To ramp up sales, some companies will buy lists of potential customer leads from third party vendors. These lists include contact details of individuals supposedly interested in certain products, allowing sales reps to reach out to them with a sales pitch that will close the deal. It costs money, so the leads better be high quality. Or the very least, align with your ideal customer profile. But the ideal customer profile for Dr. Mark Mazzare was if that customer was a Medicare patient, and the contact information needed was the Bank Identification Number (BIN) number. Mazzare M.D. purchased Medicare beneficiary identifiers (BINs) that were used to bill Medicare millions of dollars for over the counter (OTC) COVID-19 test kits.
The BIN number is the series of numbers on a Medicare card that identify the cards issuer and facilitates electronic transactions. It helps pharmacies determine which insurance company to bill. And Medicare beneficiaries must give explicit permission for each specific interaction. Seems like customer contact would be necessary for Mazzare to bill Medicare for an OTC COVID-19 test kit using BIN numbers. However, Mazzare entered into a sham agreement with a purported marketer to purchase “lead packages,” which in reality consisted of BINs and fraudulently generated audio recordings purporting to be the voices of the beneficiaries requesting the OTC COVID-19 tests.
From in or around November 2022 to in or around June 2023, Mazzare submitted more than $5.5 million in claims to Medicare for OTC COVID-19 tests that were medically unnecessary and ineligible for reimbursement. Medicare paid approximately $3.44 million on those claims.
Mazzare pleaded guilty to conspiracy to defraud the United States and to purchase, sell, and distribute Medicare beneficiary identification numbers.
Excellent job by the Health Care Fraud Strike Force Program in its continued efforts to combat health care fraud.
Today’s Fraud of The Day is based on article “Tyler doctor admits role in $5.5 million COVID-19 scheme, DOJ says” published by KETK News on December 16, 2024.
A Tyler physician pled guilty on Monday in connection to his role in a $5.5 million over-the-counter COVID-19 test fraud scheme.
According to the Department of Justice (DOJ), Mark Mazzare, 57 of Tyler, purchased Medicare beneficiary identifiers (BINs) used to bill Medicare millions of dollars for test kits that had not been requested by the beneficiaries. Texas Medical Board’s records indicate that Mazzare is an internal medicine/pediatric specialist and worked at a clinic on Old Bullard Road in Tyler.
