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Consumer & business misconductNew in this edition

DOJ reports guilty plea in Medicare COVID test-kit scheme

DOJ reports that Syed Murtuza Kablazada pleaded guilty to two health-care fraud counts involving Medicare claims for COVID-19 test kits that were not requested or provided. DOJ says the laboratories submitted $227 million in claims, of which Medicare paid approximately $136 million. DOJ also says Kablazada agreed to forfeit more than $46 million seized from bank accounts. Claims, payments and agreed forfeiture are distinct amounts; the release does not establish a sentence or completed recovery.

Laboratory testing and claims review
Illustrative artwork; not evidence of the actual people, products or events described.

Suggested owner and action: Laboratory, revenue-cycle and program-integrity teams can review beneficiary requests, evidence of delivery, laboratory ownership and the use of third-party lead generators against their own operations.

DOJ plea announcement

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