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Spoiled Specimens

Healthcare-Medicare-6
Senior Director of Strategic Alliances
LexisNexis Risk Solutions - Government

One way that people working in healthcare defraud public insurance systems is by paying kickbacks for referrals and asking for reimbursements for services never rendered. It’s that kind of behavior that has an Illinois medical lab owner behind bars.

The 62-year-old man, from Madison County, Ill., is serving nearly three years in federal prison for taking part in a conspiracy to commit healthcare fraud and to pay illegal kickbacks for healthcare services.

The owner of Allegiance Medical Laboratory and AMS Medical Laboratory paid illegal kickbacks to “marketers” for urine and saliva specimens sent to the labs for testing. In some cases, the names of doctors were added to orders for the tests, although they had never seen or evaluated the patients and did not know their names were being used. (Why do people think they can get away with this?)

Healthcare fraud isn’t just about the money. During the conspiracy, many disabled and elderly patients living in residential care facilities were repeatedly subjected to medically unnecessary testing. (How would the fraudsters feel if their parents were subjected to unnecessary testing? They probably wouldn’t care.)

The marketers, operating in Missouri and in other states paid $150-$200 for each specimen that Medicare and Medicaid paid the labs. Besides his incarceration, the lab owner from Illinois was ordered to pay $3.5 million in restitution.

Today’s Fraud of the Day is based on the U.S. Justice Department press release, “Illinois Man Sentenced for Health Care Fraud Participated in Kickback Scheme Involving Medical Laboratory,” issued July 8, 2019.

St. Louis, MO – Anthony B. Camillo, 62, of Madison County, Illinois, was sentenced today to 30 months in prison for participating in a conspiracy to commit health care fraud and to pay illegal kickbacks for health care services.  He appeared in federal court today before U.S. District Court Judge Audrey G. Fleissig and ordered Camillo to pay $3,469,810 in restitution.

According to court documents, Anthony Camillo, the owner of Allegiance Medical Laboratory and AMS Medical Laboratory, paid illegal kickbacks to “marketers” for urine and saliva specimens sent to the labs for testing. In some instances, doctors’ names were used on orders for the tests, although the doctors had never seen or evaluated the patients and did not know their names were being used on the orders. During the conspiracy, many disabled and elderly patients living in residential care facilities were repeatedly subjected to medically unnecessary testing. Camillo usually paid the marketers, operating in Missouri and other states, $150-$200 for each specimen that Medicare and Medicaid paid the labs.

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