Physician convicted in $9.5M fraud scheme

A federal jury convicted a Chicago physician for his role in a $9.5 million healthcare fraud scheme. 

Benjamin Toh, MD, was convicted of conspiracy to violate the federal Anti-Kickback Statute after a two-week trial, according to a Sept. 5 Justice Department news release. 

From March through September 2019, Dr. Toh and others submitted more than $9.5 million in fraudulent claims to Medicare and Medicaid for cancer genetic tests, according to the release. He ordered thousands of tests despite never meeting the patients in person or via telemedicine and never reviewing the results.

Dr. Toh was paid kickbacks by co-conspiring telemedicine companies in exchange for providing signed genetic testing orders. These companies were in turn paid by co-conspirator marketing companies that targeted Medicare and Medicaid patients and convinced them to provide their genetic material via a mouth swab kit. Marketers then sent the kits to a Tennessee lab that billed Medicaid and Medicaid for the tests, the release said. 

Dr. Toh faces up to five years in prison and a $250,000 fine. He will be sentenced Jan. 9. The jury was unable to reach a verdict on a second conspiracy charge. 

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