Miami, Florida - Three telemarketing company owners were charged for their alleged participation in a $47 million health care fraud, kickback, and money laundering scheme involving the referral of medically unnecessary cancer genetic tests to labs in exchange for kickbacks.
An indictment, unsealed Monday, charges Christian McKeon, 35, and Athanasios Ziros, 42, each of Boca Raton, Florida, with one count of conspiracy to commit health care fraud, one count of conspiracy to pay and receive kickbacks, multiple counts of substantive health care fraud and kickback offenses, conspiracy to commit money laundering, and substantive counts of money laundering offenses. Also, an information, unsealed today, charges Gregory Orr, 64, of Boca Raton, with one count of conspiracy to pay and receive kickbacks and one substantive count of receipt of kickbacks for his alleged role in this scheme.
According to the indictment, McKeon and Ziros allegedly participated in a scheme to operate a telemarketing campaign targeting Medicare beneficiaries in an effort to induce them to accept cancer genetic tests regardless of whether the tests were medically necessary or eligible for Medicare reimbursement. As part of the scheme, McKeon and Ziros allegedly offered and paid illegal kickbacks and bribes to telemedicine companies in exchange for doctors’ orders for expensive cancer genetic tests. The doctors’ orders were written by doctors contracted with telemedicine companies, even though those telemedicine doctors had no prior relationship with the beneficiaries, were not treating the beneficiaries for cancer or symptoms of cancer, did not use the test results in the treatment of the beneficiaries, and did not conduct a proper telemedicine visit.
According to court documents, all three men sold these signed doctors’ orders for cancer genetic tests to labs in exchange for illegal kickbacks. The indictment and information allege that the defendants caused one of the labs to submit approximately $46 million in claims to Medicare, of which over $27 million was paid. The indictment further alleges that the lab paid McKeon, Ziros, and others kickbacks totaling over $14 million, and that McKeon and Ziros laundered these unlawful proceeds knowing that the transactions at issue had been designed to conceal and disguise the nature, source, and control of the proceeds.
McKeon made his initial court appearance today before U.S. Magistrate Judge William Matthewman of the U.S. District Court for the Southern District of Florida, West Palm Division. Ziros and Orr are scheduled to appear for their initial appearances in front of Magistrate Judge Matthewman on May 5.
The counts charging conspiracy to commit health care fraud and wire fraud count, conspiracy to commit money laundering, and substantive money laundering are each punishable by a maximum potential penalty of 20 years in prison. The counts charging health care fraud and anti-kickback violations are each punishable by a maximum potential penalty of 10 years in prison. Finally, the conspiracy to pay and receive kickbacks count is punishable by a maximum potential penalty of five years in prison. A federal district court judge will determine any sentence after considering the U.S. Sentencing Guidelines and other statutory factors.
Acting Assistant Attorney General Nicholas L. McQuaid of the Justice Department’s Criminal Division; Acting U.S. Attorney Juan Antonio Gonzalez of the Southern District of Florida; Special Agent in Charge George L. Piro of the FBI’s Miami Field Office; and Special Agent in Charge Omar Perez of the U.S. Department of Health and Human Services (HHS) Office of Inspector General’s (HHS-OIG) Miami Region made the announcement.
Trial Attorney Patrick Queenan of the Criminal Division’s Fraud Section is prosecuting the case. Assistant U.S. Attorney Richard Brown of the Southern District of Florida is handling the forfeiture aspect of the case.
The Fraud Section leads the Medicare Fraud Strike Force. Since its inception in March 2007, the Medicare Fraud Strike Force, which maintains 15 strike forces operating in 24 districts, has charged more than 4,200 defendants who have collectively billed the Medicare program for nearly $19 billion. In addition, the HHS Centers for Medicare & Medicaid Services, working in conjunction with the HHS-OIG, are taking steps to increase accountability and decrease the presence of fraudulent providers.
Any doctors or medical professionals who have been involved with alleged fraudulent telemedicine or genetic testing marketing schemes should call to report this conduct to the FBI hotline at 1-800-CALL-FBI.
An indictment and an information are merely allegations and all defendants are presumed innocent until proven guilty beyond a reasonable doubt in a court of law.