Feds Charge 20 in Alleged $150M COVID Fraud Schemes

COVID, fraud, scams, billing fraud, healthcare fraud

Federal prosecutors have filed charges against a number of people over the past few weeks for allegedly carrying out a variety of scams connected to the COVID pandemic that totaled $150 million in improper government payments.

As The Wall Street Journal reported Wednesday (April 20), the 20 charges come as the U.S. Justice Department is increasing its effort to ferret out thefts from programs that gave billions to the healthcare system during the pandemic.

These new cases were filed all over the country, exposing the array of ways in which some healthcare providers allegedly tried to cheat programs like Medicare.

In one case, a Maryland doctor who ran drive-through COVID testing sites is accused of billing Medicare for many of those tests, as well as $1.5 million for physician visits that were supposed to accompany them, but allegedly didn’t really happen.

That doctor, Ron Elfenbein, allegedly told his staff to submit the tests for reimbursement as services that required 30-minute consultations, as the higher complexity services were the “‘bread and butter’ of how we got paid,” an indictment returned on Tuesday (April 19) said.

Another case involved a Miami nurse practitioner accused of billing Medicare for $134 million in fraudulent claims, taking advantage of relaxed telemedicine rules to order unnecessary genetic tests and medical equipment.

The alleged schemes “involve extraordinary efforts to prosecute some of the largest and most wide-ranging pandemic frauds detected to date,” said Kevin Chambers, who is overseeing the Justice Department’s COVID fraud enforcement efforts.

COVID-related fraud goes beyond the medical field. Earlier this month, the Federal Reserve imposed lifetime bans on six former bankers for approving fraudulent loans for small businesses that needed a boost during the COVID pandemic.

Read more: Federal Reserve Bans Six Bankers for COVID-19 Loan Fraud

The Fed said the loans were granted “based on false and fraudulent representations and used the funds for unauthorized personal expenses.”

The six bankers secured loans via the Small Business Administration’s COVID-19 Economic Injury Disaster Loan program and did not admit or deny their involvement in the fraud as part of their punishment.