In this case [https://www.justice.gov/opa/pr/jury-convicts-medical-equipment-company-owners-27-million-fraud] the defendants were found guilty of paying a fixed fee for patient leads (i.e. paying for patients). The defendants paid a fixed rate per DME patient to a call center/lead generator in exchange for prescriptions and patient paperwork completed by telemedicine doctors. The defendants paid illegal bribes and kickbacks to a call center in the Philippines that provided signed doctor’s orders for orthotic braces and other DME.
Generally speaking, a DME company may pay a fixed fee for an “unqualified lead” but may not pay a fixed fee for a “qualified lead”.