The U.S. Departmnet of Justice announced on May 3, 2021 that three telemarketing company owners were charged for their alleged participation in a $47 million health care fraud, kickback, and money laundering scheme involving the referral of medically unnecessary cancer genetic tests to labs in exchange for kickbacks.
An indictment charges Christian McKeon, 35, and Athanasios Ziros, 42, of Boca Raton, Florida, with one count of conspiracy to commit health care fraud, one count of conspiracy to pay and receive kickbacks, multiple counts of substantive health care fraud and kickback offenses, conspiracy to commit money laundering, and substantive counts of money laundering offenses. An information also charges Gregory Orr, 64, of Boca Raton, Florida, with one count of conspiracy to pay and receive kickbacks and one substantive count of receipt of kickbacks for his alleged role in this scheme.
According to the indictment, McKeon and Ziros allegedly participated in a scheme to operate a telemarketing campaign targeting Medicare beneficiaries in an effort to induce them to accept cancer genetic tests regardless of whether the tests were medically necessary or eligible for Medicare reimbursement. As part of the scheme, McKeon and Ziros allegedly offered and paid illegal kickbacks and bribes to telemedicine companies in exchange for doctors’ orders for expensive cancer genetic tests. The doctors’ orders were written by doctors contracted with telemedicine companies, even though those telemedicine doctors had no prior relationship with the beneficiaries, were not treating the beneficiaries for cancer or symptoms of cancer, did not use the test results in the treatment of the beneficiaries, and did not conduct a proper telemedicine visit.
According to court documents, all three men sold the signed doctors’ orders for cancer genetic tests to labs in exchange for illegal kickbacks. The indictment and information allege that the defendants caused one of the labs to submit approximately $46 million in claims to Medicare, of which over $27 million was paid. The indictment further alleges that the lab paid McKeon, Ziros, and others kickbacks totaling over $14 million, and that McKeon and Ziros laundered these unlawful proceeds knowing that the transactions at issue had been designed to conceal and disguise the nature, source, and control of the proceeds.
The counts charging conspiracy to commit health care fraud and wire fraud count, conspiracy to commit money laundering, and substantive money laundering are each punishable by a maximum potential penalty of 20 years in prison. The counts charging health care fraud and anti-kickback violations are each punishable by a maximum potential penalty of 10 years in prison. Finally, the conspiracy to pay and receive kickbacks count is punishable by a maximum potential penalty of five years in prison. A federal district court judge will determine any sentence after considering the U.S. Sentencing Guidelines and other statutory factors.
If you have information regarding false claims having been submitted to Medicare, Medicaid, TRICARE, other federal health care programs, or to other federal agencies/programs, and the information is not publically known and no actions have been taken by the government with regard to recovering the false claims, you should promptly consult with a False Claims Act attorney (also known as qui tam attorneys) in your U.S. state who may investigate the basis of your False Claims Act allegations and who may also assist you in bringing a qui tam lawsuit on behalf of the United States, if appropriate, for which you may be entitled to receive a portion of the recovery received by the U.S. government.
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