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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 - SWAT Team

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

Published: Tuesday, January 12, 2021

Printer Friendly Version Printer friendly version

2021 Buyers Guide Computer Telephony Integration

 
1.) 
Call Center Studio

Call Center Studio
Call Center Studio is the world’s first call center built on Google and is one of the most secure and stable systems with some of the industry’s best reporting. It is one of the most full-featured enterprise grade systems (with the most calling features, one of the best call distribution, outbound dialing features and integrations—including IVR, AI Speech Recognition, blended inbound/outbound calling and includes Google’s new Dialogflow and Speech API. Call Center Studio is the absolute easiest to use (with a 10 minute setup), and is the price performance leader with lower equipment cost and less setup time.
PH: +1 512-872-7565

2.) 
ComSys S.A.

CLink for CRM and Call Center Integration
CLink by Comsys is a middleware that connects in real-time the CRM and the contact center applications. CLink enhances the CRM with interaction management capabilities from the contact center that allow agents to work more productively across all communication channels.
Comsys is a provider of οmnichannel customer engagement solutions that assist companies around the world in delivering unique customer experiences. For the last 15 years, Comsys designs and implements complex projects for clients from the outsourcing, financial services, telecommunications, and retail sectors. Comsys enjoys strategic partnerships with technology vendors like Cisco®, Aspect Software®, and Microsoft® for the delivery of innovative interaction management and contact center optimization solutions.
PH: +302109241486

3.) 
Consilium Software

Consilium UniAgent™
Today’s call centers need their agents to work more naturally, and respond better and faster. Here, we talk about the innovations Consilium has made with the latest desktop and mobile agent releases of the UniAgent™ CRM connector. From small enterprises to Fortune 500 companies and governments across 110 countries, UniAgent™ comes into action right at the moment of reckoning, making every contact center experience engaging and personalized, powered by simplified customer identification and anticipating customer needs.
UniAgent™ provides CRM integrations between all the Cisco contact center solutions (UCCX, PCCE, UCCE and HCS-CC) and over 20 CRMs, such as Salesforce, Microsoft Dynamics 365...
(read more)
PH: (+61) 406 501 368

4.) 
IntraNext Systems

IntraNext Systems develops agent efficiency tools and data security software solutions for medium-to-large contact centers. Our Event Intelligence® Platform solutions include SmartCTI™, iGuard®, and SmartSIP™. SmartSIP is based on our patented SIP layer technology and provides a DTMF masking solution for VoIP environments.
PH: 888.638.6398

5.) 
Megacall

CRM integration
CRM
We know how important it is for a business to obtain data from its customers and to manage them effectively, so we help small to large companies by integrating their CRM with the Virtual Switchboard.

This type of integration will simplify the work of your team and improve the management performance of the contact list and its information.
PH: +34 952 667 511

6.) 
NovelVox

NovelVox CTI Connector
NextGen Cisco Finesse, Genesys & Avaya Embedded CTI Connectors for Salesforce, Microsoft Dynamics, ServiceNow, Zendesk & more.
PH: (+1) 301 202 3672
 

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