A new internal report revealed that new channels of Medicare fraud opened up during the COVID pandemic. This was due in large part to meet newly emerging health care needs of older Americans which left the program vulnerable to falsified billings. In just one example, the Office of Inspector General (OIG) at the U.S. Department of Health and Human Services released a study in September that said it had already detected potentially fraudulent billings related to telehealth from more than 1,700 health care providers. This translated to a loss to the government of $128 million. In California, a federal jury convicted Mark Schena, the president of a Silicon Valley medical technology company, of a conspiracy to bilk Medicare and private insurers out of $77 million. They marketed a COVID test not approved by the Food and Drug Administration (FDA) and paired it with other expensive tests. Also in our state, health-testing laboratory owners Imran Shams and Lourdes Navarro face charges of defrauding Medicare out of $214 million. They used COVID testing as a pretext to add on expensive and unnecessary respiratory pathogen tests while paying illegal bribes to medical marketers for directing doctor’s orders to their labs.
