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Fraud

$500 Million Nationwide Scheme Exposed: Two Individuals Charged for COVID-19 Testing Scam

Strategic Insights

— 1 min read

As the United States continues to battle the COVID-19 pandemic, authorities have uncovered a massive scheme that has defrauded Medicare, Medicaid, TRICARE, and private health insurance programs for over $500 million. The masterminds behind this scheme, Cemhan "Jimmy" Biricik and Dr. Martin Perlin, were arrested and charged with conspiracy to commit health care fraud and over 50 substantive counts of health care fraud.

Key Takeaways:

  • The scheme, orchestrated by Fast Lab Technologies, LLC, involved billing health insurance programs for COVID-19 testing services that were never rendered.
  • Over 500 million dollars in claims were billed, with Biricik receiving over 50 million dollars in payments.
  • Dr. Perlin, the Medical Director of Fast Lab, ordered the majority of the tests despite not having a treating relationship with the beneficiaries.
  • The scheme involved using individuals' insurance information to fraudulently bill for COVID-19 tests, with the vast majority of tests taken at home and not observed by medical professionals.
  • The scheme was uncovered through an investigation involving multiple agencies, including the Department of Health and Human Services Office of Inspector General, the FBI, and the Internal Revenue Service - Criminal Investigation.

Statistics:

  • Over $500 million in claims were billed by Fast Lab Technologies, LLC.
  • Over 50 million dollars in payments were made to Cemhan "Jimmy" Biricik.
  • 500+ individuals were affected by the scheme, with some receiving multiple bills for the same testing services.
  • The scheme involved multiple health insurance programs, including Medicare, Medicaid, TRICARE, and private insurers.
  • Dr. Martin Perlin ordered over 90% of the tests, despite not having a treating relationship with the beneficiaries.

Sources:

  • United States Attorney Jerome F. Gorgon Jr.
  • U.S. Department of Health and Human Services Office of Inspector General (HHS-OIG)
  • Federal Bureau of Investigation, Detroit Division
  • U.S. Office of Personnel Management Office of the Inspector General
  • Employee Benefits Security Administration (DOL-EBSA)
  • Defense Criminal Investigative Service (DCIS)
  • Internal Revenue Service - Criminal Investigation (IRS-CI)
  • U.S. Department of Labor, Office of Inspector General (DOL-OIG)
  • U.S. Marshal Service
  • Michigan Attorney General Dana Nessel, Medicaid Fraud Control Unit (MFCU)

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