Even as mask restrictions are being relaxed in most parts of the country, the U.S. Department of Justice is ramping up its oversight of federal funds spent to fight the COVID-19 pandemic.  Just last week, DOJ announced criminal charges against 21 defendants in nine federal districts for their alleged participation in COVID-19 fraud schemes that resulted in over $149 million in false billings to federal programs.

The fraud schemes targeted by DOJ appear to fall into three general categories.  First, DOJ is taking enforcement action against healthcare providers engaged in fraud related to COVID-19 testing.  The DOJ press release highlights several cases of this type, including the Los Angeles area, where two owners of a clinical lab were charged with fraudulently billing over $125 million in fraudulent claims during the pandemic for COVID-19 and respiratory pathogen testing.  And two cases—one in Massachusetts, the other in New York—where owners of medical clinics allegedly obtained confidential information from patients seeking COVID-19 testing at drive-thru testing sites and then submitted fraudulent claims for lengthy office visits with patients that did not occur.  Similarly, in Florida, DOJ has charged medical professionals with allegedly billing for sham telemedicine patient visits that never occurred and ordering medically unnecessary genetic testing.  One defendant has already been sentenced to 82 months in prison related to this scheme.

Second, DOJ is also pursuing individuals for misappropriating Provider Relief Funds (PRF) intended for frontline medical providers.  So far, ten defendants have been charged with this type of fraud, and three have pleaded guilty.

Third, DOJ is cracking down on fraudsters who manufacture and distribute fake COVID-19 vaccination records.  For example, in California, three defendants have been charged in a scheme to sell unapproved immunizations for COVID-19 and falsify COVID-19 vaccination record cards to make it appear that customers received government-authorized vaccines.  Likewise, in Washington, one manufacturer has been charged in the multistate distribution of fake COVID-19 vaccination cards after allegedly telling an undercover federal agent that “until I get caught and go to jail, [expletive] it I’m taking the money, ha! I don’t care.”

The DOJ press release implicitly recognizes the importance of whistleblowers in ferreting out COVID-19 related fraud, stating that it “needs the public’s assistance in remaining vigilant and reporting suspected fraudulent activity.”

It is a commonplace observation that hard times bring out a person’s true character.  Most healthcare workers and business owners have risen to the challenge presented by the COVID-19 pandemic.  Some have taken heroic actions to save the lives of others.  But sadly, at the other end of the spectrum are those who, in the words of Assistant Attorney General Kenneth A. Polite, Jr., of the Justice Department’s Criminal Division, have “placed greed above care.”  With the help of whistleblowers and the public-at-large, these individuals must be brought to justice.

If you have information about healthcare fraud, or would like to speak to a member of the Constantine Cannon whistleblower lawyer team, please contact us for a confidential consultation.

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COVID-19 Fraud
The False Claims Act
Healthcare Fraud
I Think I Have a Whistleblower Case
Whistleblower FAQs

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