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New York Doctor Indicted for $20.7 Million in Medicare Fraud and Kickback Scheme

Posted  02/23/24
doctor with dollars

On February 21, 2024, a federal grand jury in New Jersey indicted Dr. Alexander Baldonado, of Queens, New York, for his alleged involvement in a complex health care fraud and illegal kickback scheme. According to the DOJ press release, this scheme involved the submission of over $20.7 million in false and fraudulent claims to Medicare, primarily for medically unnecessary genetic cancer screening and Covid-19...

Testing Lab and Owner/CEO Settle False Claims Act Case for $13.25 Million

Posted  01/12/24
Laboratory Analysis. Scientist Measuring Sample
RDx Bioscience Inc. (“RDx”), a clinical laboratory that operated in New Jersey, and its owner and CEO agreed to pay $13.25 million to settle a False Claims Act case alleging kickbacks and unnecessary testing schemes, according to a recent DOJ press release.  The press release also notes that RDx and its owner/CEO agreed to cooperate with the DOJ’s “investigations of, and litigation against, other participants...

Genetic Testing Scheme Leads to Another Fraud Conviction

Posted  10/11/23
Scientist Testing a Specimen
The DOJ recently announced another fraud conviction in connection with genetic testing. This conviction from a federal jury in Florida is the latest word in a string of fraud actions against companies and individuals offering to provide genetic testing services. According to the DOJ, Jose Goyos and others managed the “‘doctor chase’ division” of a call center, which “contacted the primary care physicians...

Scoundrel Spotlight - Medicare Fraudster Minal Patel

Posted  08/23/23
Medicare Paper on Hundred Dollar Bills
This week's Scoundrel in the Spotlight is Minal Patel who last week (August 18) was sentenced to 27 years in prison for defrauding Medicare of almost half a billion dollars for genetic testing patients did not need and were procured through bribes and kickbacks.  In announcing the sentencing, the government trumpeted the matter as one of the largest genetic testing fraud cases ever tried to verdict. Here is how...

Top Ten Healthcare Fraud Recoveries of 2021

Posted  01/11/22
doctor holding stethoscope
Consistent with the trend in prior years, the bulk of the Justice Department’s fraud and false claims recoveries in 2021 stemmed from healthcare fraud matters. Most of the funds recovered arose from cases originated by whistleblowers under the qui tam provisions of the False Claims Act. The majority of the recoveries on this list involve allegations of violations of the Anti-Kickback Statute, a federal law that...

Catch of the Week: Classic Medicare Fraud

Posted  11/5/21
medicare dollars
For those like your correspondents who spend their days deep in the weeds of complex Medicare fraud, it’s a delight when something refreshingly simple comes along.  Thanks to Billy Joe Taylor of Arkansas, we can relax this Friday with a cool glass of straightforward Medicare fraud.  For allegedly making $100 million in claims to CMS for tests that were not ordered or ever performed, he is our Catch of the...

Catch of the Week: Fraudulent Sleep Tests in Fresno

Posted  10/29/21
bed with pillow and sheets scattered
Fraud permeates through all aspects of America’s healthcare system- from hospitals to big pharma to chiropractors. This week’s catch of the week focuses on another part of the system, sleep clinics. As increasing numbers of troubled sleepers are seeking diagnosis and treatment of chronic sleep disorders, the significant growth in sleep medicine over recent years brings increasing opportunities for the unscrupulous...

Catch of the Week: Laboratory and Two Founders Will Pay up to $16M Over Fraudulent Billing for Urine Drug Testing

Posted  10/22/21
Person wearing lab coat in laboratory
Clinical laboratory MD Labs Inc., and co-founders and owners, Denis Grizelj and Matthew Rutledge, settled charges the lab falsely billed Medicare, Medicaid, and other federal payors for pricey and unnecessary urine drug tests. Over a four-year period, the lab regularly ran two different drug tests at once and then sent results from both tests to the ordering healthcare physician simultaneously, according to the...

DOJ Lowers The Boom On COVID-19 Healthcare Scams, Again

Posted  05/28/21
COVID Virus Zoomed In
Hey, fraudsters, did you hear?  There was a global pandemic, so the government pumped trillions of dollars into the economy.  Probably a good time to get a piece of the cut, you ask?  They’ll never find out, right?  So many ways to grift! Well, not so much.  From the start, the cops on the beat, led by the United States Department of Justice, have screamed from the rooftops:  “Don’t do it.  We WILL...

Catch of the Week: University of Miami to Pay $22 Million to Resolve Allegations of Lab Test Fraud

Posted  05/14/21
University of Miami logo
The University of Miami will pay $22 million to resolve three False Claims Act lawsuits, the first of which was filed in 2013.  The government alleged that UM, which operates a medical school out of Jackson Memorial Hospital and an extensive health system spanning four south Florida counties, fraudulently billed government health care programs to boost declining revenues.  Jackson Memorial will separately pay $1.1...
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