COVID-19 Fraud Enforcement Remains Priority for Federal Law Enforcement

Blogs, Eye on Enforcement

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Eye on 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.