A Florida man has been sentenced to a decade behind bars after investigators discovered $3.3 million in fraudulent Medicare claims for genetic cancer testing that patients didn’t need.
Ivan Andre Scott, 36, of Kissimmee, was convicted by a federal jury in January on one count of conspiracy to commit health care fraud, three counts of health care fraud, one count of conspiracy to pay and receive unlawful healthcare kickbacks, and three counts of receiving unlawful kickbacks.
He is said to have targeted Medicare patients via his Scott Global telemarketing company, cold-calling and persuading them they were eligible to receive cancer screening genetic (CGx) tests, which usually cost an estimated $6000 each.
He is then said to have paid bribes to telemedicine companies to have doctors authorize the tests, despite never having seen the patients or treated them for cancer-like symptoms.
Scott was then able to sell the doctors’ orders for these tests to laboratories, which paid him kickbacks in return. Scott submitted invoices to the labs for hourly marketing services rather than per referral, to conceal what was going on.
The labs are said to have submitted over $3.3 million in claims to Medicare for these tests, of which the government health insurance program paid out over $1.3 million. Scott received $194,000 for his role in the scheme.
“Fraudsters who steal from taxpayer-funded federal health care programs and engage in predatory telemarketing calls are a threat to our country’s healthcare system and its most vulnerable beneficiaries,” said special agent in charge Omar Pérez Aybar of the US Health and Human Services, Office of Inspector General.
“Our agents will continue to aggressively investigate health care fraud and hold criminals responsible for their actions.”
Healthcare fraud is big business in the US and has been growing during the pandemic, with a surge in telemedicine appointments providing cover for dishonest doctors, telemarketers, labs and other stakeholders.
Operation Double Helix, under which this case was investigated, has already resulted in charges against dozens of individuals associated with telemedicine companies and cancer genetic testing laboratories.