In addition to those indicted by the DOJ, more than 50 medical providers are also facing administrative action from the Center for Program Integrity and the Centers for Medicare & Medicaid Services for their involvement in healthcare-related fraud schemes. at 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 such programs accountable to the fullest extent of the law. “
FBI Director Christopher Wray also said the agency is committed to tackling healthcare fraud linked to Covid-19.
The DOJ announcement also noted that profits from the fraudulent schemes were said to have been laundered through shell companies and used to purchase exotic cars and luxury real estate.
After Covid-19 was recognized as a national emergency, telehealth regulations were expanded to give Medicare beneficiaries better access to a wider range of services to avoid risky trips to care sites health. The defendants allegedly exploited these extensions of the regulations to submit fraudulent claims to Medicare for telemedicine encounters that never happened, according to the DOJ.
In Arkansas, a man who has 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 orders for lab tests 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 screening advertising event he attended. The man also reportedly billed Medicare for services he never provided to beneficiaries, totaling around $ 19 million. in healthcare fraud systems.
Another man in the state who was a partner in a diagnostic testing lab is said to have offered bribes in exchange for breathing 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 report claims that the defendants “allegedly used an elaborate network of international money laundering operations to cover up and disguise the proceeds of the scheme.”
“Healthcare providers were the unsung heroes. … It is disheartening that some have abused their authorities, ”said Wray.