Newark, N.J. – A brazen scheme to fleece Medicare has come to an end, with a Georgia man pleading guilty to a conspiracy involving Covid-19 and cancer genetic testing.
Erik Santos, 52, of Braselton, Georgia, pleaded guilty to a two-count Information charging him with conspiracy to violate the Federal Anti-Kickback statute and conspiracy to commit health care fraud, before U.S. District Judge Kevin McNulty in Newark federal court.
According to documents filed in this case and statements made in court, Santos owned and operated a company that conducted business with medical testing companies. From September 2019 through March 2020, Santos and others agreed to engage in a scheme to provide medical testing companies with qualified patient leads and tests for medically unnecessary cancer genetic screening tests for Medicare beneficiaries in exchange for kickbacks of approximately $1,000 to $1,500 for each test that resulted in a reimbursement from Medicare.
Santos entered into a sham contract and utilized sham invoices to make it appear that he was being paid for legitimate services and to conceal his fraudulent kickback scheme. During the course of the scheme, Santos received kickbacks of approximately $33,250 for cancer genetic screening tests. Santos’s scheme aimed to submit more than $1.1 million in fraudulent claims to Medicare.
At a time when many individuals reported difficulty obtaining Covid-19 tests, Santos and others agreed to extend their scheme to also incorporate those tests, along with significantly more expensive and medically unnecessary respiratory pathogen panel tests. Specifically, Santos and his co-conspirators agreed that Santos would be paid kickbacks for each Covid-19 test submitted to a laboratory, provided that those tests were bundled with significantly more expensive respiratory pathogen panel tests, which did not treat or identify Covid-19, and regardless of the medical necessity of either test.
The count of conspiracy to commit health care fraud carries a maximum potential punishment of 10 years in prison. The count of conspiracy to violate the Anti-Kickback Statute carries a maximum potential penalty of five years in prison. Both offenses are also punishable by a fine of $250,000 or twice the gross gain or loss from the offense.
U.S. Attorney Philip R. Sellinger credited the FBI, the U.S. Department of Health and Human Services, Office of Inspector General, and other agencies with the ongoing investigation leading to today’s guilty plea.
The government is represented by Assistant U.S. Attorney Sean M. Sherman of the Criminal Division in Newark.
Defense counsel for Erik Santos is James Smith.
MANDATORY FACTS: Defendant Erik Santos; Criminal Charges: Conspiracy to violate the Federal Anti-Kickback statute and conspiracy to commit health care fraud; City and State: Newark, N.J.; Exact Date: Not specified; Sentence or Outcome: Not specified, pending sentencing; Dollar Amounts: $33,250 and $1.1 million.
Related Federal Cases
- Seth Rehfuss, Medicare Genetic Testing Fraud, NJ 2023 · Maryland
- Jane Batista, COVID-19 Relief Program Fraud, New Jersey 2024 · Connecticut
- Damaris Valerio, COVID Relief Fraud, New Jersey 2022 · Connecticut
- Vadym Iermolovych, International Securities Fraud, New Jersey 2024 · New York
- Daniel Dadoun, PPP Loan Fraud, New Jersey 2024 · Georgia
Key Facts
- State: New Jersey
- Category: Fraud & Financial Crimes
- Source: DOJ Press Release â†â€â€
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