$15M in medical device and cancer testing fraud earns chiropractor 43 months in prison
A chiropractor from Georgia was sentenced to prison for her role in a conspiracy to defraud health insurers and the Medicare program by submitting unnecessary claims for tests and medical equipment. Medicare alone lost $14.9 million by reimbursing the fraudulent medical claims, the U.S. Department of Justice revealed in an announcement.
For her role in the scheme, Teflyon Cameron, 59, of Powder Springs, Georgia, has been sentenced to 43 months in prison after pleading guilty on March 2 to conspiracy to commit health care fraud and conspiracy to violate the Federal Anti-Kickback Statute.
Her sentence, issued by a federal court in New Jersey, was announced on Monday.
Acts of fraud involved multiple coconspirators and went on for “several years,” according to the DOJ. Authorities said Cameron alone personally took home more than “$1.3 million in fraud proceeds” by billing health plans for durable medical equipment and cancer genetic tests that patients didn’t need.
Prosecutors said Cameron and her unnamed accomplices “owned, operated and had a financial interest” in the genetic testing and medical device companies they would bill for labs and equipment, sending kickbacks to the doctors who sent the orders after claims were paid by insurers.
Telehealth orders from complicit doctors
According to court documents and Cameron’s statements, most fraudulent durable medical equipment orders were for orthotic braces billed to Medicare beneficiaries who did not need them. These often came from marketing call centers and telehealth companies, where doctors made the requests on behalf of healthy patients.
Prosecutors said the scheme related to the cancer tests was similar. Cameron agreed to provide an unnamed clinical laboratory with “leads of beneficiaries who were qualified to receive federal healthcare benefits for cancer genetic tests.” She would then send medically unnecessary orders from doctors to the labs, which would bill Medicare and private insurance for the wasteful testing.
Cameron would then submit invoices to the lab and receive a kickback payment for every Medicare patient she was able to refer. The invoices provided cover to disguise illegal activity, the DOJ stated.
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