Authorities are continuing to crack down on fraudulent “PGX and CGX” genetic testing! This article from the U.S. Attorney’s Office is a good example of fraudulent telehealth/genetic testing schemes.
Southern District of Georgia continues to lead nationwide effort against fraudulent ‘telehealth’ scams
AUGUSTA, GA: A man and his “marketing company” have been named in a five-count federal indictment for a scheme that paid workers to solicit elderly residents for information used to fraudulently bill government medical programs.
Patrick Siado, of Texas, and his company, Optimus Prime Marketing, LLC, are charged with one count of Conspiracy and four counts of Health Care Fraud, said Bobby L. Christine, U.S. Attorney for the Southern District of Georgia. The Conspiracy charge carries a penalty of up to five years in prison, while each count of Health Care Fraud carries a penalty of up to 10 years in prison. In addition to substantial fines and penalties, the charges also call for up to three years of supervised release after completion of any prison sentence. There is no parole in the federal system.
“Fraudulent testing and billing schemes make health care more expensive for everyone,” said U.S. Attorney Christine. “It’s even worse when it targets programs designed to assist the elderly and poor, while potentially threatening their future health care needs. We’re grateful for the work to protect these vulnerable citizens by our federal, state and local partners, particularly the Augusta District Attorney’s Office and the Burke County Sheriff’s Office.”
According to the indictment, Siado and his company, along with other companies referenced as unindicted co-conspirators, hired individuals to solicit information and DNA swabs from low-income and elderly residents. The individuals were paid $150 for each “patient,” with the information transmitted to another unindicted co-conspirator company that in turn would submit fraudulent claims to Medicare and Medicaid. Siado and his company would then receive a kickback of from $100 to $575 per test accepted for billing.
The indictment states, “Siado knew that his orders were procured through an unlawful kickback relationship, not ordered as medically necessary by the beneficiary’s treating physician, and not payable.” Each of those claims were billed to Medicaid for more than $30,000.
“When individuals bilk government subsidized programs like Medicare and Medicaid, there are many losers, to include every single taxpayer in this country and the low-income and elderly who are entitled to those funds,” said Special Agent in Charge of FBI Atlanta, Chris Hacker. “The FBI makes it a priority to root out such abuse by partnering with our federal, state and local partners.”
“The fraudulent billing of Medicare and Medicaid by unscrupulous individuals in order to line their own pockets, as alleged in this case, is unacceptable,” said Derrick L. Jackson, Special Agent in Charge for the Office of Inspector General of the U.S. Department of Health and Human Services. “Our office will continue to work with our partners to ensure that those responsible for such schemes are held accountable.”
“Schemes which intentionally target our Medicaid population for profit without any intention of helping those individuals must be stopped,” said Georgia Attorney General Chris Carr. “This prosecution reflects our office’s ongoing commitment to working with our federal and local partners to put a stop to such predatory behavior.”
“I am incredibly proud of the hard work that my C.A.V.E. (Crimes Against the Vulnerable and Elderly) Unit put in to this investigation,” said Natalie Paine, District Attorney for the Augusta Judicial Circuit. “The men and women who serve on C.A.V.E. continue to prove that preying on our vulnerable citizens will not be tolerated. I am thankful for U.S. Attorney Bobby Christine’s unwavering commitment to aiding in the prosecution of those whom C.A.V.E. has worked so hard to bring to justice.”
“Community policing; partnerships with the community along with local, state, and federal agencies; and proactive officers and deputies help to prevent or end situations such as this,” said Burke County Sheriff’s Office Chief Deputy Lewis Blanchard. “We are proud that our C.A.V.E. team member deputy, along with the Waynesboro Police Department officers, ensured that this situation was taken to the next level. Protecting our most vulnerable and elderly citizens is a high priority for our office.”
Criminal indictments contain only charges; defendants are presumed innocent unless and until proven guilty.
Including the defendants charged today, the Southern District of Georgia has now charged 21 individuals and companies as part of the nationwide crackdown on fraudulent genetic testing, and prescribing of orthotic braces and pain creams. For the 21 Southern District of Georgia defendants alone, this scheme has led to more than $400 million in losses to Medicare and Medicaid. Those who believe they might have been a victim of such a scheme should contact Assistant U.S. Attorney J. Thomas Clarkson at 912-652-4422.
The investigation is being conducted by the FBI, the Office of Inspector General of the U.S. Department of Health and Human Services, the Medicaid Fraud Control Unit of the Georgia Attorney General’s Office, the Augusta Judicial Circuit District Attorney’s Office, and the Burke County Sheriff’s Office, and prosecuted by Assistant U.S. Attorneys J. Thomas Clarkson and Hank Syms, and Special Assistant U.S. Attorney James P. Mooney.