Seattle City Wire

The U.S. Department of Justice has announced the resolution of allegations against Dr. Joseph Upton, a physician based in Bellevue, Washington. Dr. Upton has agreed to pay $65,680 to settle claims that he caused false submissions to Medicare, according to U.S. Attorney Tessa M. Gorman. The settlement includes $32,840 as restitution and the remainder as a penalty under the False Claims Act.

The United States alleged that between August 1, 2018, and April 30, 2019, Dr. Upton was involved in activities leading to false claims submitted to Medicare. Specifically, while working for a telemedicine company called REMN, he reportedly signed orders for durable medical equipment and genetic testing for Medicare beneficiaries without examining or speaking with them or verifying the necessity of these orders as required by Medicare.

Special Agent in Charge Steven J. Ryan from the U.S. Department of Health and Human Services Office of Inspector General stated: “Our federal health care system relies on the basic principle that providers must bill properly and follow the rules, and the taxpayers who fund the Medicare and Medicaid programs deserve nothing less.” He added that they are committed to safeguarding federal health care programs by investigating schemes undermining legitimate telehealth services.

It is important to note that these claims are allegations only; there has been no determination of liability against Dr. Upton.

Assistant United States Attorney Ashley Burns handled this matter which was investigated by the Office of Inspector General for the Department of Health and Human Services (HHS-OIG).