Georgia man pleads guilty to fraud and bribery involving genetic testing for Covid-19 and cancer | USAO-NJ

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NEWARK, NJ – A Georgia man pleaded guilty today to his role in a conspiracy to commit health care fraud and receive bribes in connection with fraudulent COVID test requests -19 and genetic cancer screenings, U.S. Attorney Philip R. Sellinger said.

Erik Santos, 52, of Braselton, Georgia, pleaded guilty to a two-count information charging him, in the first count, with conspiracy to violate federal anti-bribery law and , in count two, of conspiracy to commit health care fraud, before the United States. District Judge Kevin McNulty in federal court in Newark.

According to documents filed in this case and statements made in court:

Santos owned and operated a company that did business with medical testing companies. From September 2019 through March 2020, Santos and others agreed to engage in a program to provide medical testing companies with qualified patient leads and medically unnecessary cancer genetic screening tests for Medicare beneficiaries in exchange of bribes of approximately $1,000 to $1,500 for each test that resulted in reimbursement by Medicare. Santos entered into a fictitious contract and used fictitious invoices to give the impression that he was being paid for legitimate services and to conceal his fraudulent kickback scheme. During the program, Santos received bribes of approximately $33,250 for genetic testing for cancer. Santos’ scheme sought to submit more than $1.1 million in fraudulent Medicare claims.

In March 2020, at a time when many people reported difficulty obtaining Covid-19 tests, Santos and others agreed to expand their program to also incorporate these tests, as well as agent panel tests. much more expensive and medically unnecessary respiratory pathogens. Specifically, Santos and his co-conspirators agreed that Santos would receive kickbacks for every Covid-19 test submitted to a lab, on the condition that those tests be bundled with much more expensive respiratory pathogen panel tests, that did not treat or identify Covid-19. , and regardless of the medical necessity of either test. Santos agreed to use fictitious contracts and fictitious invoices to conceal this part of the scheme as well.

The count of conspiracy to commit health care fraud carries a potential maximum sentence of 10 years in prison. The count of conspiracy to violate the anti-bribery law faces a potential maximum sentence of five years in prison. Both offenses are equally punishable by a fine of $250,000 or double the gross gain or loss of the offense.

U.S. Attorney Sellinger credited FBI Special Agents, under Special Agent in Charge Jesse Levine in Newark; the US Department of Health and Human Services, Office of Inspector General, under Special Agent in Charge Scott J. Lampert; the US Department of Defense, Office of Inspector General, Defense Criminal Investigative Service, Northeast Field Office, under the direction of Special Agent in Charge Patrick Hegarty; the Office of the Inspector General of the United States Department of Veterans Affairs, Northeast Field Office under the direction of Special Agent in Charge Christopher Algieri with the ongoing investigation leading to today’s guilty plea today.

The government is represented by Assistant U.S. Attorney Sean M. Sherman of the Newark Criminal Division.

Defense attorney: James Smith

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