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News : Patient Recruiter Convicted in Telemedicine Scheme Against Medicare

#contactcenterworld

Washington, DC, USA, Jan 11, 2021 -- The owner of an Orlando-area telemarketing call center was convicted for his role in a kickback scheme involving expensive genetic tests and fraudulent telemedicine services that resulted in the payment of approximately $2.8 million in false and fraudulent claims to Medicare.

Acting Assistant Attorney General David P. Burns of the Justice Department’s Criminal Division, U.S. Attorney Maria Chapa Lopez of the Middle District of Florida, Special Agent in Charge Michael F. McPherson of the FBI’s Tampa Division, and Special Agent in Charge Omar Pérez Aybar of the Department of Health and Human Services – Office of Inspector General (HHS-OIG) for the Middle District of Florida, made the announcement.

Ivan Andre Scott, 34, of Kissimmee, Florida was convicted after a four-day trial of one count of conspiracy to commit health care fraud, three counts of health care fraud, one count of conspiracy to defraud the United States and pay and receive health care kickbacks, and three counts of receiving kickbacks.

According to evidence presented at trial, Scott was the owner of Scott Global, a telemarketing call center located in Orlando. The evidence showed that Scott targeted Medicare beneficiaries with telemarketing phone calls falsely stating that Medicare covered expensive cancer screening genetic testing, or "CGx." The tests could cost as much as $6,000 per test. After beneficiaries agreed to take the test, the evidence showed Scott paid bribes and kickbacks to telemedicine companies to obtain doctor’s orders authorizing the tests.

The evidence showed that the telemedicine doctors approved the expensive testing even though they were not treating the beneficiary for cancer or symptoms of cancer, and often without even speaking with the beneficiary. According to the evidence presented at trial, Scott then sold the genetic tests and doctor’s orders to laboratories in exchange for illegal kickbacks. To conceal the illegal kickbacks, Scott submitted invoices to the laboratories and other marketers making it appears as though he were being paid for hourly marketing services, rather than per referral.

Between November 2018 and May 2019, labs submitted more than $2.8 million in claims to Medicare for genetic tests Scott referred to them, of which Medicare paid over $880,000. In that timeframe, Scott personally received approximately $180,000 for his role in the scheme.

The case was investigated by the HHS-OIG and the FBI and was brought as part of Operation Double Helix, a federal law enforcement action led by the Health Care Fraud Strike Force, under the supervision of the Criminal Division’s Fraud Section, focused on fraudulent genetic cancer testing that has resulted in charges against dozens of defendants associated with telemedicine companies and cancer genetic testing laboratories for their alleged participation in one of the largest health care fraud schemes ever charged. Trial Attorneys Alejandro Salicrup and Jamie de Boer of the Criminal Division’s Fraud Section are prosecuting the case.

#contactcenterworld

Posted by Veronica Silva Cusi, news correspondent
Source: https://www.justice.gov


Today's Tip of the Day - Plan Training In Advance

Read today's tip or listen to it on podcast.

Published: Tuesday, January 12, 2021

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2021 Buyers Guide Recruitment Products/Services

 
1.) 
Emmersion

Automated Language Testing
Emmersion offers automated assessments to quickly and accurately test speaking, writing, and grammar fluency in 9 languages and counting. We help contact centers improve CSAT scores by screening for top talent and retaining top performers.

2.) 
MainTrax

HireTrax
HireTrax, MainTrax's standalone pre-hire virtual interviewing solution, automatically analyzes the behavioral characteristics found in each candidate's VOICE to help you select reps better suited for the specific job at hand. After all, agents speak with your customers for hours each day so it's vital they possess the behavioral characteristics and personality traits necessary to be successful. By picking those with tendencies of empathy and positive behavioral traits, you'll have a higher caliber of candidates who will perform better on the job and stay.

3.) 
Orion Learning Services Inc.

Assessments for Recruitment, Talent Management, Succession Planning
Looking for assessment tools to help you recruit faster, better and more accurately?

Orion Learning offers a full suite of assessment tools designed to target and report on candidate potential. Our tools are used for recruitment, talent management, succession planning and coaching/mentoring. All of the tools are delivered online and the reports are available online and will provide you with an amazing view of the candidate/individual's potential, interview questions, coaching/mentoring steps and much more.

If you're looking to find the candidate/individual with the highest potential, call Orion today!

4.) 
Vads

VADS Recruitment Services
VADS Indonesia provides a recruitment process with strict selection with various requirements according to client needs. VADS Indonesia also has a database of trained candidates so that it can meet the agent needs quickly and in large numbers.

5.) 
SalesMatch Ltd

Contact Centre Behavioural Assessments
SalesMatch is an intelligent web based sales and contact centre behavioural assessment platform. It is based on the well known, tried and tested DISC psychometric theory, used by thousands of organisations round the world.

- Reduces Agent Attrition - By selecting the right agent for the role
- Increases Performance - By matching the character profile to the task
- Reduces Time Off - A well matched profile to the role reduced work
stress
- Reduces Recruitment Costs - By early identification of the right candidates

Putting the right person in the job role has become the key focus in the drive...
(read more)

6.) 
TactiCall Recruitment Services

TactiCall Recruitment Services
Permanent Placement
Temporary / Labour Hire / Contingent and Contract Hire
Recruitment Consulting Services
Assessment Centre Design and Facilitation
 

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