As telehealth has become a routine part of healthcare delivery, federal and state agencies continue to strengthen efforts to identify and prevent fraud involving virtual care. Recent developments at the federal level reflect a growing emphasis on collaboration, data sharing, and coordinated enforcement to protect the integrity of healthcare programs while preserving access to legitimate telehealth services.
One recent example is the launch of the US Department of Justice (DOJ) Medicaid Fraud Data Sharing Initiative. The charge of this initiative is to bring together federal agencies, state Medicaid Fraud Control Units (MFCUs), and participating state partners to improve the sharing of information related to Medicaid fraud investigations. By combining claims data and provider information across jurisdictions, the new DOJ initiative will identify suspicious billing patterns, highlight providers operating across multiple states, and detect coordinated fraud schemes that may not be easily apparent when states only review claims independently. According to a recent article in Healthcare IT News, CMS Administrator Dr. Oz indicated the fraud collaboration would “accelerate the removal of ‘high-risk providers’”. The Medicaid Fraud Data Sharing Initiative aligns with the Administration's broader anti-fraud efforts following the creation of the White House Anti-Fraud Task Force in March 2026, which directed federal agencies to strengthen information sharing and coordination to combat fraud in federal benefit programs.
The Medicaid Fraud Data Sharing Initiative is already being put into practice in Indiana and Ohio, making them the first two states to participate in the program. Indiana is partnering with the DOJ, the Centers for Medicare & Medicaid Services (CMS), and Oracle Health to securely share Medicaid claims data with one another. Similarly, Ohio has announced the launch of its new Medicaid Data Intelligence Platform and has entered into a memorandum of understanding with the DOJ in an effort to help strengthen fraud detection and accelerate the identification of high-risk providers. While these efforts are not necessarily specific to telehealth, they do still have potential impacts on telehealth utilization, as they clearly demonstrate the many ways in which states are increasingly leveraging technology, interstate collaboration, and data analytics to work toward strengthening Medicaid program integrity. As it can be rather common for telehealth providers to furnish health care services across state lines and, consequently, participate in multiple Medicaid programs, initiatives like this will allow for improved data sharing and claims analysis and may ultimately enhance the identification of suspicious billing patterns while also helping to distinguish legitimate virtual care from fraudulent activity.
The aforementioned DOJ announcement also follows a significant telehealth-related enforcement action. In early July, the founder of Done Global [website currently unavailable], a telehealth company that provided treatment for attention-deficit/hyperactivity disorder (ADHD), was sentenced to six years in federal prison for their role in a scheme involving the unlawful distribution of controlled substances and healthcare fraud. According to the DOJ, the company prioritized rapid prescribing of Adderall and other stimulants through brief telehealth encounters while allegedly encouraging clinicians to prescribe medications without adequate medical justification. The case serves as another reminder that federal enforcement continues to target business models that misuse telehealth to facilitate fraudulent or unlawful activity. CCHP has followed the Done Global case since 2024 when federal charges were first announced. At that time, CCHP addressed the matter in its newsletter, "Fraud Is Fraud, So Don't Blame Telehealth," emphasizing the importance of distinguishing fraudulent business practices from legitimate telehealth care.
The culmination of these varying actions actually builds upon the broader enforcement trends that CCHP has continually highlighted in recent years. Last year, CCHP reported on the DOJ's nationwide healthcare fraud takedown, which included multiple telehealth-related cases involving fraudulent durable medical equipment, genetic testing, remote patient monitoring, and other additional schemes. Together, these developments demonstrate that enforcement efforts are increasingly focused on identifying patterns of fraud through data analytics, multi-agency collaboration, and enhanced oversight rather than isolated investigations. Importantly, these cases do not suggest that telehealth technology itself creates fraud. Rather, they exhibit that, like any method of delivering healthcare, telehealth can be misused when providers or organizations engage in fraudulent billing, inappropriate prescribing, or other unlawful practices.
For more information on the DOJ's Medicaid Fraud Data Sharing Initiative, including the participation of Indiana and Ohio, see the Healthcare IT News article, "States Agree to Share Data with DOJ to Fight Medicaid Fraud." For additional information on the Done Global enforcement action, see the U.S. Department of Justice press release announcing the sentencing.