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DOJ Levels Charges Against 36 Defendants for $1.2 Billion in Healthcare Fraud

The Department of Justice recently charged 36 defendants in 13 federal districts for “alleged fraudulent telemedicine, cardiovascular and cancer genetic testing and durable medical equipment (DME) schemes.” Criminal charges were levied against medical equipment companies, lab owners and executives, medical professionals, marketing firms and more. Other government agencies took additional administrative actions against 52 more providers.

$1.2 billion in healthcare fraud

The alleged schemes involved illegal kickbacks and bribes by laboratory owners and operators. In exchange, they’d get patient referrals from other medical professionals, who worked with the telemedicine and medical technology companies.

The telemedicine schemes alone made up $1 billion in losses. The allegations included fraudulent cardiovascular genetic testing: medical professionals would make referrals for medically unnecessary cancer and genetic testing, as well as durable medical equipment. They made these referrals despite knowing cardiovascular genetic testing is not an appropriate way to diagnose a current medical condition—nor was it approved by Medicare for use as a screening test to discover potential future problems.

The complicated schemes involved several layers. For example, a clinical lab operator paid over $16 million in kickbacks to marketers. The markets then paid kickbacks to call centers and telemedicine companies, as an exchange for a referral.

Over $174 million in false claims to Medicare were submitted. However, the test results weren’t even used in treating patients. The patients and Medicare ultimately wasted time and money on unnecessary tests and equipment.

The scheme involved laundering proceeds through “a complex network” of bank accounts and other entities, including vehicles, a yacht and real estate. The DOJ is asking for over $7 million in forfeiture from these assets.

When you notice fraud or other wrongdoing at work, you may have legal protections. A skilled attorney from Kardell Law Group can review your situation and explain your legal options. Contact us today to schedule a consultation.

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