A Florida man has agreed to pay more than $97 million in restitution and give up more than $30 million in assets for a series of medical fraud schemes, including one through the former Ellwood City Medical Center.
Daniel Hurt, 58, of Fort Lauderdale, and his associates collected thousands of cancer genomic test (CGx) samples, sending them to ECMC to collect Medicare reimbursements, of which more than $25 million went to been sent.
More information regarding this incident and others was presented in a press release by U.S. Attorney Cindy K. Chung via the Western District of Pennsylvania.
The statement said Hurt pleaded guilty to one count of conspiracy to commit health care fraud, pay and receive unlawful bribes and launder money for the ECMC incident.
He also pleaded guilty to one count of conspiracy to commit health care fraud in the District of New Jersey and one count of conspiracy to pay and receive bribes in the District. south Florida. The two out-of-state cases were transferred to the Western District of Pennsylvania.
The statement said Hurt and his associates collected the CGx specimens, from Medicare beneficiaries across the United States, through targeted marketing campaigns or so-called “health fairs,” and sent them to the ‘ECMC for billing purposes, even if the establishment did not have validated equipment. perform on-site testing. This led them to recondition the samples at third-party reference labs.
In order to justify Medicare reimbursements, they illegally obtained CGx prescriptions from telemedicine doctors and submitted Medicare reimbursement claims for CGx tests that routinely exceeded $12,000 per beneficiary.
Hurt admitted to using the funds he received from the ECMC to pay millions of dollars in bribes to marketers, in which, to disguise this, he entered into fictitious contracts with marketers. marketing to imply that they were engaged in legitimate marketing and referral services.
Some of the refunds were used to pay for big-ticket items, including an approximately $3 million luxury craft in Florida called “In My DNA.”
The statement said that between January 2019 and October 2021, Hurt admitted to owning several clinical laboratories in New Jersey for medical testing, and he paid kickbacks and kickbacks to various entities that provided referrals and orders for CGx for Medicare and other health care benefit program beneficiaries. .
As in Pennsylvania, Hurt filed Medicare claims and entered into fictitious contracts. This resulted in Medicare paying Hurt-controlled labs at least $53.3 million, with Hurt receiving at least $26.9 million of that amount.
The statement said that in Florida, Hurt and his co-conspirators were in a scheme to defraud health insurance plans, including two from the US government, TRICARE and CAMPVA.
TRICARE provides worldwide health care benefits to military personnel, their dependents, and military retirees, while CHAMPVA operates through the US Department of Veterans Affairs.
The statement said they worked to bill insurers for expensive compound drugs, which were not medically necessary, through a company, OptimuMD, which was established in the fall of 2014.
The release says that, through OptimuMD, they purchased a 3% stake in Executive Pharmacy, located in Broward County, Florida. In return, they would receive up to 70% of Executive Pharmacy’s gross revenue.
They would order patient recruiters and telemedicine services to send thousands of medically unnecessary prescriptions to Executive Pharmacy, which would bill patients’ insurance plans for thousands of compound drugs. In return, the pharmacy would bribe Hurt and his co-conspirators, who in turn would bribe patient recruiters.
Hurt personally received $4,265,144 from this scheme.
In total, as part of his plea agreement, Hurt is to pay Medicare, TRICARE and CHAMPVA $97,360,451.76 in restitution, and has agreed to forfeit money judgments totaling $31,148,624.70 and waive to the luxury watercraft.
Hurt is due to be sentenced at 10 a.m. on January 23, 2023.