Medical Doctor Charged for $20.7M Health Care Fraud, Illegal Kickback Schemes

He accused of ordering expensive and medically unnecessary cancer genetic tests that patients did not request.

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A federal grand jury in New Jersey returned a superseding indictment charging a medical doctor with allegedly engaging in a health care fraud and illegal kickback scheme that involved the submission of over $20.7 million in false and fraudulent claims to Medicare for laboratory tests, including cancer genetic tests. 

According to court documents, Alexander Baldonado, 68, of Queens, New York, allegedly received cash kickbacks from a laboratory representative and others in exchange for approving orders for laboratory tests billed to Medicare. As part of the scheme, Baldonado also allegedly participated in COVID-19 testing events at which he authorized COVID-19 tests as well as expensive and medically unnecessary cancer genetic tests that patients did not request, that were not used in the patient’s treatment, and for which the patients rarely received the results. Baldonado also allegedly billed Medicare for lengthy office visits that he never provided to these patients.   

In addition, Baldonado allegedly engaged in a scheme to defraud Medicare and Medicaid by soliciting and receiving cash kickbacks and bribes from an owner of a durable medical equipment supply company in exchange for ordering orthotic braces that were medically unnecessary and ineligible for reimbursement.

Baldonado is charged with one count of conspiracy to commit health care fraud, six counts of health care fraud, two counts of conspiracy to defraud the United States and pay and receive health care kickbacks, and one count of soliciting health care kickbacks. If convicted, he faces a maximum penalty of 10 years in prison for each count of conspiracy to commit health care fraud, health care fraud, and soliciting health care kickbacks, and a maximum penalty of five years in prison on each count of conspiracy to defraud the United States and pay and receive health care kickbacks. A federal district judge will determine any sentence after considering the U.S. Sentencing Guidelines and other statutory factors.

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