Feds nab alleged Medicare fraudster for COVID test kickbacks

by: Roy Edroso May 19, 2020

When the pandemic came to the U.S., a Medicare scamster tried to add COVID-19 tests to her fraud portfolio, a U.S. Attorney charges.

Ashley Hoobler, owner and operator of Encore Health Enrollment Inc. in Atlanta, was arrested May 15 on changes of attempt and conspiracy to defraud the United States by the U.S. Attorney for Middle District of Florida, which also published the criminal complaint.

Upon an affidavit from an OIG special agent, Hoobler was accused of arranging kickbacks with local labs for expensive tests that would be given with no regard for medical necessity and charged to Medicare.

Between 2018 and February of this year, OIG special agent Derek Maloney testifies, Hoobler arranged cancer genomic ("CGX") tests for patients who did not have cancer or whose condition would in no way benefit from the testing.

Hoobler did this by sending "marketers" who "targeted older individuals at gyms, among other places," Maloney further states, and got samples from them, for which Hoobler acquired test orders via MedSymphony aka meetmydoc.com, a Hilton Head, S.C., telemedicine practice, to whose owner she allegedly paid kickbacks. Hoobler would then have the tests done by an unnamed Ridgeland, Miss., Medicare provider with a lab, the complaint further alleged, who would pay Hoobler kickbacks.

The MedSymphony proprietor is unnamed; however, a Hilton Head man running a company by that name was charged in 2019 in a large health care fraud case. The complaint says this person, "Cooperator #2," pleaded guilty in February 2020 and began then to work with the feds.

Around that time COVID-19 became a national issue and, according to phone calls relayed by another alleged co-conspirator-turned-informant, Hoobler said she could get $150 from the Mississippi provider if they could get patients to submit not only regular COVID-19 tests but also respiratory pathogen panel (RPP) nasopharyngeal swab tests, the complaint says.

"Medicare’s reimbursement rates for the RPP tests are approximately four times higher than the reimbursement rates for the COVID-19 test," says the U.S. Attorney's press release.

Blog Tags: anti-fraud, COVID-19, OIG

To comment, login here.

Login

User Name:
Password:
Remember me Forgot password
Welcome to the new Part B News Online. If you are a returning user having trouble logging in, please click here.