Federal prosecutors have charged 14 people – including a doctor and owners of labs, pharmacies and a home health agency – in several Covid-related fraud schemes that allegedly defrauded consumers and insurers over $ 143 million , the Ministry of Justice ad Wednesday.
In addition, the Center for Program Integrity of the Centers for Medicare & Medicaid Services announced that it has taken administrative action against more than 50 medical providers for their involvement in healthcare fraud schemes linked to Covid-19. .
The DOJ Fraud Section, which heads the Medicare Fraud Strike Force, has announced that it is pursuing prosecutions in the following districts: Western District of Arkansas, Northern District of California, Middle District of Louisiana, Central District of California, Southern District of Florida, District of New Jersey and the Eastern District of New York.
“These healthcare professionals, business leaders and others would have taken advantage of the COVID-19 pandemic to line their pockets instead of providing the healthcare services needed during this unprecedented time in our country,” said Deputy Attorney General Lisa Monaco. “We are determined to hold those who operate these programs accountable to the fullest extent of the law. “
FBI Director Christopher Wray also said the agency is committed to tackling Covid-related healthcare fraud. “Healthcare providers were the unsung heroes. … It is disheartening that some have abused their authorities. “
The defendants are said to have engaged in various types of schemes “designed to exploit the COVID-19 pandemic,” the DOJ said in a press release.
“For example, several defendants have offered COVID-19 testing to Medicare beneficiaries at retirement homes, drive-thru COVID-19 testing sites, and doctor’s offices to trick beneficiaries into providing their personally identifiable information and a sample of saliva or blood, ”the DOJ says. “The defendants then allegedly abused the information and samples to submit claims to Medicare for unrelated, medically unnecessary and much more expensive laboratory tests, including cancer genetic testing, allergy testing and panel testing. respiratory pathogens. The DOJ said the proceeds of the schemes were allegedly laundered through shell companies and used to buy exotic cars and luxury real estate.
In another example, a defendant allegedly exploited extensions of telehealth regulation to submit fraudulent claims to Medicare for telemedicine encounters that never happened, according to the DOJ. Telehealth regulations were expanded after Covid-19 was recognized as a national emergency to give Medicare beneficiaries better access to a wider range of services so they can avoid risky trips to care sites health.
Here are some of the cases the DOJ has announced it is pursuing:
In Arkansas, a man who owns two testing labs has been charged with healthcare fraud in connection with an alleged scheme to defraud the United States of more than $ 88 million. The man allegedly used access to beneficiary and medical provider information from previous lab test orders to submit hundreds of fraudulent claims for urine, drug and other tests. Some of the bogus claims concerned beneficiaries who were already deceased.
A New Jersey doctor has reportedly ordered costly and medically unnecessary genetic testing for Medicare beneficiaries who attended a Covid-19 testing event he attended. The man is also said to have billed Medicare for beneficiary services he never provided, totaling around $ 19 million in healthcare fraud schemes.
Another man in the state who was a partner in a diagnostic testing lab is said to have offered bribes in exchange for respiratory pathogen tests that were poorly associated with Covid tests and billed to Medicare. The man allegedly paid and received bribes in a scheme totaling $ 5.4 million.
In New York City, charges were laid against two people who owned multiple drugstores and fake drugstore wholesale companies for committing health care frauds, wire transfers and money laundering totaling 45 millions of dollars. The two and their co-conspirators are said to have acquired billing privileges for several pharmacies. They also allegedly submitted fraudulent claims to Medicare by abusing the Covid-19 emergency rules to avoid otherwise applicable limits on expensive drug refills. The DOJ press release said the defendants “allegedly used an elaborate network of international money laundering operations to cover up and disguise the proceeds of the scheme.”
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