Federal prosecutors have charged 21 people in the past couple of weeks with allegedly engaging in various health care fraud schemes related to the Covid-19 pandemic that amounted to about $150 million in illegal government claims. The cases have been filed in nine federal districts around the country against medical industry professionals, with the charges ranging from overcharging for medical services to selling fake vaccination cards.
Several defendants are charged with allegedly using COVID-19 testing to gather patients’ personal information and saliva or blood samples and then submitting claims for more expensive, unnecessary tests, according to the Department of Justice press release.
Two of the cases involve defendants in the Southern District of Florida.
In one case, an advanced registered nurse practitioner from Miami was charged by indictment in connection with an alleged health care fraud and wire fraud conspiracy that resulted in the submission of over $134 million dollars of false and fraudulent claims to Medicare. This included claims that the defendant took advantage of Medicare’s relaxed telemedicine rules during the COVID-19 pandemic, which were designed to enable access to care during the public health emergency. The defendant allegedly signed an enormous amount of doctor’s orders for medically unnecessary genetic testing and durable medical equipment in exchange for kickbacks in the form of sham telehealth consultation fees and the opportunity to bill Medicare, under the COVID-19 telemedicine waivers, for telemedicine consultations that were not performed as represented to Medicare.
In the second case, a Port Saint Lucie man was indicted for conspiracy to commit health care fraud and wire fraud, health care fraud, conspiracy to defraud the United States and pay health care kickbacks, paying health care kickbacks, and wire fraud. These charges stem from the defendant allegedly billing Medicare for $2,598,318 worth of medically unnecessary doctors’ orders for durable medical equipment and submitting a false application for $105,800 of COVID-19 relief funding. The defendant allegedly paid kickbacks to marketing companies in exchange for the doctors’ orders that were obtained by soliciting the durable medical equipment to Medicare beneficiaries that did not need or want it. In June 2020, the defendant applied for a $105,800 Economic Injury Disaster Loan for one of his companies that he used to bill for the medically unnecessary doctors’ orders. In the application, he allegedly claimed to have several employees that the company did not have and listed gross revenues that derived from the kickback scheme.