Federal authorities have charged 35 individuals in a fraudulent genetic testing operation that resulted in $2.1 billion in losses, including a Flower Mound physician. The defendants are associated with numerous telemedicine companies and cancer genetic testing laboratories that fraudulently billed Medicare.
Dr. Daniel R. Canchola of Flower Mound Texas was charged for referring Medicare patients for unnecessary “cancer screening” tests, and received kickbacks and bribes for the orders. Canchola allegedly made the orders without seeing or having a relationship with patients, and beneficiaries often never received their testing results. He is allegedly responsible for $69 million in fraudulent claims to Medicare.
Over the past month, the Health Care Fraud Unit, Medicare Fraud Strike Force, and other law enforcement agencies has made a series of busts of medical companies and physicians (including several North Texas physicians and companies) that follow a similar pattern. Doctors make fraudulent orders for prescriptions or tests, and the pharmacies and testing centers charge the payers. When the payers investigate the claims, they find that the doctors didn’t see many of the patients, and were receiving kickbacks from the pharmacies and testing centers for the referrals.
In this iteration, some defendants who controlled telemarketing networks allegedly enlisted hundreds of thousands of elderly and/or disabled patients into the scheme, while testing companies paid doctors to prescribe fraudulent cancer testing without any patient interaction or just a brief phone conversation.
“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 said via release. “Together with our law enforcement partners, the Department will continue to protect the public fisc and prosecute those who steal our taxpayer dollars.”
Read about the case and other defendants here.