Justice Department Announces $1.2 Billion Health Care Crackdown Tied to Telehealth, Cardiovascular Tests

WASHINGTON—The Justice Department unveiled a $1.2 billion health care fraud crackdown on Wednesday, revealing criminal charges against 36 defendants for alleged fraudulent billing schemes tied to telemedicine, genetic and cardiovascular testing, and equipment.

The criminal charges, which were unsealed across 13 federal districts between July 11 through July 20, target clinical laboratory owners, marketers, medical professionals, and telemedicine executives.

Prosecutors said the schemes intended to bilk Medicare out of $1.2 billion, though the actual losses are closer to $440 million.

“The cases announced today include charges against people who brazenly used Medicare funds to purchase luxury items, medical professionals who corruptly approved testing and equipment, and business owners who submitted false and fraudulent claims for services patients did not need,” Kenneth Polite, the head of the department’s criminal division, told Reuters in a statement.

Separately, the Center for Medicare Services, part of the Department of Health and Human Services, took parallel administrative action against 52 companies involved in similar schemes.

The alleged fraud schemes relate to both older and well-known billing and kick-back practices that target the Medicare program, as well as a burgeoning new fraudulent practice which involves “preying on patients’ fear of cardiovascular disease” by duping them into submitting to medically unnecessary cardiovascular disease screening tests, a Justice Department official told Reuters in an interview on Tuesday.

Billing for such cardiovascular genetic tests has spiked in the past year, Justice Department officials added, noting that some of these tests get billed for as high as $10,000 each, with claims sometimes paying out as much as $8,000.

The official said the total amount billed in the cases involving cardiovascular genetic testing fraud was $748 million, of which $223 million was paid. However, those figures also include billings for genetic cancer screenings that were tacked on as well.

Prior to the