The Department of Justice (DOJ) announced a nationwide coordinated law enforcement action to combat healthcare-related covid fraud. On April 21, 2022, the DOJ announced criminal charges against 21 defendants in nine federal districts across the United States for their alleged participation in various health care related fraud schemes that exploited the COVID-19 pandemic. These cases allegedly resulted in over $149 million in COVID-19-related false billings to federally-funded programs. In connection with the enforcement action, DOJ seized over $8 million in cash and proceeds. https://www.justice.gov/usao-ndca/pr/justice-department-announces-nationwide-coordinated-law-enforcement-action-combat.
The cases involved various types of alleged COVID-19/healthcare fraud. Below is an overview of some of the more significant cases announced.
- Unnecessary and unauthorized laboratory testing. Several cases involved defendants who allegedly offered COVID-19 testing to induce patients to provide their personal identifying information and a saliva or blood sample. The defendants are alleged to have then used the information and samples to submit false and fraudulent claims to Medicare for unrelated, medically unnecessary, and far more expensive tests or services.
- One case involved billing for telemedicine encounters that did not occur and agreeing to order unnecessary genetic testing in exchange for access to telehealth patients. This is not the first such case filed. See https://wirskyelawfirm.com/covid-19-telehealth-fraud-indictment/.
- Misuse of provider relief funds (PRF). Ten defendants were charged with misappropriating PRF monies intended for medical providers and three have already plead guilty.
- Fake Covid-19 vaccination record cards. These cases include charges against manufacturers and distributors of fake COVID-19 vaccination record cards who allegedly sought to obstruct the Department of Health and Human Services (HHS) and Centers for Disease Control and Prevention (CDC) in their efforts to administer the nationwide vaccination program and provide Americans with accurate proof of vaccination.
The DOJ will certainly continue to investigate and file similar cases in the future.