21 people charged in alleged COVID schemes
The US Department of Justice (DOJ) has charged 21 people in multiple states with fraudulent claims related to COVID-19 pandemic medical assistance and selling fake vaccination cards in the past two weeks.
Since the pandemic started, the federal government has injected billions of dollars into the American healthcare system. Some people tried to defraud the government by making false claims totaling $150 million. About $20 million has been paid out for some of those claims.
In Miami, Florida, a 43-year-old nurse practitioner was charged with submission of more than $134 million of false and fraudulent claims to Medicare.
She and her co-conspirators allegedly signed several doctor's orders for medically unnecessary genetic testing and durable medical equipment in exchange for kickbacks in the form of sham telehealth consultation fees. Those alleged telemedicine consultations never happened.
In California, two people both 63 years old were charged with trying to defraud Medicare of more than $214 million for laboratory tests, of which $144 million was in false and fraudulent claims for COVID-19 and respiratory pathogen tests that were submitted without regard to medical necessity.
The indictment also alleges that they paid kickbacks to marketers who obtained specimens and test orders and laundered the proceeds of the scheme through shell companies. They allegedly used the money to buy real estate, luxury items and personal goods and services.
In Maryland, a medical director was charged with instructing his employees to submit claims to Medicare and other insurers for moderate or complex office visits even though those visits lasted only five minutes or less for a COVID-19 test. The fraudulent claims amounted to $1.5 million.
A New York state doctor was charged for billing Medicare and Medicaid more than $1.3 million in claims in connection with coronavirus testing that his office didn't provide.
A few others, including a post office worker, were charged with making and selling fake COVID-19 vaccination record cards.
"This COVID-19 health care fraud enforcement action involves extraordinary efforts to prosecute some of the largest and most wide-ranging pandemic frauds detected to date," said Kevin Chambers, director for COVID-19 fraud enforcement, in a DOJ statement. "The scale and complexity of the schemes prosecuted today illustrates the success of our unprecedented interagency effort to quickly investigate and prosecute those who abuse our critical health care programs."
Last year, the DOJ charged a dozen people with similar fraud conducted by healthcare providers totaling $143 million for false claims to the government.
In one case, a Florida owner of multiple labs was sentenced to 82 months in prison for filing false claims and paying and receiving kickbacks by taking advantage of temporary telehealth waivers to authorize thousands of medically unnecessary cancer and cardiovascular genetic testing orders.
Last year in May, the US attorney general established the COVID-19 Fraud Enforcement Task Force to combat and prevent pandemic-related fraud.
"These health care fraud abuses erode the integrity and trust patients have with those in the health care industry, particularly during a vulnerable and worrisome time for many individuals," Luis Quesada, assistant director of the FBI's Criminal Investigative Division, said in a DOJ statement. "The actions of these criminals are unacceptable."
