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The Extra Cost of Fraud

The Extra Cost of Fraud

Healthcare-7
Senior Director of Strategic Alliances
LexisNexis Risk Solutions - Government

On April 8, 2025, Dr. Scott Taggart Roethle pled guilty for his role in a Medicaid scheme that stole millions of dollars from the U.S. taxpayer. Roethle was an anesthesiologist licensed to practice medicine in 22 states. But he also was contracted with multiple health care companies as a telemedicine doctor, although not for anesthesia consultations. From 2017 until 2020, he conspired with the healthcare companies to order medically unnecessary durable medical equipment, pain creams and genetic tests for patients in exchange for thousands of dollars in kickbacks.

Roethle did not have prior doctor-patient relationships with the patients. Using electronic patient portals provided by the healthcare companies he was contracted with, Roethle would review the online patient information and then create orders for healthcare services without evaluating the patients or their medical needs. Roethle did not provide any follow-up care after ordering the healthcare services either, despite numerous complaints from patients regarding the items they did not want or hadn’t ordered.

Involved in a scheme which went undetected for over three years, Roethle’s fraud cost the U.S. taxpayer millions of dollars more then the fraudulent proceeds he received. At $30 for each fraudulent order he wrote, Roethle admitted to receiving payments of $674,000 from five companies. He believed that Medicare paid at least $1.5 million to other fraudsters who were relying on his fraudulent orders. However, the extra costs of fraud extend beyond immediate financial loss, including but not limited to costs for investigations and recovery. The U.S. Attorney’s Office argued that the total loss due to the health care fraud was between $7 million and $9.5 million.

Shout out to the Department of Health and Human Services in this case.

Today’s Fraud of The Day is based on article “Doc pleads guilty to telehealth scheme” published by HME News on April 8, 2025.

Dr. Scott Taggart Roethle, 47, pleaded guilty in U.S. District Court in St. Louis to one count of health care fraud for conspiring with health care companies and others to order medically unnecessary durable medical equipment, pain creams and genetic tests for thousands of patients in exchange for hundreds of thousands of dollars in kickbacks.

 From 2017 until 202, Roethle contracted with multiple health care companies as a telemedicine doctor. Using electronic portals to review patient information and documents, Roethle ordered health care services for patients without evaluating them or their actual medical needs.

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