Nineteen defendants charged in largest healthcare fraud scheme in Southern District history
Bogus billings siphoned millions of dollars from Medicare
SAVANNAH, GA: More than a dozen defendants, including 10 physicians and other medical professionals, have been charged for their alleged participation in a massive healthcare fraud scheme responsible for – in the Southern District of Georgia alone – more than $400 million in losses to Medicare.
The charges against 19 defendants in the Southern District of Georgia were announced Sept. 27 as part of a nationwide Department of Justice operation into a scheme that involved trafficking orders and prescriptions for genetic testing, orthotic braces and pain creams. The charges were part of Operation Double Helix, which focused on fraudulent billing of genetic testing, and the charges announced today involve tens of millions of dollars billed to Medicare and generating more than $7 million in fraudulent genetic testing charges to the Georgia Medicaid Program, said Bobby L. Christine, U.S. Attorney for the Southern District of Georgia.
The healthcare fraud scheme charged is the largest in the history of the Southern District of Georgia. The Medicare and Medicaid beneficiaries whose identities were used as part of the scheme are located throughout the Southern District of Georgia, including the Augusta, Brunswick, Dublin, Savannah, Statesboro, and Waycross Divisions, as well as elsewhere in the United States.
“The scope and sophistication of the health care fraud detected in Operation Double Helix and the related Operation Brace Yourself is nearly unprecedented. But the citizens of the Southern District of Georgia should know that we put together an unprecedented response,” said U.S. Attorney Christine. “Our office charged more defendants, responsible for more health care fraud losses, than ever before in this office’s history. While these charges might be some of the first, they won’t be the last.”
The charges filed in the Southern District of Georgia were part of a nationwide operation, unveiled today by the U.S. Department of Justice, into individuals and entities that trafficked in patient information and prescriptions for genetic testing, orthotic braces, and pain creams. Nationwide, the DOJ announced charges against 35 defendants connected with the scheme, which is estimated to have resulted in more than $1.7 billion in fraudulent billing to the Medicare Program.
“These defendants allegedly duped Medicare beneficiaries into signing up for unnecessary genetic tests, costing Medicare billions of dollars,” Assistant Attorney General Brian A. Benczkowski of the Justice Department’s Criminal Division. “Together with our law enforcement partners, the Department will continue to protect the public fisc and prosecute those who steal our taxpayer dollars.”
As part of this national enforcement action, U.S. Attorney Christine announced the following actions in the Southern District of Georgia:
- A federal grand jury in Savannah indicted Dr. Anthony Securo of Columbus, Ga., on five counts of health care fraud and five counts of false statements relating to health care. The indictment alleges that that Securo ordered more than 25,000 items of durable medical equipment for Medicare beneficiaries he claimed to be “treating,” but in fact never even met. These thousands of items were billed to Medicare for more than $23 million. According to the indictment, Securo ordered these medically unnecessary items after having short telephone conversations with the patients, but then signed medical records stating that Securo had performed examinations or physical tests of the patients that were never actually performed.
- The United States charged owners of two “telemedicine” physician recruiting companies who, according to court documents, operated companies that identified medical practitioners to write orders in exchange for payments, and facilitated such payments. Court documents allege that the two charged individuals, who were charged by criminal information with single counts of conspiracy, facilitated physician orders that ultimately were billed to Medicare for a combined $170 million.
- The United States charged nine medical professionals in addition to Securo for their roles in the healthcare fraud scheme, in which, according to court documents, the physicians and nurse practitioners ordered orthotic braces for Medicare beneficiaries they did not examine. Each were charged by criminal information with single counts of conspiracy for generating orders for orthotics, creams and laboratory tests that were billed to Medicare and the Georgia Medicaid Program for a combined $185 million.
Others charged in the Southern District of Georgia in the investigation included:
- The United States charged two individuals by criminal information with single counts of conspiracy for operating companies that bought and sold Medicare beneficiary information, and for operating companies that submitted claims for orthotic braces to the Medicare Program. Court documents allege that the two charged individuals brokered the sale of physician orders that ultimately were billed to Medicare for more than $10 million.
- The United States charged one company by criminal information with one count of conspiracy. According to court documents, the company brokered the sale of physician orders that ultimately were billed to Medicare for more than $10 million.
- The United States also charged by criminal information four companies that were created for the specific purpose of billing related to this scheme and billed no less than $8 million.
Indictments or criminal informations contain only charges; defendants are presumed innocent unless and until proven guilty.
“Through the dedicated work of U.S. Attorney Christine’s office, the FBI, HHS-OIG and our Medicaid Fraud Division, those who attempt to bilk government programs will be held accountable,” said Georgia Attorney General Chris Carr. “We are proud of this collaborative effort to stop the architects and implementers of these sophisticated healthcare schemes in their tracks.”
“The FBI and its Savannah Resident Agency are proud to have participated in this nationwide effort to help protect the much-needed federal funds that Medicare provides,” said Chris Hacker, Special Agent in Charge of FBI Atlanta. “When providers are driven by greed and abuse the Medicare program, every taxpaying citizen is a victim, especially those who use the federal funds for their health care needs. Improper billing inflates costs, and the FBI and its law enforcement partners are determined to hold those who do it accountable.”
“Being a healthcare professional in the Medicare program is a privilege, not a right. When physicians and other healthcare providers put their own financial gain above patient well-being and honest billing of government health programs, they violate the basic trust that taxpayers extend to healthcare professionals,” said Special Agent in Charge Derrick L. Jackson, with the Department of Health and Human Services Office of Inspector General. “These charges put corrupt medical professionals on alert that law enforcement will do everything possible to root out all forms of waste, fraud and abuse in our federal health care programs.”
“This type of corruption involving health care fraud against Medicare and Medicaid has managed to defraud American taxpayers of millions upon millions of dollars,” said Resident Agent in Charge Glen M. Kessler of the U.S. Secret Service. “The U.S. Secret Service is always willing to take prompt and coordinated actions to hold these telemarketers and medical professionals responsible for placing personal greed above the good of the public.”
This investigation is ongoing. Any doctors or medical professionals who have been involved with alleged fraudulent telemedicine and medical equipment marketing schemes should report this conduct to the FBI hotline at 1-800-CALL-FBI. Any beneficiaries who believe their identity may have been used fraudulently also should contact the FBI hotline.
U.S. Attorney Christine acclaimed the hard work of the investigatory team, led by the FBI, the Department of Health and Human Services Office of Inspector General, the United States Secret Service and the office of the Attorney General of Georgia.
Assistant U.S. Attorneys J. Thomas Clarkson and Jonathan A. Porter are prosecuting these cases on behalf of the United States, and Assistant Attorney General James P. Mooney is prosecuting cases on behalf of the Georgia Medicaid Fraud Control Unit.