Justice Department Announces Nationwide Coordinated Law Enforcement Action to Combat Health Care-Related COVID-19 Fraud
Summary
A press release of the U.S. Attorney's Office for the Northern District of California, dated April 21, 2022 and quoting U.S. Attorney Stephanie M. Hinds, on a nationwide Justice Department action charging 21 defendants in nine federal districts in health care related COVID-19 fraud schemes alleged to involve over $149 million. In the Northern District of California, three additional defendants were charged in a scheme to sell homeoprophylaxis immunizations and falsify COVID-19 vaccination record cards, and one defendant allegedly used a position as Director of Pharmacy at a hospital to obtain real Moderna lot numbers. The release also describes a Central District of California laboratory case involving over $214 million in billing.
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“Justice Department Announces Nationwide Coordinated Law Enforcement Action to Combat Health Care-Related COVID-19 Fraud.”
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Department of Justice
U.S. Attorney’s Office
Northern District of California
FOR IMMEDIATE RELEASE Thursday, April 21, 2022
Justice Department Announces Nationwide Coordinated
Law Enforcement Action To Combat Health Care-Related
COVID-19 Fraud
Criminal Charges Brought Against Owners and Executives of Medical
Businesses, Physicians, Marketers, and Manufacturers of Fake COVID-19
Vaccination Record Cards with Losses Exceeding $149 Million
SAN FRANCISCO – The Department of Justice today announced criminal charges against 21
defendants in nine federal districts across the United States for their alleged participation in various
health care related fraud schemes that exploited the COVID-19 pandemic. These cases allegedly
resulted in over $149 million in COVID-19-related false billings to federal programs and theft from
federally-funded pandemic assistance programs. In connection with the enforcement action, the
department seized over $8 million in cash and other fraud proceeds.
“Today’s announcement by the Department of Justice demonstrates our continued resolve to protect
the integrity of the government efforts to combat the COVID 19 pandemic,” said U.S. Attorney
Stephanie M. Hinds for the Northern District of California. “We will pursue anyone seeking to profit
from this health care crisis by committing crimes that endanger the health and well-being of the
public at a time when confidence in our public health system is of critical importance. Every day, the
multi-agency partnership formed to combat pandemic-related fraud is holding fraudsters to account
for their crimes.”
“The Department of Justice’s Health Care Fraud Unit and our partners are dedicated to rooting out
schemes that have exploited the pandemic,” said Assistant Attorney General Kenneth A. Polite, Jr. of
the Justice Department’s Criminal Division. “Today’s enforcement action reinforces our commitment
to using all available tools to hold accountable medical professionals, corporate executives, and
others who have placed greed above care during an unprecedented public health emergency.”
“This COVID-19 health care fraud enforcement action involves extraordinary efforts to prosecute
some of the largest and most wide-ranging pandemic frauds detected to date,” said Director for
COVID-19 Fraud Enforcement Kevin Chambers. “The scale and complexity of the schemes
prosecuted today illustrates the success of our unprecedented interagency effort to quickly
investigate and prosecute those who abuse our critical health care programs.”
This announcement builds on the success of the May 2021 COVID-19 Enforcement Action and
involves the prosecution of various COVID-19 health care fraud schemes. For example, several cases
announced today involve defendants who allegedly offered COVID-19 testing to induce patients to
provide their personal identifying information and a saliva or blood sample. The defendants are
alleged to have then used the information and samples to submit false and fraudulent claims to
Medicare for unrelated, medically unnecessary, and far more expensive tests or services. In one such
scheme in the Central District of California, two owners of a clinical laboratory were charged with a
health care fraud, kickback, and money laundering scheme that involved the fraudulent billing of
over $214 million for laboratory tests, over $125 million of which allegedly involved fraudulent
claims during the pandemic for COVID-19 and respiratory pathogen tests. In two separate cases in
the District of Maryland and the Eastern District of New York, owners of medical clinics allegedly
obtained confidential information from patients seeking COVID-19 testing at drive-thru testing sites
and then submitted fraudulent claims for lengthy office visits with the patients that did not, in fact,
occur. The proceeds of these fraudulent schemes were allegedly laundered through shell
corporations in the United States, transferred to foreign countries, and used to purchase real estate
and luxury items.
“Throughout the pandemic, we have seen trusted medical professionals orchestrate and carry out
egregious crimes against their patients all for financial gain,” said Assistant Director Luis Quesada of
the FBI’s Criminal Investigative Division. “These health care fraud abuses erode the integrity and
trust patients have with those in the health care industry, particularly during a vulnerable and
worrisome time for many individuals. The actions of these criminals are unacceptable, and the FBI,
working in coordination with our law enforcement partners, will continue to investigate and pursue
those who exploit the integrity of the health care industry for profit.”
In another type of COVID-19 health care fraud scheme announced today, defendants allegedly
exploited policies that the Centers for Medicare and Medicaid Services (CMS) put in place to enable
increased access to care during the COVID-19 pandemic. For example, in the Southern District of
Florida, one medical professional was charged with a health care fraud, wire fraud, and kickback
scheme that allegedly involved billing for sham telemedicine encounters that did not occur and
agreeing to order unnecessary genetic testing in exchange for access to telehealth patients. Late last
year, one defendant previously was sentenced to 82 months in prison in connection with this
scheme.
“The attempt to profit from the COVID-19 pandemic by targeting beneficiaries and stealing from
federal health care programs is unconscionable,” said Inspector General Christi A. Grimm of the
Department of Health and Human Services (HHS). “HHS-OIG is proud to work alongside our law
enforcement partners at the federal and state levels to ensure that bad actors who perpetrate
egregious and harmful crimes are held accountable.”
