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Catch of the Week: Telemarketer Gets 10 Years in $3.3 Million Telemedicine and Genetic Testing Fraud Scheme

Posted  April 16, 2021

Ivan Andre Scott, a 36-year-old Florida man, just landed a 10-year prison sentence for organizing a $3.3 million Medicare fraud scheme involving two of the hottest healthcare trends – telemedicine and genetic testing to assess the likelihood of future cancer. The conspiracy targeted vulnerable Medicare beneficiaries for pricey cancer screening genetic tests, prosecutors said. Claims for these tests were falsely billed to Medicare even though they did not meet the federally funded insurance program’s limited coverage requirements and were tainted by illegal kickbacks.

Through his Orlando telemarketing call center, Scott got Medicare beneficiaries to agree to genetic cancer testing by falsely claiming Medicare covered the tests, which can cost up to $6,000 a pop. He then paid illegal bribes and kickbacks to telemedicine companies to get medical professionals to order the tests, according to evidence at trial. The telemedicine doctors approved the tests, often without even speaking to the beneficiary, let alone treating them for cancer.

Scott then sold the genetic tests and doctor’s orders to laboratories in exchange for illegal kickbacks, and the labs billed Medicare for $3.3 million in false claims from these referrals. The Justice Department said Scott personally pocketed $194,000.

On January 8, 2021, a federal jury convicted Scott of conspiracy to commit healthcare fraud, conspiracy to pay and receive unlawful healthcare kickbacks, and receiving unlawful kickbacks. The Justice Department announced his 10-year sentence on April 14, 2021.

“The department will continue working with our law enforcement partners to bring to justice those who seek to use new technologies to plunder our government health care programs,” said Acting Assistant Attorney General Nicholas L. McQuaid in a Justice Department press release.

Healthcare technology, particularly telehealth or telemedicine, has dramatically expanded over the past several years, especially as the pandemic forced many industries to shift to a virtual setting. Telemedicine (and related innovations) can do a lot of good and is likely here to stay. But as telehealth has grown, so has fraud and abuse in telehealth services. Whistleblowers with information about fraud in telemedicine may have a case under the False Claims Act and may be eligible to receive a whistleblower reward.

If you think you might have a case, contact our whistleblower lawyer team to learn more.

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Tagged in: Anti-Kickback and Stark, Catch of the Week, FCA Federal, Healthcare Fraud, Laboratory and IDTF, Lack of Medical Necessity, Medicare,