On May 26, the U.S. Department of Justice (DOJ) announced criminal charges against 14 defendants in six states for participation in healthcare fraud schemes related to the COVID-19 pandemic. The coordinated takedown involved fraudulent claims for laboratory testing, telemedicine fraud, pharmacy fraud, payment of kickbacks for referrals, and alleged misappropriation of COVID-19 Provider Relief Fund proceeds. The enforcement actions were coordinated by DOJ’s Health Care Fraud Unit’s Medicare Fraud Strike Force in conjunction with numerous other federal and state authorities.
Fraudulent COVID-19 testing was at the core of most of the cases. Case-by case variations included additional unnecessary genetic testing (an ongoing problem previously discussed here); payments of kickbacks for referrals of patients or specimens; and enabling telehealth providers to bill for consultations with Medicare beneficiaries that never occurred, in exchange for referrals for medically unnecessary testing. According to DOJ, the schemes resulted in a total of $143 million in false billing in Arkansas, California, Florida, Louisiana, New Jersey and New York.