A Florida man pleaded guilty for his role in a scheme that defrauded Medicare by submitting over $52 million in false and fraudulent claims for genetic testing and buying physician’s orders, according to a Jan. 15 press release.
What happened?
- Sean Alterman owned and operated two laboratories — Live Beyond Medical MGMT and Dynix Diagnostics — through which he purchased physicians’ orders for expensive genetic tests from patient recruiters. The recruiters ran deceptive telemarketing campaigns that targeted Medicare beneficiaries and persuaded them to agree to tests they did not need.
- As part of the scheme, recruiters used a tactic known as “doctor chasing,” faxing physicians false and misleading prescription requests designed to trick them into approving tests for patients they had not examined or treated. The requests falsely claimed they were submitted on behalf of mutual patients.
- Mr. Alterman’s laboratories billed approximately $52 million to Medicare for the fraudulent claims, of which Medicare paid approximately $36 million. Mr. Alterman made roughly $5.5 million from the scheme, much of which he received through shell companies he owned.
