NEWYou can now listen to articles!
FIRST ON FOX: Two men were sentenced Monday for charges related to orchestrating a sprawling $522 million fraud scheme that targeted Medicare, Medicaid and private insurers — using kickbacks, fake medical orders and DNA samples collected from patients across the country.
Reyad Salahaldeen, 57, of Buford, Georgia, was sentenced to 12 years and 7 months in prison after pleading guilty to conspiracy to commit health care fraud and wire fraud. Mohamad Mustafa, 28, of Duluth, Georgia, was sentenced to three years in prison after pleading guilty to paying illegal health care kickbacks, according to the Justice Department.
“Under the guise of health care, these two fraudsters attempted to steal more than half a billion dollars from taxpayers,” the Justice Department said.
Federal prosecutors said the scheme led to roughly $84 million in payouts from Medicare, Medicaid and private insurers, highlighting the scale of fraud authorities say is draining taxpayer-funded health programs and driving a broader federal crackdown.
Reyad Salahaldeen, 57, of Buford, Georgia, was sentenced to prison after pleading guilty to conspiracy to commit health care fraud and wire fraud. (DOJ)
JURY CONVICTS FORMER NFL PLAYER KEITH J GRAY IN $328 MILLION MEDICARE FRAUD SCHEME INVOLVING KICKBACKS
The scheme relied on a network of marketers who targeted individuals — many covered by Medicare — and persuaded them to take genetic tests by promoting them as free or medically important screenings, including for cancer risk.
Prosecutors said the tests were often not medically necessary and were ordered by medical providers who had not treated the patients and did not use the results in their care.
That allowed the laboratories to bill government health programs for costly tests that would not otherwise have been approved, officials said.
Both men were also ordered to pay substantial restitution. Salahaldeen was ordered to repay more than $84.5 million, while Mustafa must pay more than $64.3 million.
Salahaldeen was also ordered to forfeit more than $3 million from bank accounts, along with a 2019 GMC Yukon and properties in Texas and Georgia.
Mustafa was born in the United States, while Salahaldeen is a Palestinian national who became a lawful permanent resident in 2004, according to officials.
The scheme ran from 2018 through August 2020 and used a network of marketers making telemarketing calls, door-to-door outreach and health fairs to collect DNA samples and insurance information from patients.
Court documents say Salahaldeen controlled multiple laboratories across New Jersey, Georgia and Texas, including Express Diagnostics and BioConfirm Laboratories.
Prosecutors said marketers were paid illegal kickbacks to obtain genetic testing orders from medical providers who had not treated the patients and did not use the results in care.
Authorities said Salahaldeen falsified requisition forms, letters of medical necessity and other records to make the tests appear legitimate.
MAN CHARGED IN $90M MEDICARE FRAUD SCHEME; DOJ SAYS SUSPECT MAY HAVE ENTERED US ILLEGALLY
Mustafa, who co-controlled some of the laboratories, helped carry out the scheme by paying kickbacks and creating sham contracts and invoices to disguise illegal payments as legitimate marketing services.
In total, the labs billed roughly $522 million in fraudulent claims. Government health programs and private insurers paid out approximately $84 million, officials said.
Authorities said Salahaldeen attempted to evade arrest after learning of the charges, traveling from North Carolina to Texas and attempting to cross into Mexico using another person’s identification before being apprehended at the border.
A TIMELINE OF THE ‘LARGEST COVID-19 FRAUD SCHEME’ IN THE UNITED STATE
Federal officials say many of the largest schemes are no longer isolated — but driven by organized networks coordinating across multiple states.
The scheme ran from 2018 through August 2020 and relied on a network of marketers who used telemarketing calls, door-to-door outreach and health fairs to collect DNA samples and insurance information from patients. (DOJ)
Authorities have pointed to major cases in recent years, including a COVID-19 pandemic-era fraud scheme in Minnesota that prosecutors allege siphoned more than $240 million in federal funds meant to feed children.
That case, known as Feeding Our Future, has led to dozens of charges and sentences of up to 28 years in prison.
Prosecutors say the scheme relied on shell nonprofits, fake meal counts and falsified records — tactics similar to those used in the genetic testing fraud case.
Two men were sentenced Monday for orchestrating a sprawling $522 million fraud scheme that targeted Medicare, Medicaid and private insurers. (iStock/Getty Images)
The case is part of a broader federal crackdown on health care fraud. Eleven additional co-conspirators — including marketers, nurse practitioners and doctors — already have been sentenced, receiving penalties ranging from probation to nearly four years in prison.
CLICK HERE TO DOWNLOAD THE APP
Justice Department officials said the case reflects an intensified push to combat fraud under Trump’s Task Force to Eliminate Fraud, chaired by Vice President JD Vance.
Since 2007, the DOJ’s Health Care Fraud Strike Force Program has charged more than 6,200 defendants responsible for over $45 billion in fraudulent billing, according to the department.
Attorney information for Salahaldeen and Mustafa was not immediately available.