Today’s announcement includes charges against two additional defendants for schemes targeting the
Provider Relief Fund (PRF). The PRF is part of the Coronavirus Aid, Relief, and Economic Security
(CARES) Act, a federal law enacted in March 2020 that provided financial assistance to medical
providers to provide needed medical care to Americans suffering from COVID-19. In total, 10
defendants have been charged with crimes related to misappropriating PRF monies intended for
frontline medical providers and three have pleaded guilty.
Today’s announcement also includes charges against manufacturers and distributors of fake COVID-
19 vaccination record cards who, according to the allegations, intentionally sought to obstruct the
HHS and Centers for Disease Control and Prevention in their efforts to administer the nationwide
vaccination program and provide Americans with accurate proof of vaccination. For example, in the
Northern District of California, three additional defendants were charged in a scheme to sell
homeoprophylaxis immunizations for COVID-19 and falsify COVID-19 vaccination record cards to
make it appear that customers received government-authorized vaccines. One defendant allegedly
misused her position as the Director of Pharmacy at a northern California hospital to obtain real lot
numbers for the Moderna vaccine that were then used to falsify COVID-19 vaccination record cards.
“As alleged, the defendants knowingly deceived the public for their own gain while endangering the
health of our community members,” said FBI Acting Special Agent in Charge Sean Ragan. “The FBI
San Francisco office and our federal partners will continue to aggressively pursue the criminal
behavior of those seeking to fraudulently profit from the current health crisis.”
Another defendant in the Northern District of California pleaded guilty to the scheme in April 2022.
U.S. Attorney Hinds described additional schemes being prosecuted in the Northern District of
California in a video posted here.
In addition, in a separate case in the Western District of Washington, one manufacturer was charged
in the multistate distribution of fake COVID-19 vaccination record cards after allegedly telling an
undercover federal agent that “until I get caught and go to jail, [expletive] it I’m taking the money,
ha! I don’t care.”
Further, the Center for Program Integrity, Centers for Medicare & Medicaid Services (CPI/CMS)
separately announced today that it has taken an additional 28 administrative actions against
providers for their alleged involvement in fraud, waste, and abuse schemes related to the delivery of
care for COVID-19, as well as schemes that capitalize upon the public health emergency.
“We are committed to working closely with our law enforcement partners to combat fraud, waste and
abuse in our federal health care programs,” said CMS Administrator Chiquita Brooks-LaSure. “The
administrative actions CMS has taken protect the Medicare Trust Funds while also safeguarding
people enrolled in Medicare.”
Today’s enforcement actions were led and coordinated by Assistant Chief Jacob Foster and Trial
Attorney D. Keith Clouser of the National Rapid Response Strike Force, and Assistant Chief Justin
Woodard of the Health Care Fraud Unit’s Gulf Coast Strike Force in the Criminal Division’s Fraud
Section. The Fraud Section’s National Rapid Response Strike Force and the Health Care Fraud Unit’s
Strike Forces (SF) in Brooklyn, the Gulf Coast, Miami, Los Angeles, and Newark, as well as the U.S.
Attorneys’ Offices for the District of Maryland, District of New Jersey, District of Utah, Northern
District of California, and Western District of Tennessee are prosecuting these cases. Descriptions of
each case involved in today’s enforcement action are available on the department’s website
at: https://www.justice.gov/criminal-fraud/health-care-fraud-unit/case-summaries.
In addition to the FBI, HHS-OIG, and CPI/CMS, the U.S. Postal Inspection Service; U.S. Postal
Service Office of the Inspector General; Department of Defense Office of Inspector General;
Department of the Interior Office of the Inspector General; Department of Labor Office of the
Inspector General; Food and Drug Administration Office of Criminal Investigations; Homeland
Security Investigations; U.S. Department of Veterans Affairs Office of the Inspector General; and
other federal and local law enforcement agencies participated in the law enforcement action.
The Fraud Section leads the Health Care Fraud Strike Force. Since its inception in March 2007, the
Health Care Fraud Strike Force, which maintains 15 strike forces operating in 24 federal districts,
has charged more than 4,200 defendants who have collectively billed the Medicare program for
nearly $19 billion. In addition, the CMS, working in conjunction with the HHS-OIG, are taking steps
to increase accountability and decrease the presence of fraudulent providers.
On May 17, 2021, the Attorney General established the COVID-19 Fraud Enforcement Task Force to
marshal the resources of the Department of Justice in partnership with agencies across government
to enhance efforts to combat and prevent pandemic-related fraud. The Task Force bolsters efforts to
investigate and prosecute the most culpable domestic and international criminal actors and assists
agencies tasked with administering relief programs to prevent fraud by, among other methods,
augmenting and incorporating existing coordination mechanisms, identifying resources and
techniques to uncover fraudulent actors and their schemes, and sharing and harnessing information
and insights gained from prior enforcement efforts. For more information on the department’s
response to the pandemic, please visit https://www.justice.gov/coronavirus.
The Department of Justice needs the public’s assistance in remaining vigilant and reporting
suspected fraudulent activity. To report suspected fraud, contact the National Center for Disaster
Fraud (NCDF) at (866) 720-5721 or file an online complaint at: https://www.justice.gov/disaster-
fraud/webform/ncdf-disaster-complaint-form. Complaints filed will be reviewed at the NCDF and
referred to federal, state, local, or international law enforcement or regulatory agencies for
investigation.
An indictment, complaint, or information is merely an allegation, and all defendants are presumed
innocent until proven guilty beyond a reasonable doubt in a court of law.
Topic(s): Component(s):
Coronavirus USAO - California, Northern
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