Justice makes arrests in $2.1B healthcare scheme

Thirty-five defendants have been charged by the Department of Justice in a Medicare fraud case worth more than $2.1 billion. The healthcare fraud case is one of the biggest ever charged.

The case involved fraudulent genetic testing across dozens of telemedicine companies and cancer genetic testing laboratories, charging CEOs, CFOs and others. The DOJ worked with HHS and FBI. CMS’ Center for Program Integrity (CMS/CPI) also announced administrative action against cancer genetic testing companies and medical professionals for $.17 billion in Medicare claims.

The fraud scheme involved illegal kickbacks and bribes by cancer genetic testing labs in exchange for Medicare beneficiary referrals from medical professionals working with fraudulent telemedicine companies. These tests were expensive and medically unnecessary.

In some cases, the tests were “worthless” to the beneficiaries’ doctors or weren’t performed at all, according to the DOJ. Allegedly, hundreds of thousands of elderly and disabled patients were lured into the network by the defendants.

“These defendants allegedly duped Medicare beneficiaries into signing up for unnecessary genetic tests, costing Medicare billions of dollars,” Assistant Attorney General Brian A. Benczkowski of the Justice Department’s Criminal Division said in a statement. “Together with our law enforcement partners, the Department will continue to protect the public fisc and prosecute those who steal our taxpayer dollars.”

The DOJ announced charges against defendants in Florida, Louisiana, Georgia, Texas and New Jersey.

“Unfortunately, audacious schemes such as those alleged in the indictments are pervasive and exploit the promise of new medical technologies such as genetic testing and telemedicine for financial gain, not patient care,” Deputy Inspector General for Investigations Gary L. Cantrell of HHS-OIG, said in a statement.