A Chicago-based doctor was convicted by a federal jury in a more than $9.5 million kickback scheme that targeted Medicare and Medicaid patients at nursing homes.
Benjamin Toh, MD, assigned orders for cancer genetic testing for telemedicine companies, but the orders were signed without proof of medical necessity, according to a press release from the US Attorney’s Office for the Middle District of Tennessee announcing the verdict Tuesday. Authorities gave no indication that nursing home officials or patients were aware of the deception.
“The defendant abused the trust Medicare placed in him to enrich himself and his co-conspirators at the expense of Medicare recipients and taxpayers,” said US Attorney Henry C. Leventis. “The jury’s verdict should serve as a powerful reminder that health care providers who do so will be held accountable.”
From March 2019 to September 2019, Toh participated in the kickback scheme in which more than $9.5 million in fraudulent claims were submitted to Medicare and Medicaid for the tests. The release said that he ordered thousands of genetic tests despite not seeing patients either in person or via telemedicine. He also never reviewed test results with any patients. Evidence at trial showed Toh was enrolled as a Medicare provider and licensed to practice in multiple states.
“In exchange for providing signed orders for genetic testing, the defendant was paid kickbacks by co-conspirator telemedicine companies,” the US Attorney in the Middle District of Tennessee said. “These companies were, in turn, paid by co-conspirator marketing companies that targeted Medicare and Medicaid patients through door-to-door marketing, at senior fairs, at nursing homes, and at other locations, and convinced patients to provide their genetic material via a mouth swab kit.”
Toh was indicted in December and was convicted of conspiracy to violate the federal Anti-Kickback Statute after a two-week trial. He faces up to five years in prison and a $250,000 fine. He is scheduled to be sentenced on Jan. 9, 2024.