Trump Administration Imprisoning Telemedicine Fraudsters
President Trump’s State of the Union address promised to root out federally funded healthcare fraud. As a demonstration of the new get tough policy, the DOJ just sent Reinaldo Wilson to 7 years in prison and could send his wife Jean to prison for up to 20 years for tele-medicine scams that defrauded American taxpayers the U.S. for $192 million in just 2 years.
The Obama administration in 2016 passed the ‘CONNECT for Health Act’ to begin removing Medicare and Medicaid treatment geographic restrictions by allowing internet technologies to enable patients to virtually consult via video; phone; or messaging platforms with medical professionals to receive general wellness consultations, mental health support, and prescription drugs, and other specialized care.
But after Medicare telemedicine billings leaped from $28.7 million for 500,000 sessions in 2016 to $130 million for about 840,000 sessions in 2019, the first Trump administration formed a Health and Human Services and DOJ launched a fraud enforcement take-down.
Before Trump left office in January 2021, the enforcement team identified $1.2 billion in alleged telemedicine “high-risk of fraud schemes,” including dozens of initiatives such as ‘Operation Happy Clickers’ that targeted fraudulent approvals for braces and genetic testing via telemedicine.
One of the task force’s top targets were two telemedicine companies based in New Jersey: Advantage Choice Care LLC and Tele Medcare LLC that began doing business in 2017.
According to U.S. Department of Justice records, owner Reinaldo Wilson, who was convicted in an alleged conspiracy that over 25 months used telemedicine to fraudulently bill Medicare for approximately $56 million in unnecessary durable medical equipment, primarily orthotic braces.
His wife Jean, a former nurse practitioner, was charged in the same case for conspiracy, involving $136 million in fraudulent telemedicine billings.
The scheme entailed paying illegal kickbacks and bribes to healthcare providers, patient recruiters, pharmacies, and brace suppliers in exchange for orders of medically unnecessary equipment for Medicare beneficiaries.
When Covid-19 broke out in 2020 and Medicare face-to-face access to Medicare was suspended, telemedicine billings exploded to $4.8 billion for 45 million sessions. Court closings also delayed sentencing of the Wilsons.
Despite the ending of Covid-19 lock-downs, annual Medicare telemedicine utilization activity during the Biden administration from 2021 through 2024 averaged $3 billion for over 20 million sessions each year.
The prime reason telemedicine utilization continued to remain high during the Biden years was due to a dramatic rise of behavioral health services billings that by 2022 were capturing 40% all Medicare telemedicine claims.
The Health & Human Services Office of Inspector General began conducting audits and investigations in 2022, they identified 1,714 providers with high-risk billing practices for telehealth services involving tens of billions of dollars of overpayments.
But the Biden administration tended to ignore the findings and expanded “Medicare telehealth flexibilities” in the Consolidated Appropriations Act of 2023 through December 31, 2024. The Biden DOJ did not move forward with prosecuting or imprisoning telemedicine fraudsters, like the Wilsons.
The second Trump administration launched the Department of Government Efficiency (DOGE) on its full first day in office on January 21, 2025. DOGE was directed to root out inefficiency and fraud, especially via telemedicine.
The Trump DOJ is concentrating on pursuing rampant cases involving Medicare and Medicaid telemedicine fraud in California, including prosecution and conviction of San Fracisco based Done Global Inc. that represented the first federal criminal drug distribution prosecution linked to telemedicine prescribing through a digital health platform.
Done Global generated over $100 million in revenue by illegally distributing over 40 million Adderall pills and other stimulants via deceptive telemedicine advertising, subscription-based models, and fraudulent reimbursement claims to Medicare, Medicaid, and commercial insurers.
Two principals of the company were tried and convicted of conspiracy to distribute controlled substances and obstructing justice. Founder Ruthia He and Clinical President David Brody are scheduled for sentencing on February 25, 2026, with both facing up to 20 years in prison.
Seven other defendants associated with Done Global pleaded guilty in connection with the investigation, including two corporate executives and five medical professionals. They are expected to be sentenced soon.
Two days after President Trump gave his SOTU address last week to get tough on fraud; Reinaldo Wilson who had pleaded guilty in March 2021, was finally sentenced to seven years in federal prison and ordered to pay restitution. His wife Jean Wilson is expected to be sentenced in the next couple of weeks.
I think most of them are engaging in fraud.
A Pakistani doctor continued to bill years after my mother had died.