The scams allegedly took place across seven federal districts in the U.S., resulting in over $143 million in false billings being submitted to CMS, according to the Justice Department.
The Justice Department alleges that the defendants engaged in various healthcare fraud schemes, including one in which scammers offered COVID-19 tests to Medicare beneficiaries but then submitted the Medicare claims for more expensive and unnecessary medical testing like cancer genetic testing. In another reported scheme, the Justice Department is accusing the defendants of exploiting CMS policies to enhance telehealth accessibility by submitting claims for telehealth visits that didn’t occur, and a third alleged scheme misused federal COVID-19 relief funding.
In another case the Justice Department outlined, Billy Joe Taylor, the owner and operator of testing labs Vitas Laboratories and Beach Tox, allegedly used his access to beneficiary and medical provider information from prior COVID-19 testing to submit fraudulent claims for unnecessary tests. Mr. Taylor is accused of trying to defraud the U.S. out of $88 million.
An additional defendant, Alexander Baldonado, MD, is charged with six counts of healthcare fraud for allegedly ordering expensive and medically unnecessary cancer genetic testing for Medicare beneficiaries after they came in for COVID-19 testing.
The Justice Department’s criminal division, the FBI, seven U.S. attorney’s offices and the HHS’ Office of the Inspector General collaborated on bringing the allegations.
Access the full news release here.
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