Florida resident charged in apparent $25M fraud involving Lawrence County medical facility
A man from Fort Lauderdale, Florida, could see time behind bars for his involvement for submitting $25 million in fraudulent Medicare claims.
Daniel Hurt, 58, was charged with conspiracy to commit health care fraud, pay and receive unlawful kickbacks and engage in money laundering involving the Ellwood City Medical Center (ECMC) in Lawrence County..
The charges stem from claims Hurt allegedly made between late 2018 and 2019.
Hurt allegedly participated in a conspiracy related to Medicare billing for cancer genomic testing, which uses DNA sequencing to detect mutations in genes that could indicate a higher risk of developing certain types of cancers in the future, according to a news release from U.S. Department of Justice.
It is not, however, a method of diagnosing whether an individual presently had cancer.
Hurt and his alleged co-conspirators, including people associated with marketing entities, acquired thousands of testing samples from Medicare beneficiaries located throughout the states.
Marketers ran targeted campaigns to collect specimens for genomic testing by use of cheek swabs sent to their homes or provided to them at "health fairs" throughout the country, according to the DOJ.
They then sent these collections to the ECMC, which did not have properly validated equipment to conduct this kind of testing. The DOJ accuses Hurt then directed the hospital to repackage the sampling and send it to a third-party to finish testing.
To justify the reimbursement for the Testing, Hurt and his co-conspirators got prescriptions from telemedicine doctors who were not "generally qualified to understand and interpret" test results for genomic testing.
The group, according to the DOJ, used ECMC to submit claims for the testing, regularly exceeding $12,000 per beneficiary. In all, between January of 2019 and October of 2019, the Medicare allegedly reimbursed ECMC for more than $25 million in this kind of testing.
None of these results were used to help the people that gave this DNA to the supposed fraudsters.
From here, Hurt reportedly instructed staff members of the hospital to transfer this money into accounts he controlled. He then paid millions of dollars in kickbacks to marketers, among others in exchange for their work obtaining samples, the DOJ claims.
These payments were based on the volume of tests and the amount of Medicare reimbursements.
To cover his tracks, Hurt entered into fake contracts to make it look like he was engaged in legitimate contracts that were being paid.
Some of what Hurt used that money that may be connected to this apparent conspiracy on includes a $3 million luxury boat in Florida, called "In my DNA," according to the DOJ.
If convicted, Hurt faces a maximum sentence of five years in prison and a fine of $250,000.