Health

Top 8 COVID-Related Health Fraud Cases

Dozens of healthcare professionals, executives and healthcare business owners have faced charges or other consequences for their involvement in COVID-19 fraud schemes and the abuse of programs designed to facilitate access to healthcare during the pandemic.

According to the latest allegations, a laboratory operator has filed fraudulent claims worth $ 88 million. According to the US, he and others received funds that they then used to buy things like exotic cars and luxury real estate. Department of Justice on Thursday.

The Justice Department is currently involved in nine COVID-19-related health fraud cases, which are ranked lower in terms of financial size.

1. Billy Joe Taylor, owner and operator of Vitas Laboratories in Arkansas and Beach Tox in California, was allegedly involved in a $ 88 million scheme in which he filed fake claims for tests that were not ordered or performed, including a panel of respiratory pathogens and COVID-19 tests. According to the complaint, hundreds of claims filed were for deceased beneficiaries and those who no longer provide samples.

The charges against the following defenders were first disclosed on 26 May.

2. Michael Stein, owner and operator of the consulting company 1523 Holdings, and Leonel Palatnik, owner of the Panda Conservation Group and its testing laboratories in Texas, have been charged with an alleged $ 73 million conspiracy to defraud the government in paying and receiving kickbacks during the pandemic …

3. Mark Schena, President of Arrayit Corporation, has been indicted for his involvement in more than $ 70 million in false and fraudulent claims based on allergy and COVID-19 tests. The tests were unreliable, prosecutors said. The charges were brought against the vice president of marketing for Arrayit and the president of a marketing organization in Arizona.

4. Peter Haim and Arkady Haimov, owners of New York pharmacies and fake pharmacy wholesale companies, were charged with surrogate charges of allegedly participating in a money laundering scheme, filing $ 45 million are false claims to Medicare and the use of COVID-19 emergency assistance … abolish “billing codes to avoid pre-authorization requirements and restocking restrictions.”

5. Dr. Alexander Baldonado of Queens, NY, allegedly ordered expensive and unnecessary cancer genetic tests for Medicare beneficiaries at a COVID-19 testing event and billed Medicare for additional services it did not provide. Baldonado was charged with filing fraudulent claims worth about $ 17 million.

6. Under a proposed $ 15 million scheme, Malena Lepetic, owner of MedLogic Laboratories in Louisiana, has offered to pay kickbacks for referrals for testing for COVID-19 and respiratory pathogens. Lepetic allegedly filed claims with Medicare, Medicaid and the Louisiana Blue Cross Blue Shield for more than $ 10 million for panels of expensive and medically unnecessary tests.

7. Florida residents Juan Nava Ruiz, Eric Frank and Christopher Licata were charged with a $ 9.3 million scheme involving kickbacks, referring Medicare recipients to Boca Toxicology for unnecessary laboratory testing and filing claims related to panel testing of respiratory pathogens and genetic testing incorrectly associated with COVID-19 testing.

8. As a partner in a New York diagnostic testing laboratory, Donald Clarkin was involved in a $ 5.4 million conspiracy to exploit the pandemic by offering kickbacks in exchange for panel tests of respiratory pathogens that would be incorrectly combined with tests for COVID-19 and exposed by Medicare. …

9. Hollywood Home Health Services owner Petros Hannesian allegedly misappropriated US $ 229,454 from the CARES Act Provider Assistance Fund and submitted false loan applications to the Economic Injury Loan Program instead of using the funds to treat COVID-19 patients and small business support.

The pandemic has created a situation where large sums of money have to be delivered quickly and unverified to provide adequate medical care, said Mark Zilberman, partner and vice chairman of the Benesch National Health Group.

“Every time you have a significant outflow of public funds, you will also have a period of audit, investigation and enforcement,” Silberman said.

In September, the Justice Department also indicted 42 doctors and nurses and about 100 other healthcare professionals accused of alleged healthcare fraud schemes that cost the government more than $ 1 billion in damages, of which $ 29 million was related to fraud related with a pandemic.

Clearer guidelines for regulatory filing are needed to enable suppliers to do things right without being investigated, Silberman said.

According to Robert Salcido, partner at Akin Gump Strauss Hauer & Feld, more lawsuits and healthcare fraud are inevitable in the coming months as investigations deepen into more institutions and smaller communities.


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