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COVID-19 Fraud Enforcement Remains Priority for Federal Law Enforcement

By Bradley, Ocasha O. Musah & Jonathan H. Ferry on May 1, 2023
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COVID-19 Fraud Enforcement Remains Priority for Federal Law Enforcement

On April 20, 2023, the Department of Justice announced criminal charges against 18 defendants in nine federal districts, alleging over $490 million in alleged theft from federally funded COVID-19 relief programs. This clearly shows that, even as the COVID-19 pandemic continues to recede into the national memory—evidenced by the recent culmination of the national emergency powers—federal prosecutors and healthcare regulatory agencies have kept COVID-19 related fraud at the top of their minds and enforcement priorities.

Fraud Schemes Across the U.S.

The alleged fraudulent schemes were as varied as the jurisdictions where they occurred. Spanning from New York to Puerto Rico and involving unnecessary COVID-19 testing to fake vaccination cards, the announced actions demonstrate the breadth of DOJ’s pandemic enforcement focus.

  • In California, a lab owner allegedly defrauded the COVID-19 Uninsured Program by billing for unnecessary and unwanted respiratory pathogen panel tests.
  • Another California doctor, who was the largest biller to the Uninsured Program at $230 million, allegedly billed for insured patients, and submitted claims for unrendered and medically unnecessary services. The same doctor also submitted over 70 allegedly fraudulent loans to the Paycheck Protection Program and Economic Injury Disaster Loan Program.
  • In a case involving a novel charge, a Florida doctor and marketer were charged with submitting false claims to Medicare when they allegedly bought Medicare beneficiary I.D. numbers and shipped COVID-19 over-the-counter tests to unknowing beneficiaries across the country.
  • A Louisiana primary care clinic and spa was also charged with submitting fraudulent paperwork to obtain loans under the CARES Act’s Provider Relief Fund Initiative. In all, the operator of the clinic received over $1.1 million in funds allegedly used to purchase real estate and luxury vehicles, among other purchases.
  • In New York, three individuals working at a small midwife practice were charged for allegedly providing nearly 2700 fake vaccination cards.
  • Similarly, two individuals in Utah were charged for allegedly creating and selling about 120,000 fake COVID-19 vaccination cards online.  

These announced enforcement actions follow similar announcements from May 2021 and April 2022. In the last three years, the Health Care Fraud Strike Force has charged 53 defendants throughout the country with COVID-19 related fraud, resulting in 20 convictions to date. With this announcement, the Strike Force shows no signs of slowing down.

 

Photo of Ocasha O. Musah Ocasha O. Musah

Ocasha Musah is an associate in Bradley’s Government Enforcement and Investigations Practice Group. He has experience advising clients on various types of internal investigations, including FCPA and securities enforcement actions. His litigation experience includes complex multidistrict litigation and arbitrations. He also has experience…

Ocasha Musah is an associate in Bradley’s Government Enforcement and Investigations Practice Group. He has experience advising clients on various types of internal investigations, including FCPA and securities enforcement actions. His litigation experience includes complex multidistrict litigation and arbitrations. He also has experience advising clients on antitrust issues related to emerging technologies.

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Photo of Jonathan H. Ferry Jonathan H. Ferry

Jon Ferry brings his substantial experience as a federal prosecutor to assisting clients in False Claims Act litigation, government investigations and other enforcement actions, internal risk analysis and internal investigations.

Jon served as Assistant U.S. Attorney for the Western District of North Carolina…

Jon Ferry brings his substantial experience as a federal prosecutor to assisting clients in False Claims Act litigation, government investigations and other enforcement actions, internal risk analysis and internal investigations.

Jon served as Assistant U.S. Attorney for the Western District of North Carolina for over seven years. As the head of the Affirmative Civil Enforcement (ACE) program and the Healthcare Fraud Coordinator for the U.S. Attorney’s Office, Jon led and supervised numerous investigations in the areas of healthcare, financial services and other complex frauds. He has significant experience with the False Claims Act and other whistleblower actions, healthcare regulations (including the Anti-Kickback Statute and Stark Law), the Food Drugs and Cosmetics Act, and the Financial Institutions Reform, Recovery and Enforcement Act (FIRREA).

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  • Posted in:
    Featured Posts, Government
  • Blog:
    Eye on Enforcement
  • Organization:
    Bradley Arant Boult Cummings LLP
  • Article: View Original Source

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