Dozens of healthcare staff, executives and medical enterprise homeowners have confronted expenses or different penalties for his or her involvement in fraud schemes associated to COVID-19 and abuse of packages designed to facilitate entry to medical care throughout the pandemic.
The newest expenses allege a laboratory operator submitted $88 million in fraudulent claims. He and different people gained funds they then used to buy gadgets like unique vehicles and luxurious actual property, in keeping with the U.S. Department of Justice on Thursday.
Presently, the Division of Justice is concerned in 9 circumstances of COVID-19 healthcare fraud, that are ranked under by monetary scope.
1. Billy Joe Taylor, the proprietor and operator of Vitas Laboratories in Arkansas and Seaside Tox in California allegedly was concerned in a $88 million scheme the place he submitted fraudulent claims for checks that weren’t ordered or carried out, together with respiratory pathogen panel and COVID-19 checks. A whole bunch of claims submitted had been for deceased beneficiaries and people not offering samples, in keeping with the grievance.
The fees in opposition to the next defendents had been first revealed on Might 26.
2. Michael Stein, proprietor and operator of the consulting firm 1523 Holdings, and Leonel Palatnik, proprietor of Panda Conservation Group and its Texas testing laboratories, had been charged associated to an alleged $73 million conspiracy to defraud the federal government whereas paying and receiving kickbacks throughout the pandemic.
3. Mark Schena, the president of Arrayit Company, was charged, for his reference to greater than $70 million in false and fraudulent claims for allergy and COVID-19 checks. The checks had been unreliable, in keeping with prosecutors. Arrayit’s vice chairman of promoting and the president of an Arizona advertising group additionally had been charged.
4. Peter Khaim and Arkadiy Khaimov, the homeowners of New York pharmacies and faux pharmacy wholesaling firms, had been charged in a superseding indictment for allegedly taking part in a cash laundering scheme, submitting $45 million is fake claims to Medicare and utilizing COVID-19 “emergency override” billing codes to keep away from pre-authorization necessities and limits for drug refills.
5. Dr. Alexander Baldonado of Queens, New York, allegedly ordered costly and pointless genetic most cancers testing for Medicare beneficiaries at a COVID-19 testing occasion, and billed Medicare for extra providers he didn’t present. Baldonado was charged with submitting roughly $17 million in fraudulent claims.
6. In an alleged $15 million scheme, Malena Lepetich, the proprietor of MedLogic Laboratories in Louisiana, supplied to pay kickbacks for COVID-19 and respiratory pathogen testing referrals. Lepetich allegedly submitted greater than $10 million in claims to Medicare, Medicaid, and Blue Cross Blue Protect of Louisiana for panels of pricy and medically pointless testing.
7. Florida residents Juan Nava Ruiz, Eric Frank and Christopher Licata had been charged in a $9.3 million scheme involving kickbacks, Medicare beneficiary referrals to Boca Toxicology for pointless laboratory testing and declare submissions associated to respiratory pathogen panel testing and genetic testing being improperly bundled with COVID-19 testing.
8. As a associate at a diagnostic testing laboratory in New York, Donald Clarkin was linked to a $5.4 million conspiracy to use the pandemic by providing kickbacks in change for respiratory pathogen panel checks to be improperly bundled with COVID-19 checks and billed to Medicare.
9. Hollywood Dwelling Well being Providers’ proprietor Petros Hannesyan allegedly misappropriated $229,454 from the CARES Act Supplier Reduction Fund and submitted false mortgage functions to the Financial Damage Catastrophe Mortgage Program, as a substitute of utilizing the funds for COVID-19 affected person care and small enterprise help.
The pandemic created a scenario the place the supply of huge sums of cash was required shortly, in an untested method, to supply ample healthcare, stated Mark Silberman, associate and vice chair of Benesch’s nationwide healthcare group.
“Anytime you may have a major outflow of presidency funds, you are additionally going to have the audit, investigation and enforcement interval that follows,” Silberman stated.
The DOJ additionally levied charges in opposition to 42 medical doctors and nurses and round 100 different medical professionals in September for alleged healthcare fraud schemes that value the federal government greater than $1 billion in losses, $29 million of which got here from pandemic-related fraud.
Clearer steerage relating to regulatory document conserving is required to permit suppliers to do issues the precise method with out falling topic to the investigative efforts, Silberman stated
It’s inevitable that within the coming months, extra lawsuits and cases of healthcare fraud will come to mild as investigations dig deeper into extra establishments and smaller communities, stated Robert Salcido, associate at Akin Gump Strauss Hauer & Feld.
