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Partners In Life and Fraud

Partners In Life and Fraud

Medicare enrollment form and glasses
Senior Director of Strategic Alliances
LexisNexis Risk Solutions - Government

There’s a ton of advice on whether couples working together is a good idea. And generally, it could be good if it is not based off creating fraudulent schemes. Husband and wife team, Imran Shams and Lourdes Navarro owned and operated the Health Care Providers Laboratory (HCPL). They were also serial Medicare fraudsters. As far back as 1991, these two have each been found guilty of various Medicare fraud schemes and banned numerous times from U.S. Federal Health Care programs because of those convictions. Shams and Navarro just didn’t know how to quit.

On November 6, 2018, Navarro submitted to the Department of Health and Human Services a false and fraudulent Application for Reinstatement to Federal Health Care Programs, claiming she had not owned or operated a health care entity, or served as a manager, administrator, or director of any entity that furnished health care items or services, during the period of her most recent suspension as a Medicare provider. Based on that fraudulent information, HHS reinstated Navarro’s status as a Medicare provider.

Navarro and Shams conspired to obtain nasal swab specimens to be processed at their business HCPL for COVID-19 and Respiratory Pathogen Panel (RPP) tests. The specimens were collected from residents and staff at nursing homes, assisted living facilities, rehabilitation facilities, and similar types of facilities, and from students and staff at primary and secondary schools. Most of the individuals were not only asymptomatic, but based on age and capacity were unlikely or unable to resist having the test performed on them. Despite no medical justification for conducting the tests, HCPL billed Medicare approximately $369 million in fraudulent claims and were reimbursed approximately $46.7 million.

On January 30, 3035, Navarro and Shams were sentenced to nine years and fifteen years respectively and ordered full restitution.

Great job by the FBI and HHS-OIG in this case.

Today’s Fraud of The Day is based on article “9 years for $369M COVID-testing scammer who misused nursing home patients” published by McKnight’s Long Term Care News on January 30, 2025.

A laboratory owner has been sentenced to nine years in prison for her role in submitting false claims for unnecessary COVID-19 test that used nasal swab specimens from nursing home residents and others, resulting in Medicare being wrongly billed for $369 million.

Lourdes Navarro of Glendale, CA, owned and operated the Matias Clinical Laboratory, also known as the Health Care Providers Laboratory, along with partner Imran Shams.

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