“The unscrupulous tactics used in this scheme to steal from taxpayers is what drives our investigators to combat healthcare fraud.” – Michael McPherson, FBI Special Investigator, Tampa
It is easy enough for Ivan Andre Scott to be made into the villain, but on trial is a much larger issue. Scott has just been sentenced to a 10-year term for his role in a $3.3 million genetic testing scam. Scott is charged with conspiracy to commit healthcare fraud, receiving illegal kickbacks and other fraud activities related to Medicare.
The Scott Global Scam
Scott had the nerve to call his illegal telemarketing call center Scott Global, while at the same time knowing he was scamming the system. It turns out that Scott was a bit of a player. With the boiler-room tactics in full-force, Scott called Medicare beneficiaries stating that Medicare covered genetic testing for cancer. It was a lie. In reality, each test cost the system $6,000.
Here is where the healthcare system as well as Scott should be under suspicion. Scott, of course, is not a physician. He needed physicians. So, what Scott did was that he bribed the telemedicine companies backed by physicians who had to authorize the genetic tests. They did so gladly.
According to the FBI and the Department of Justice:
“The evidence at trial 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.”
Why would anyone do that? It’s all in the kickbacks. Hundreds of thousands in kickbacks. Scott thought he was being clever (as most fraudsters do) and instead of paying money under the table outright, he created “consulting invoices” showing that the telemedicine companies were charging him for their services. The scam occurred between November 2018 and May 2019, where well over $3 million in claims for unneeded genetic tests were billed to Medicare. In that time, Scott received nearly $200,000 in “fees” from the telemedicine companies.
The investigation eventually wound its way to dozens of telemedicine providers and genetic testing laboratories.
But why?
In retrospect, Ivan Andre Scott could have made more money flipping hamburgers than what it will cost him to serve 10 years of his life in the slammer for defrauding innocent people. After all, they only agreed for “peace of mind.” Scott did what he did for a piece of the action.
As with most fraudsters, Scott looked around at his scheme and realized that “no one” was looking over his shoulder. The healthcare providers undoubtedly felt the same. It was, they rationalized, the uncounted billions of the government and “who cared” if a few million went missing every year? They had a need for money, fueled by the need for greed. No one in the scam, it seems, could imagine that any of it would come back to them.
The wonder in all of this is that the physicians and genetic testing laboratories were all highly educated people. They were supposedly focused on higher purpose. And yet, they succumbed to, and endorsed fraud.
What then happens to legitimate patients who may have desperately needed the testing, but could not get covered by Medicare? The answer is obvious: they are pushed aside by the system.
Emboldened
Scott could not have functioned unless he was emboldened by a system and by healthcare providers who saw the opportunity to defraud. While “ethics” is a term far too often bandied about by the system, the expectation of ethical behavior is rarely backed by expectation and by action. The Medicare system needs an ethical overhaul, not just lip service on forms and forums.
Of course, Ivan Andre Scott is a scam artist, but he has far too many to work with him in delivering fraud rather than healthcare. Unless there is a seismic shift toward ethics, it is almost guaranteed that as we speak, others are waiting in the wings to defraud the system.
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