Washington doctor settles allegations he submitted false claims to federal healthcare programs

Press Release

Dr. Joseph Upton is alleged to have ordered medically unnecessary durable medical equipment and genetic testing for Medicare beneficiaries

Seattle - The U.S. Department of Justice today resolved allegations that Dr. Joseph Upton, of Bellevue, Washington, caused the submission of false claims to Medicare, announced U.S. Attorney Tessa M. Gorman. Dr. Upton agreed to pay $65,680 to resolve the matter. Of the settlement amount, $32,840 is restitution and the rest is a penalty under the False Claims Act.

According to the settlement agreement, the United States alleges that between August 1, 2018, and April 30, 2019, Dr. Upton engaged in conduct that resulted in the submission of false claims to the Medicare program. Specifically, in connection with his work for a purported telemedicine company known as REMN, Dr. Upton signed durable medical equipment and genetic testing orders for Medicare beneficiaries, despite never examining or speaking with the patients or confirming that the orders were medically necessary and reasonable as required by Medicare.

"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," said Special Agent in Charge Steven J. Ryan of the U.S. Department of Health and Human Services Office of Inspector General. "We are committed to protecting the integrity of federal health care programs, including investigating schemes that seek to undermine the legitimate delivery of telehealth services."

The claims resolved by the settlement are allegations only and there has been no determination of liability.

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

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Updated October 25, 2024