The U.S. Department of Justice (DOJ) announced on April 20 that it has brought criminal charges against 18 defendants across the U.S. for various fraud schemes related to the COVID-19 pandemic. The DOJ seized more than $16 million in cash and other proceeds from the schemes, which resulted in more than $490 million in false billings to, and thefts from, federal programs.
One defendant, a laboratory owner in California, is charged with submitting over $358 million in fraudulent claims to Medicare, the Health Resources and Services Administration (HRSA) COVID-19 Uninsured Program, and a private insurance company for laboratory testing. In addition to COVID-19 screenings for schools and nursing homes, the lab billed for unnecessary respiratory pathogen panel tests.
Also in California, a physician was charged with submitting $230 million in fraudulent claims to the HRSA Uninsured Program for treatment of patients who actually were insured, and billing for services that were not rendered or were not medically necessary. The same doctor and two other people allegedly submitted more than 70 fraudulent loan applications through the Paycheck Protection Program (PPP) and Economic Injury Disaster Loan (EIDL) Program, and fraudulently obtained over $3 million in loan funds.
The DOJ also announced charges against suppliers of over-the-counter COVID-19 tests, for which Medicare has reimbursed for its beneficiaries since April 2022. A Florida doctor and a marketer were charged with unlawfully purchasing Medicare beneficiary identification numbers and shipping unrequested COVID tests to those individuals, resulting in $8.4 million in fraudulent claims to Medicare.
Finally (for now), the DOJ announced charges for manufacturing and selling fake COVID-19 vaccination cards, for distributing phony cards to people who were not vaccinated, and for defrauding the Provider Relief Fund (PRF). The PRF is part of the Coronavirus Aid, Relief, and Economic Security (CARES) Act, which provided financial assistance to medical providers during the pandemic.
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