documentation, medical records, and expert testimony to show that telehealth services were medically appropriate, based on clinical guidelines, and consistent with federal and state telemedicine laws.
3. Examining the Role of Third Parties
We closely investigate the role of marketing firms, lead generators, or billing companies, and argue that our clients were not aware of any unlawful activity taking place in the broader operation.
4. Engaging Early in the Process
When clients come to us during the audit or subpoena stage, we proactively communicate with prosecutors and often prevent charges from being filed at all, resolving matters through settlements or compliance adjustments.
5. Preparing for Trial if Necessary
Should the case go to trial, we are fully prepared to litigate. With decades of courtroom experience in federal healthcare fraud cases, Sosinsky Law knows how to challenge the government’s experts, cross-examine witnesses, and present your story persuasively to a jury.
Who We Represent
Our clients in telemedicine-related cases include:
- Physicians and nurse practitioners
- Behavioral health providers offering remote therapy or psychiatry
- Telehealth platform executives
- Billing and compliance officers
- Durable medical equipment (DME) providers
- Pharmacy benefit managers (PBMs)
- Marketers and business development partners in the telemedicine space
Whether you’re an independent provider or part of a national healthcare platform, we can help you navigate the legal risks and protect your future.
Why Choose Sosinsky Law?
Extensive Healthcare Fraud Defense Experience
We’ve successfully defended clients in federal healthcare fraud investigations across New York City, including those involving telemedicine, DME, mental health, and Medicare billing. We understand both the legal system and the business realities of modern healthcare delivery.
Deep Understanding of Telehealth Law and Technology
We stay ahead of evolving CMS and DOJ enforcement policies surrounding telehealth, including compliance requirements for virtual visits, e-prescribing, and interstate practice.
Aggressive, Personalized Representation
Each client receives individualized attention, a thorough case review, and a custom defense strategy. We don’t settle for surface-level arguments—we dig deep into the records and facts.
Respected by Prosecutors and Judges
Our reputation for honesty, preparedness, and professionalism often gives us leverage in negotiations, making it more likely that we can resolve cases favorably and discreetly.
Contact an Experienced Telemedicine Fraud Defense Lawyer in NYC Today
If you are a healthcare provider, executive, or entrepreneur facing allegations related to telemedicine fraud, you cannot afford to wait. The federal government is pursuing these cases aggressively, and the consequences are serious. You need a skilled legal team that understands the intersection of healthcare, billing law, and criminal defense.
At Sosinsky Law, we fight to protect medical professionals from unjust charges and help them preserve their practice, reputation, and livelihood. We’ve successfully defended clients against complex healthcare fraud claims, and we’re ready to do the same for you.
Call Sosinsky Law today for a confidential consultation and take the first step toward protecting your future.