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Catch of the Week: Classic Medicare Fraud

Posted  November 5, 2021

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 Week.

Taylor first hit these pages as part of DOJ’s fraud sweep in May 2021, when they announced charges against fourteen people.  On November 3, 2021, DOJ announced that Taylor had been indicted for allegedly making $100 million dollars in false billing for various testing and laboratory services.  Taylor owned five LLCs that purportedly provided urine drug testing, COVID-19 testing, and other clinical laboratory services, including a California-based company called Beach Tox.

According to the grand jury indictment, Taylor began his alleged scheme to defraud Medicare in 2017.  In essence, he allegedly used various methods to get ahold of beneficiary and provider information that had been used for claims to Medicare.  Nefariously, this allegedly included acquiring existing labs and accessing their information.  He allegedly would then take that information and use it to submit new claims to Medicare for testing that was not ordered or performed.  When the pandemic came around, according to DOJ, he allegedly bundled claims for false COVID-19 testing alongside other tests, to the tune of $42 million. He also allegedly concealed from CMS his ownership and control over the various lab companies in question.

Never fear, though, the allegedly ill-gotten gains went to good ends: prosecutors have asked for forfeiture of seized assets including numerous vehicles, campers, trailers, 574 guitars, paintings of guitars, and “assorted percussion equipment to include bongos, mounted and un-mounted toms, bass drums, percussion, snare, subkick, and shake drums.”  It just goes to show: Medicare fraud doesn’t pay, but it might get you temporary ownership of some bongos.

If you would like more information about healthcare fraud or would like to speak to a member of the Constantine Cannon whistleblower lawyer team, please contact us for a confidential consultation.

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Tagged in: Catch of the Week, COVID-19, Healthcare Fraud, Laboratory and IDTF, Lack of Medical Necessity, Medical Billing Fraud, Medicare, Provider Fraud,