March 17, 2024 - Richland, WA – Physician William Edward Salko, D.O., formerly of Richland, Washington, and Jackson & Coker LocumTenens, LLC (JCLT) agreed to pay $700,000 to resolve allegations that they participated in a kick-back scheme to bill Medicare for medically unnecessary durable medical equipment (DME) and diagnostic laboratory testing announced Vanessa R. Waldref, the United States Attorney for the Eastern District of Washington. 

Medicare provides health insurance to elderly and disabled United States citizens.  Medicare pays for covered health services, including DME and genetic laboratory testing, under certain conditions.  In order for DME and genetic laboratory testing to be covered under Medicare, the DME or laboratory test must be ordered by a physician who is treating the beneficiary for a specific medical problem and must be used as part of the course of treatment for that specific medical problem. 

According to court documents, JCLT is a healthcare staffing company that sources physicians and other medical professionals for clients.  Between April and September 2021, Dr. Salko was retained through JCLT to provide contracted telemedicine services for a company known as Nationwide Health Advocates (Nationwide).  Nationwide employed telemarketing companies to target and contact Medicare beneficiaries, and to speak with them about obtaining DME or laboratory testing at no cost to the beneficiaries.  The telemarketers obtained personal information from the beneficiary and used it to generate a physician order for the DME or laboratory test, and supporting documentation that made it appear as though the physician was treating the beneficiary for a specific medical problem and ordering the DME or test as part of the course of that treatment.  Nationwide then provided the physician order and supporting documentation electronically to Dr. Salko, who electronically signed the orders, after which they were billed to Medicare. Nationwide then paid JCLT, and JCLT paid Dr. Salko, for each order that he reviewed, nearly all of which he approved.  Dr. Salko was not treating, and never even spoke to, any of the beneficiaries for whom he placed orders through Nationwide.

In September 2023, David Santana, the former owner and president of Nationwide, agreed to plead guilty to felony health care fraud conspiracy charges brought in the District of Massachusetts, in connection with Santana and Nationwide’s participation in the health care fraud scheme and conspiracy to fraudulently bill Medicare for DME and genetic testing services. In the Plea Agreement, Santana admitted to his and Nationwide’s participation in the scheme to fraudulently bill Medicare for false DME and laboratory testing physician orders issued by physicians who were not treating the purported beneficiaries. 

“Physicians and health care staffing cannot ignore red flags about whether they are engaged in a Medicare fraud scheme,” said United States Attorney Waldref.  “Schemes like that employed by Nationwide only work when doctors are willing to turn a blind eye and issue prescriptions and orders for patients that they are not treating.  This settlement is a signal to physicians that they will be held accountable for participating in health care fraud schemes.”

“Providers and entities who exploit Medicare through fraudulent telemedicine schemes violate the trust of enrollees and waste valuable taxpayer dollars,” said Steven J. Ryan, Special Agent in Charge with the U.S. Department of Health and Human Services, Office of Inspector General (HHS-OIG). “This settlement demonstrates HHS-OIG’s unwavering commitment to root out and hold accountable those who put profit and personal gain ahead of the provision of legitimate medical services.”

According to the Settlement Agreement, JCLT cooperated fully with the United States’ investigation, and has taken significant remedial actions designed to improve its legal and compliance efforts and internal controls related to placing providers with telemedicine clients.

“I credit JCLT with stepping up, taking responsibility, and taking steps to prevent occurrences like these in the future,” continued United States Attorney Waldref.  “Health care staffing companies like JCLT play an important role in ensuring that contract physician opportunities are appropriately vetted for legal compliance and possible fraud.  I also commend the exceptional investigative work by, and our close partnership with, HHS-OIG, which made this result possible.  We will continue working with health care providers, medical staffing companies, and our law enforcement partners to combat telemedicine and telemarketing fraud schemes that prey on elderly and disabled members of the community.” 

The settlement was the result of an investigation conducted by the U.S. Attorney’s Office for the Eastern District of Washington and the U.S. Department of Health and Human Services, Office of Inspector General, Seattle Field Office.  Assistant United States Attorneys Dan Fruchter and Tyler H.L. Tornabene, and Law Clerk Jacquelyn Nader, handled this matter on behalf of the United States. 

Source: DOJ Release