Two Florida men pleaded guilty for their roles in a scheme to defraud Medicare by submitting over $67 million in false claims for genetic testing and durable medical equipment that patients did not need and that the defendants procured with kickbacks.
The pleas came after four days of trial in the Southern District of Florida.
According to court documents, Daniel M. Carver, of Boca Raton, owned and managed call centers that he used to conduct deceptive telemarketing campaigns targeting Medicare beneficiaries to solicit them for unnecessary genetic testing and durable medical equipment. Louis “Gino” Carver, of Delray Beach, worked for these call centers and acted as a straw owner for a laboratory that submitted false genetic testing claims.
The Carvers and their co-conspirators paid kickbacks and bribes to telemedicine companies in exchange for completed doctors’ orders, sold doctors’ orders to laboratories and durable medical equipment companies in exchange for kickbacks, forged doctors’ and patients’ signatures, and tricked medical providers into ordering medically unnecessary genetic testing. Between January 2020 and July 2021, the scheme resulted in the submission of over $67 million in false claims to Medicare for medically unnecessary genetic tests and durable medical equipment.
Daniel Carver pleaded guilty to conspiracy to commit health care fraud and wire fraud and conspiracy to defraud the United States and to pay and receive kickbacks. He faces a maximum penalty of 25 years in prison. Louis Carver pleaded guilty to conspiracy to commit health care fraud and faces a maximum penalty of 10 years in prison. Both men are scheduled to be sentenced on Dec. 5. A federal district court judge will determine any sentence after considering the U.S. Sentencing Guidelines and other statutory factors.
In addition to last week’s guilty pleas, five other defendants in this case have pleaded guilty and are awaiting sentencing. Three defendants are scheduled for a trial set to commence on Sept. 26.
Assistant Attorney General Kenneth A. Polite, Jr. of the Justice Department’s Criminal Division, Assistant Director Luis Quesada of the FBI’s Criminal Investigative Division, and Deputy Inspector General for Investigations Christian J. Schrank of the Department of Health and Human Services Office of Inspector General (HHS-OIG) made the announcement.
The FBI and HHS-OIG are investigating the case.
Trial Attorneys Patrick Queenan, Reginald Cuyler Jr., and Andrew Tamayo of the Criminal Division’s Fraud Section are prosecuting the case.
The Fraud Section leads the Criminal Division’s efforts to combat health care fraud through the Health Care Fraud Strike Force Program. Since March 2007, this program, comprised of 15 strike forces operating in 25 federal districts, has charged more than 5,000 defendants who collectively have billed federal health care programs and private insurers more than $24 billion. In addition, the Centers for Medicare & Medicaid Services, working in conjunction with the Office of the Inspector General for the Department of Health and Human Services, are taking steps to hold providers accountable for their involvement in health care fraud schemes.