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Senior Director of Strategic Alliances
LexisNexis Risk Solutions - Government

As the coronavirus pandemic swept across the United States, free COVID-19 testing events were hosted by local healthcare services with the primary goal of controlling community spread in urban locations by increasing testing while educating about safe public health practices. Dr. Alexander Baldonado was at many of these COVID-19 testing events with his own booth. But he wasn’t there to test for COVID-19. He was there to commit fraud.

Starting in 2020 while hiding under the guise of the CARES Act critical assistance, Baldonado authorized hundreds of cancer genetic tests for Medicare beneficiaries who attended COVID-19 testing events at assisted living facilities, adult day care centers, and retirement communities. Although Baldonado billed Medicare for supposed office visits, Baldonado did not treat any of the patients who attended the testing events for COVID-19 or cancer concerns. And, in most cases, did not speak to or examine the patients prior to ordering cancer genetic tests and other laboratory tests for them.

In addition to the laboratory testing scheme, Baldonado also received illegal cash kickbacks and bribes from the owner of a durable medical equipment supply company in exchange for ordering medically unnecessary orthotic braces for Medicare and Medicaid beneficiaries. The evidence presented at trial showed Baldonado on an undercover video receiving a large sum of cash in exchange for signed prescriptions for orthotic braces.

On February 12, 2025, Baldonado was found guilty of Medicare fraud. Baldonado had billed Medicare more than $24 million in claims for unnecessary laboratory tests and orthotic braces.

Great job by the Department of Health and Human Services Office of Inspector General in this case.

Today’s Fraud of The Day is based on article “Filipino doctor in US convicted over $24-M health care fraud” publishe by GMA News on February 12, 2025.

Dr. Alexander Baldonado, a Filipino-Canadian and U.S. permanent resident, was convicted on 10 counts of health care fraud totaling $24 million. A US Department of Justice statement said court documents and evidence presented at trial showed that Baldonado received tens of thousands of dollars in illegal cash kickbacks and bribes in exchange for ordering laboratory tests, including expensive cancer genetic tests, which were billed to Medicare by two related laboratories in New York.

As part of the scheme, Baldonado was said to have authorized hundreds of cancer genetic tests for Medicare beneficiaries who attended COVID-19 testing events at assisted living facilities, adult day care centers, and a retirement community in 2020.

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