A Georgia man is accused of orchestrating a scheme to defraud federal and privately funded healthcare benefit programs related to the COVID-19 virus and genetic cancer testing.
Erik Santos, 49, of Braselton, Georgia, is charged with one count of conspiring to commit healthcare fraud and one count of conspiring to violate the Anti-Kickback Statute. He was arrested at his home by the FBI and has his initial court appearance Monday afternoon in Atlanta federal court.
“The complaint, in this case, describes a defendant who saw the spread of COVID-19 as nothing more than an opportunity to profit personally,” U.S. Attorney Craig Carpenito said. “As the complaint alleges, he offered kickbacks in exchange for medically unnecessary tests, including potentially hard-to-obtain COVID-19 tests, thus preying on people’s fear in order to defraud the government and make money for himself.”
According to documents and statements made in court, Santos ran a marketing company that generated leads to testing companies. He and others participated “in a large-scale scheme to defraud Medicare by soliciting and receiving kickback payments from companies involved in clinical and diagnostic testing in exchange for steering to those companies individuals eligible for testing that Medicare would reimburse.”
Prosecutors said Santos was paid kickbacks on a per-test basis for submitting genetic cancer screening tests to diagnostic testing facilities, regardless of medical necessity, and the scheme aimed to submit more than $1.1 million in fraudulent claims to Medicare.
As the coronavirus began to spread, prosecutors said Santos used the pandemic “to capitalize on a national emergency for his own financial gain.” He was paid kickbacks on a per-test basis for a COVID-19 virus test, which included a more expensive respiratory pathogen panel test that doesn’t identify or treat the virus.
“While there are people going through what they are going through, you can either go bankrupt of you can prosper,” Santos said in a telephone call on March 19, explaining he viewed the pandemic as a money-making opportunity.
The count of conspiracy to commit healthcare fraud carries a maximum potential punishment of 10 years in prison. 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.
“Throughout this challenging crisis, the FBI remains on duty and vigilant in our efforts to capture anyone who puts money before humanity,” said FBI agent Gregory Ehrie of Newark.
