Maryland man convicted for $18M Medicare fraud scheme involving Annapolis mansion

A Maryland business owner from Annapolis was convicted by a jury for running a multimillion-dollar Medicare fraud scheme, according to FOX45 Baltimore. The man, who owned a laboratory, billed Medicare for over $18 million in respiratory tests that were never ordered or performed, prosecutors said.

Federal prosecutors detailed that during the COVID-19 pandemic in 2020, the business owner targeted nursing homes nationwide, billing Medicare for expensive respiratory pathogen panel tests after collecting specimens from residents. However, many of these tests were unnecessary, and some patients had already died by the time charges were made, FOX45 Baltimore reported.

Court documents and witness testimony showed that doctors never requested these tests, and some physicians said they had never ordered such tests in their careers. The business owner instructed employees to bill Medicare for these tests every time a COVID-19 test was performed, regardless of medical necessity.

The company involved, Provista Health, received $18.7 million for these tests in six months, with Medicare paying out more than $7.2 million. Prosecutors also revealed that proceeds from the fraud were used to make $25,000 monthly payments on an Annapolis waterfront mansion and to purchase a Porsche 911, FOX45 Baltimore reported.

The investigation was conducted by the Department of Health and Human Services Office of Inspector General and the FBI. The case highlights ongoing concerns about healthcare fraud, especially during the pandemic period when nursing homes were vulnerable.