Scammers racked up $143 million in bogus medical claims by exploiting COVID, feds say

Bailey Aldridge
·3 min read

More than a dozen people are facing charges related to health care fraud schemes that “exploited the COVID-19 pandemic” to rack up more than $143 million, federal officials say.

The U.S. Department of Justice on Wednesday announced the criminal charges against 14 people from across the United States. They are accused of participating in “various” schemes that were “designed to exploit the COVID-19 pandemic” and that together racked up tens of millions in bogus billings.

Those charged include medical professionals, corporate executives and others, Deputy Attorney General Lisa Monaco said in a news release.

“The multiple health care fraud schemes charged today describe theft from American taxpayers through the exploitation of the national emergency,” Monaco said.

The accused fraudsters used a variety of coronavirus-related services to scam victims, feds say.

Multiple defendants are accused of offering coronavirus tests to Medicare recipients at testing sites, senior-living facilities and medical offices to collect personal information from beneficiaries — which feds say they then used to file Medicare claims for unrelated, unnecessary and more expensive tests.

Those tests included cancer genetic testing, allergy testing and “respiratory pathogen panel tests,” the DOJ says.

“In some cases, and as alleged, the COVID-19 test results were not provided to the beneficiaries in a timely fashion or were not reliable, risking the further spread of the disease, and the genetic, allergy and respiratory pathogen testing was medically unnecessary, and, in many cases, the results were not provided to the patients or their actual primary care doctors,” the DOJ says.

Those involved in these schemes are accused of laundering the money through “shell corporations” and using it to buy “exotic automobiles and luxury real estate.”

Others are accused of exploiting policies designed to increase access to care during the pandemic.

During the pandemic, telehealth regulations were relaxed so Medicare recipients could receive more services from their providers without having to go to a medical facility.

“The cases announced today include first in the nation charges for allegedly exploiting these expanded policies by submitting false and fraudulent claims to Medicare for sham telemedicine encounters that did not occur,” the Justice Department says.

Medical professionals are also accused of paying bribes in exchange for referrals for “medically unnecessary testing,” DOJ says.

The Centers for Medicare and Medicaid Services announced separately on Wednesday that it took action against more than 50 medical providers involved in fraud schemes or in abusing programs “designed to encourage access to medical care during the pandemic,” the DOJ says.

Feds say the “law enforcement action” announced Wednesday also includes “charges related to the misuse of Provider Relief Fund monies.” The fund was included in the CARES Act, the COVID-19 relief bill signed into law in March 2020, and was designed to “provide needed medical care to Americans suffering from COVID-19.”

“Medical providers have been the unsung heroes for the American public throughout the pandemic,” FBI Director Christopher Wray said. “It’s disheartening that some have abused their authorities and committed COVID-19 related fraud against trusting citizens. The FBI, along with our federal law enforcement and private sector partners, are committed to continuing to combat healthcare fraud and protect the American people.”

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