Seven people, including two Pennsylvania-based doctors, have been charged for their roles in a conspiracy to receive kickback in exchange for ordering genetic tests, the U.S. Attorney’s Office of the District of New Jersey announced last Thursday.
Lee Besen, 64, of Waverly, Kimberly Schmidt, 45, of Moscow, Pennsylvania, Terri Haines, of Kennett Square, and Amber Harris, 28, of Scranton, Pennsylvania are all named in criminal complaints where officials alleged they conspired to violate the Federal Anti-Kickback Statute.
“As alleged in the criminal complaints, these defendants engaged in a long-running and complex scheme to rip off Medicare to the tune of millions of dollars,” U.S. Attorney Carpenito said. “They turned patients into human ATMs, generating cash payments for medical testing and other procedures. Those who offer or receive bribes and kickbacks for patient care will be prosecuted by this Office and swiftly brought to justice.”
Besen and Yitzachok “Barry” Kurtzer, 60, who is also named in the complaint, were both primary care physicians with separate offices in the Scranton area. From at least 2018 officials say they accepted monthly cash kickbacks and bribes ranging from $500 to $5,000 in exchange for ordering unnecessary genetic tests. At one point, Kurtzer and his wife, Robin, allegedly complained that they were not getting paid enough and renegotiated a higher kickback and bribery fee.
The U.S. Attorney’s Office says that during times when Bensen and Kurtzer did not receive their payments, they did not order as many genetic tests. When they accepted payments, the volume increased. In a recorded conversion, Besen allegedly said this was because “Greenbacks speak.”
Besen was said to have begun collecting “CGx” cancer screening tests from patients in order to collect the commission payment from the lab (up to $2,500 per test). Investigators say Besen was recorded saying he hoped the extra money would help him “retire early”. Kurtzer and his staff, which included Harris and Kennedy also began ordering CGx tests to collect the kickbacks and bribes.
They continued to accept kickbacks and collect tests as the pandemic worsened despite decreased patient visits, with Kurtzer moving to cashless online payment through a smartphone app and wire payments.
Medicare was billed over $2.3 million in total between the two offices.
Haines was not a healthcare provider but living ordering CGx tests from Medicare patients at health fairs and sending them to labs for testing and collecting commissions. She could not do so without a doctor’s signature so she allegedly agreed to give Besen a kickback in exchange for using his credentials to authorize the tests despite him never attending the fairs or meeting any of the patients. Medicare was billed $1,936,795 in this scheme.
“Scams, such as the alleged, are hardly victimless,” Maureen R. Dixon, Special Agent in Charge for the Office of Inspector General of the U.S. Department of Health and Human Services, Philadelphia Regional Office, said. “These types of fraudulent activities come at a significant cost to the taxpayer and patients who were the target of these procedures. We will continue working with our law enforcement partners to stop kickbacks that threaten the integrity of government health programs.”
According to the press release, conspiracy to violate the federal anti-kickback statute is punishable by a maximum of five years in prison and a fine of $250,000, or twice the gross gain or loss derived from the offense, whichever is greater.