Doctor Convicted in $24 Million Medicare Fraud Case

One of the scariest things you can hear from a doctor is that you might be predisposed to a certain type of cancer. In some cases, it is important to get a genetic test as soon as possible, so that exploratory and preventative measures can start if a cancer risk exists. These tests are expensive and should only be ordered when there is a legitimate medical justification.

During the COVID-19 pandemic, Dr. Alexander Baldonado of New York visited a number of places where elderly people live or congregate in order to administer tests for the coronavirus. While at these nursing homes, assisted living facilities and senior centers, Baldonado took the personal information of many of the individuals he saw and used it to order cancer genetic tests for them. None of these people were his patients, but he received payment for the tests, as well as some follow-up appointments that never occurred. 

The fraudulent claims were submitted by two related laboratories located in New York, which benefited financially from the scheme and compensated Baldonado with payments. When the Department of Justice reviewed the improper billing and kickbacks, the fraud against the Medicare system was calculated at $24 million. Consequently, Baldonado was convicted on 10 criminal counts, with each count carrying a maximum sentence of several years. The case also involved kickbacks from a medical equipment manufacturer to Baldonado in exchange for prescribing orthotic braces that his patients did not need. 

Violations of the False Claims Act and Anti-Kickback Statute not only deplete funds provided by taxpayers, but also compromise the quality of healthcare that Americans receive. These are not victimless crimes, and if you are aware of this type of misconduct, there are ways you can protect yourself while taking meaningful action against the wrongdoers. 

In all full range of whistleblower cases, Kardell Law Group advocates for individuals, known as relators, who have evidence of fraud against the government that has not been previously reported. Along with the knowledge that you’ve saved taxpayer funds, you might be able to receive a share of the settlement or penalty paid by the fraudulent party.