Ohio Doctor Pleads Guilty in St. Louis to Telemedicine Kickback Scheme
ST. LOUIS – A doctor from Ohio pleaded guilty Monday to three felony charges and admitted accepting $291,000 in kickbacks from telemedicine companies involved in a nationwide fraud scheme.
Despite knowing it was illegal to solicit or accept any payments in return for referrals, Dr. Amy E. Swegan, 47, of Aurora, Ohio, was paid $30 for each “consult” she performed on behalf of a series of companies from July 25, 2017 to February 28, 2019. She then approved prescriptions for pain cremes, genetic tests for cancer and orthotic braces and other durable medical equipment for thousands of patients, her plea agreement says.
Medicare, Medicaid and other insurers will reimburse for durable medical equipment only if a qualified health professional determines that the brace is medically necessary. Swegan simply accepted the statements of the telemedicine companies that the intake workers employed by them were qualified to assess patients. She made no further inquiry or investigation, and simply ordered orthotic braces that patients did not request or need, her plea agreement says.
Swegan admitted ignoring numerous red flags and deliberately chose not to inquire as to whether the agreements and practices were improper, unethical or illegal.
Medicare and Medicaid were billed over $18 million by the companies and paid out $7.2 million, Swegan’s plea says.
Swegan pleaded guilty Monday in front of U.S. District Judge Sarah E. Pitlyk to one count of conspiracy and two counts of health care fraud. She is scheduled to be sentenced December 14. The conspiracy charge carries a penalty of up to five years in prison and a $250,000 fine and the fraud counts are punishable by up to 10 years in prison and a $250,000 fine. She will be ordered to pay $7.2 million in restitution.
"Doctors engaging in kickback schemes corrupt the provider-patient relationship and impose hidden costs on the health care system," said Curt L. Muller, Special Agent in Charge with the U.S. Department of Health and Human Services Office of Inspector General (HHS-OIG). “Alongside our law enforcement partners, HHS-OIG is committed to safeguarding the integrity of federal health care programs by, in part, holding individuals who unlawfully bill the programs accountable for their actions."
HHS-OIG, the FBI, the Defense Criminal Investigation Service and the Missouri Medicaid Fraud Control Unit investigated this case. Assistant U.S. Attorneys Dorothy McMurtry and Derek Wiseman are prosecuting the case.