Telemedicine executive imprisoned for massive Medicare billing fraud scheme
A New Jersey man who ran two telemedicine companies has been sentenced to seven years in federal prison for carrying out a large Medicare fraud scheme that brought in tens of millions of dollars. Federal officials said the case involved false claims for medical braces that many older patients did not need. The man, Reinaldo Wilson, 57, was also ordered to repay $27.9 million to the government.
Wilson operated telemedicine businesses in Bayonne, New Jersey, between 2017 and 2019. According to court records, those companies worked with medical providers who signed orders for braces known as orthotics. These braces are often used to support knees, backs, wrists, and other joints. In this case, many of the patients did not need the equipment. Still, orders were signed and sent through a chain of companies that turned the paperwork into Medicare claims.
Prosecutors said Wilson and others paid illegal kickbacks to providers in exchange for signed orders. Those orders were then sold to marketing groups, which often resold them to brace supply companies. The supply companies billed Medicare for the equipment. Investigators said more than 3,000 Medicare beneficiaries were tied to the scheme. Many were approved for four or more braces each. More than 40 people were listed as receiving orders for 10 or more braces.
During the two-year period, more than $56 million in claims were submitted to Medicare. Of that amount, Medicare paid out over $27.9 million. Officials said the volume of braces and the way patients were approached raised red flags. Some beneficiaries were pushed to accept as many braces as possible, even if they had no clear medical need.
Authorities also described steps taken to hide the fraud. After scrutiny began to grow, Wilson created a new telemedicine company. He persuaded a member of his church to invest $20,000 in what was presented as a business opportunity. The company and bank accounts were opened in her name, but investigators said Wilson controlled the operation behind the scenes.
In March 2021, Wilson pleaded guilty to conspiracy to commit wire fraud and health care fraud. This week, a federal judge sentenced him to seven years in prison. Along with the prison term, the court ordered restitution of $27.9 million, reflecting the amount Medicare paid on the false claims.
Federal officials said the case shows how fraud can damage public health programs. Medicare is funded by taxpayers and is designed to provide medical care for older adults and certain people with disabilities. When false claims are paid, funds that are meant for real care are diverted.
The investigation involved the Federal Bureau of Investigation, the Internal Revenue Service Criminal Investigation, and the U.S. Department of Health and Human Services Office of Inspector General. The case was prosecuted by the Fraud Section of the Justice Department’s Criminal Division, which handles complex financial and health care fraud matters.
The Justice Department noted that the Health Care Fraud Strike Force Program has charged more than 6,200 defendants since 2007. Those cases together involved more than $45 billion in billed losses to federal health programs and private insurers. The program operates in several federal districts across the country and focuses on large-scale fraud schemes.
Recent cases show that health care fraud remains a major focus for federal law enforcement. Officials continue to bring charges against doctors, company executives, and others accused of taking part in billing scams. In this case, prosecutors said the fraud depended on signed medical orders, aggressive marketing, and a steady stream of claims sent to Medicare.
Wilson’s sentence of seven years closes one chapter of the case, but investigators have said they will keep pursuing similar schemes. Authorities say public reporting, data review, and cooperation among agencies play a key role in spotting unusual billing patterns. The message from law enforcement is clear: false billing tied to federal health programs can lead to prison time and heavy financial penalties.
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Telemedicine Company Owner Sentenced to 7 Years in Prison for $56M Medicare Fraud Scheme
Owners of telemedicine companies charged in $56M Medicare fraud scheme
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