As the world continues to contend with the coronavirus, the Allegiant Experts team would like to reiterate its best wishes to everyone. Needless to say, this is a tough time for all of us and we sincerely hope that you’re keeping well. You don’t need us to remind you about the importance of self-isolating and social distancing, but it’s important to mention it nonetheless. Our team continues to work from home as we battle this pandemic.
We join most of the world in being saddened by the news of so many people being affected by the virus. However, we’re also dismayed by the fact that one of our biggest fears has been realized. The coronavirus pandemic is being utilized by fraudsters to make a quick and illegal buck. As reported by the District of New Jersey branch of the United States Department of Justice, earlier this week, Erik Santos has earned this dishonor.
Erik Santos has been arrested for his role in fraud scheme related to COVID-19.
According to the DoJ, the 49 year-old is accused of having a role in a conspiracy to defraud federally funded and private health care benefit programs. He is alleged to have submitted fraudulent testing claims for COVID-19 and genetic cancer screenings. Santos is charged with one count of conspiring to violate the Anti-Kickback Statute and one count of conspiring to commit health care fraud.
It is nauseating to think anyone could see the spread of COVID-19 as an opportunity to profit. However, as U.S. Attorney Craig Carpenito announced on Monday, Santos “offered kickbacks in exchange for medically unnecessary tests – including potentially hard-to-obtain COVID-19 tests – thus preying on people’s fear in order to defraud the government and make money for himself.”
Santos ran a marketing company that generated leads to testing companies.
“From November 2019 through the present, Santos and others engaged in a large-scale scheme to defraud Medicare by soliciting and receiving kickback payments from companies involved in clinical and diagnostic testing in exchange for steering to those companies individuals eligible for testing that Medicare would reimburse,” reveals the DoJ report.
Santos and his co-conspirators agreed to receive kickbacks on a per-test basis for submitting genetic cancer screening tests to diagnostic testing facilities, regardless of medical necessity. As long as the tests were bundled with much more expensive respiratory pathogen panel (RPP) tests (which do not identify or treat COVID-19), Santos was willing to scam his way into maximizing his kickback profits.
Santos’ scheme aimed to submit more than $1.1 million in fraudulent claims to Medicare.
Knowing that the COVID-19 is especially dangerous for elderly individuals, Santos saw an opportunity. Americans over the age of 65 are eligible for Medicare and TRICARE benefits. With confirmed coronavirus cases increasing in the United States, the number of people finding it hard to obtain tests rise as well.
Chris Hacker is the Special Agent in Charge of FBI Atlanta. He had this to say about the matter: “At a time when Americans are coming together in many different ways to help our fellow citizens make it through this crisis, it is unfathomable to think that some people, driven by personal greed, would try to take advantage of people who need help the most.”
Are you an attorney currently working on a health care fraud case?
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