By Sarah N. Lynch
WASHINGTON (Reuters) – A Georgia woman was arrested on Friday for allegedly bilking Medicare – the U.S. health insurance program for Americans over age 65 and the disabled – by submitting fraudulent claims related to coronavirus testing and genetic cancer tests, the U.S. Justice Department said.
The case against Ashley Hoobler Parris, 32, of Lawrencevile, Georgia, marks one of the first Medicare fraud cases in connection with billings for COVID-19, the sometimes deadly illness caused by the novel coronavirus.
It also comes on the heels of a major takedown last fall by the Justice Department and the Health and Human Services Department Office of the Inspector General involving a $2.1 billion Medicare fraud scam that snagged marketing company executives, telemedicine companies and labs that allegedly duped senior citizens across the nation into providing a swab of their DNA for medically unnecessary genetic cancer tests.
Since then, some of the labs and marketers have expanded from offering genetic cancer screening into offering tests for COVID-19.
While the Medicare reimbursement for coronavirus tests is about $100, some labs and marketers have sought to boost the amount they can reap by bundling it with respiratory pathogen panels (RPP), which test for non-COVID-19 respiratory illnesses and pay out around $500.
According to new data from the Health and Human Services Inspector General provided to Reuters this week, RPP claims submitted to Medicare from January 1, 2020 through April 30 increased by 41% compared with the same time period last year and led to $28 million so far in processed payments.
The complaint against Hoobler alleges she and other co-conspirators engaged in a kickback scheme in which they obtained cheek swabs from seniors, got doctors to sign off on the genetic tests and shipped them off to labs that billed Medicare.
During the course of the ongoing investigation into genetics testing billing, Hoobler was captured on recorded phone calls with a covert government cooperator in March saying she was working with a lab that would pay a $100 kickback for every COVID-19 test submitted.
The cooperator asked whether the payout was so high because she could “make it up” by also billing for the RPP test and that it would be an easy sell since everyone is clamoring for coronavirus tests.
“Exactly,” Hoobler replied, according to the complaint, which was filed in the U.S. District Court for the Middle District of Florida.
Reuters could not immediately determine who is representing Hoobler.
(Reporting by Sarah N. Lynch; Editing by Bill Berkrot)
