NEW YORK — The US Department of Justice announced this week that a Florida resident has been sentenced to 10 years in prison and ordered to pay $97 million in restitution for illegal healthcare schemes that included Medicare fraud for cancer genomic testing.
According to the DOJ, Florida resident Daniel Hurt and partners acquired thousands of cancer genomic testing samples from Medicare beneficiaries throughout the US using marketing campaigns that induced beneficiaries to provide cheek swab samples collected at, then sent from, their homes or provided at purported health fairs.
Through late 2018 and 2019, the samples were sent to a hospital in Pennsylvania — Ellwood City Medical Center — that was not authorized to perform genomic testing. The samples were repackaged for testing elsewhere but the hospital still billed Medicare. Hurt and his co-conspirators improperly obtained prescriptions for the genomic testing from telemedicine physicians and did not use the test results in the treatment of the Medicare beneficiaries, the DOJ said.
Hurt directed staff at the Pennsylvania hospital to transfer millions in dollars to his own accounts, which he used to pay millions in dollars in kickbacks to the marketers and for personal purchases. Medicare suffered a loss of over $25 million as a result, according to the DOJ.
In a second scheme, Hurt paid kickbacks and bribes to obtain referrals and orders for cancer genomic tests for Medicare and other healthcare benefit program beneficiaries, which were routed to several clinical labs that he owned. These labs submitted claims and were reimbursed for these tests, which were not medically necessary, according to the DOJ. From the $53.3 million reimbursed by Medicare, Hurt personally received at least $26.9 million.
Additionally, Hurt and his co-conspirators caused a loss of nearly $19 million to healthcare programs that provide benefits to military personnel, retirees, and their dependents through a scheme that billed for expensive compounded medicines that were not medically necessary.
Hurt was sentenced in the US District Court for the Western District of Pennsylvania. In addition to the prison sentence and restitution, Hurt was ordered by the court to forfeit more than $30 million and the proceeds from the sale of a yacht.