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Naples doctor faces fraudulent Medicare billing charges

A Naples doctor has been charged with authorizing the fraudulent billing of $2.6 million to Medicare in a scheme in which he received kickbacks to order unnecessary tests, the federal government alleges.

Dr. Omar Saleh, 36, of Naples, is one of 36 defendants from 13 federal jurisdictions facing criminal charges where Medicare was fraudulently billed for a total of $1.2 billion in telemedicine, genetic testing from cancer and durable medical equipment schemes, according to the Department of Justice. .

Saleh is the only Southwest Florida defendant named in the criminal cases that involved a nationwide coordinated action against a telemedicine company executive, owners and executives of clinical laboratories, equipment companies durable medical, marketing companies and other medical professionals, according to the federal. government

Saleh has been licensed in Florida since 2013, according to the state Department of Health.

Beginning in April 2020, while in Miami and elsewhere, Saleh solicited and received bribes and kickbacks in exchange for signing doctors’ orders for medically unnecessary genetic tests sent to two laboratories in Texas, according to the Justice Department.

According to the Justice Department, the kickbacks involved referrals of beneficiaries and the opportunity to bill Medicare for telemedicine visits under more flexible telehealth rules.

The federal Centers for Medicare and Medicaid Services established more flexible rules for patients to receive telemedicine visits during the COVID-19 pandemic.

His co-conspirators gained access to the information and DNA of thousands of Medicare beneficiaries through deceptive marketing practices.

Saleh’s case is based out of federal court in the Southern District of Florida, records show. Saleh could not be reached for comment.

Defendants in other cases announced Wednesday are located in South Florida, Alabama, Mississippi, Missouri, Louisiana, Michigan, Pennsylvania, Tennessee, North Carolina, New York, Texas and California.

The coordinated federal investigations focused primarily on alleged schemes involving the payment of illegal kickbacks and kickbacks by laboratory owners and operators in exchange for patient referrals by medical professionals working with fraudulent telemedicine companies and digital medical technology.

Telemedicine schemes account for more than $1 billion of the losses associated with Wednesday’s action.

The charges include some of the first prosecutions in the nation related to fraudulent cardiovascular genetic testing, which the Justice Department said is a “growing scheme.”

Medical professionals made referrals for expensive and medically unnecessary cardiovascular and cancer genetic tests, as well as durable medical equipment, according to the federal agency.

For example, cardiovascular genetic testing was not a method for diagnosing whether an individual currently had heart disease and was not approved by Medicare for use as a general screening test to indicate an increased risk of developing cardiovascular disease in the future

“The Department of Justice is committed to prosecuting those who abuse our health care system and exploit telemedicine technologies in fraud and bribery schemes,” Assistant Attorney General Kenneth A. Polite Jr. said. of the department’s criminal division, in a press release.

“This enforcement action shows that the department will do everything in its power to protect the health care systems our communities depend on from people who want to defraud them for their own personal gain,” he said .

Separately on Wednesday, CMS announced administrative actions against 52 providers involved in similar schemes. In connection with the enforcement action, the department seized more than $8 million in cash, as well as luxury vehicles and other proceeds of fraud.

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