Brett Blackman sits behind bars in the federal prison in Miami, fresh off getting a 19-year jail sentence from U.S. District Judge David Leibowitz.
His crime? He aimed to steal a billion dollars from the government — and succeeded in getting Medicare and other insurers to actually pony up more than $450 million.
Blackman was behind one of the largest single telemedicine frauds ever prosecuted, though at the rate the government is bringing new cases, there may be more record-shattering fraudsters waiting in the wings.
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Most of the cases are far smaller, though. Maybe tens of millions of dollars. In some cases, even less.
But they usually have the same basic pattern: Unscrupulous medical professionals asking the government to pay for unnecessary treatments, enriching the doctors who approve the orders, the companies manufacturing and selling the treatments, and the coordinators such as Blackman who get them all together.
Prosecutors say he managed to rope nearly 350,000 people into his scheme. They were patients with government-backed health care, such as Medicare, and he had them cajoled into applying for orthotic braces or pain creams, even though they had no valid medical reason.
Of the $452 million paid out, more than $52 million ended up in Blackman’s own accounts.
“Blackman found a unique way to defraud Medicare: a system of creating fake prescriptions for orthotics and pain creams en masse,” Darren Halverson, a Justice Department prosecutor, told the judge in a memo asking for a long sentence.
He said Blackman showed “no regard for the hundreds of thousands of beneficiaries who received no care but whose Medicare benefits were billed to the tune of $1 billion.”
Blackman’s genius, according to prosecutors, was his ability to slip into the seams of the modern health care system, positioning himself in the center of a web of telemedicine doctors ready to churn out prescriptions and medical equipment companies eager to fulfill those orders.
It all began with mailers suggesting limited-time offers. Those who called were connected to telemarketers in India and the Philippines, who would pressure the patients into signing up for the orthotics and creams.
The telemarketers were trained not to accept “no” as an answer.
The patients were then funneled over to DMERx, Blackman’s web-based platform, and the order was billed to Medicare. Sometimes no medical professional ever conducted an exam, though by the time the order reached Medicare for reimbursement, it was accompanied by certifications that an exam had in fact taken place.
Sargon Audisho, a doctor involved in the scam who would later lose his license to practice, said he would sign 100 orders a day. He admitted it was “impossible” for him to have actually examined that many people.
Nearly 347,000 people were prescribed through the scam, which lasted four years.
Most were prescribed at least three braces. More than 1,200 of them were prescribed more than 20 braces apiece.
Blackman made money on all ends. Telemarketers paid for the mass mailings, and Blackman took a $10 cut of a fulfilled order — $5 for the telemedicine sign-off and $5 for the prescribed brace.
Blackman, in his lawyer’s memo to the judge, said he personally ended up with only several million dollars and argued his case wasn’t so “cut and dry” as prosecutors suggested.
For one thing, Blackman was not just a purveyor of braces — he was also a customer. He credited a back brace that allowed him movement again. One daughter told the judge he was motivated by a desire for “others suffering similar pain to experience that same relief.”
“He wanted fewer patients falling through the cracks and fewer families facing unnecessary costs because healthcare systems couldn’t communicate,” another daughter said.
Blackman also said his case wasn’t a “classic fraud” because real people were getting real braces or pain creams that they had, in the end, asked for — and that were signed off on by a real doctor.
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