A Florida man was sentenced today to 10 years in prison for conspiracy to commit health care fraud in connection with a scheme that resulted in the submission of approximately $3.3 million in fraudulent claims to Medicare for genetic testing.
Ivan Andre Scott, 36, of Kissimmee, was convicted by a federal jury on Jan. 8, 2021, of one count of conspiracy to commit health care fraud, three counts of health care fraud, one count of conspiracy to pay and receive unlawful health care kickbacks, and three counts of receiving unlawful kickbacks. According to court documents, Scott was the owner of Scott Global, a telemarketing call center located in Orlando. The evidence showed that Scott targeted Medicare beneficiaries with telemarketing phone calls falsely stating that Medicare covered expensive cancer screening genetic testing, or “CGx” tests. Each test cost as much as $6,000. After beneficiaries agreed to take the test, the evidence showed Scott paid unlawful bribes and kickbacks to telemedicine companies to obtain doctor’s orders authorizing the tests.
The evidence at trial showed that the telemedicine doctors approved the expensive testing even though they were not treating the beneficiary for cancer or symptoms of cancer, and often without even speaking with the beneficiary. According to the evidence presented at trial, Scott then sold the genetic tests and doctor’s orders to laboratories in exchange for illegal kickbacks. To conceal the illegal kickbacks, Scott submitted invoices to the laboratories and other marketers making it appear as though he were being paid for hourly marketing services, rather than per referral.
Between November 2018 and May 2019, labs submitted more than $3.3 million in claims to Medicare for genetic tests that Scott had referred to them, of which Medicare paid over $1.3 million. In that timeframe, Scott personally received approximately $194,000 for his role in the scheme.
“The defendant used telemarketing and telemedicine to defraud Medicare of more than a million dollars for unnecessary genetic screening tests,” said Acting Assistant Attorney General Nicholas L. McQuaid of the Justice Department’s Criminal Division. “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.”
“Fraudsters who steal from taxpayer-funded federal health care programs and engage in predatory telemarketing calls are a threat to our country’s health care system and its most vulnerable beneficiaries,” said Special Agent in Charge Omar Pérez Aybar of the U.S. Health and Human Services, Office of Inspector General (HHS-OIG). “Our agents will continue to aggressively investigate health care fraud and hold criminals responsible for their actions.”
“The unscrupulous tactics used in this scheme to steal from taxpayers is what drives our investigators to combat healthcare fraud,” said Special Agent in Charge Michael McPherson of the FBI’s Tampa Field Office. “The FBI’s mission to protect the American people includes protecting them from fraudsters who cheat our nation’s federally funded healthcare systems.”
The case was investigated by HHS-OIG and the FBI and was brought as part of Operation Double Helix, a federal law enforcement action led by the Health Care Fraud Strike Force, under the supervision of the Criminal Division’s Fraud Section, focused on fraudulent genetic cancer testing and the use of telemedicine that has resulted in charges against dozens of defendants associated with telemedicine companies and cancer genetic testing laboratories for their alleged participation in one of the largest health care fraud schemes ever charged.
Trial Attorneys Alejandro Salicrup and Jamie de Boer of the Fraud Section prosecuted the case.
Official news published at https://www.justice.gov/opa/pr/patient-recruiter-sentenced-prison-33-million-cancer-genetic-testing-fraud-scheme