What is Criminal Identity Theft?
The owners of a telemarketing company based out of Boca Raton are facing criminal identity theft and money laundering charges. The defendants allegedly referred patients contacted in a telemarketing scam for unnecessary genetic testing to a predetermined list of phlebotomy labs, who in turn paid kickbacks to the owners. The scam specifically worked to target elderly recipients of Medicare benefits through a barrage of telemarketing phone calls and coercion. The defendants are also accused of bribing telemedicine companies and doctors to write fake prescriptions for expensive genetic screening tests. Because the doctors’ orders had no direct affiliation with the patients, a consultation never occurred, and there was no evidence to establish the medical necessity of diagnostic genetic testing, the crimes were investigated by the Department of Human Health and Services, and all three defendants were formally charged. This begs the question: what constitutes criminal identity theft and money laundering?
What is Identity Theft?
Criminal identity theft or identity fraud is defined by the U.S. Department of Justice as holding oneself out to be another person, or assuming another person’s identity for financial or pecuniary gain. 18 U.S.C. § 1028 (a)(7). It also means misrepresenting oneself to another person in order to defraud the victim. Criminals often gain access to victims personally identifiable information through scams, phishing, shoulder surfing, or other cyber fraud or cybercrime measures. Criminals may also hold themselves out as a government or fiduciary official who is asking routine questions, when they are actually trying to gain PII or financial information from the victim for personal or financial gain. Engaging in identity theft is a federal offense and punishable by up to thirty years in prison, substantial fines and asset forfeiture, not to mention career, education and reputation repercussions.
What is Fraud?
Medical fraud is on the rise given the Covid-19 pandemic and increase in telehealth for medical purposes. While telehealth has expanded access to medical care for so many patients, it has also exposed holes in cybersecurity and protocols for protecting patient health information. The defendants in the instant case allegedly engaged in widespread fraud by engaging other medical providers and lab banks to produce fake medical orders or referrals for unnecessary medical and genetic testing. Fraud is deemed a white collar crime and defined by the U.S. Department of Health and Human Services (HHS) as a deliberate or dishonest act meant to misrepresent or defraud, or induce another person into relinquishing money or services. Medical fraud may include misrepresentation of services rendered, misrepresentation about a provider’s identity or licensure, or billing for durable medical equipment, procedures, prescriptions or medical visits that never occurred. Healthcare fraud also includes seeking payments for services that are not medically necessary for the patient, and engaging in bribery, phony referrals or kickbacks is fraud and a violation of the Anti-Kickback Statute and the Stark Act.
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If you or a loved one received a target letter or were subpoenaed in a federal criminal investigation, you need to act quickly. Even if you have been called as a witness, it’s possible you are a subject of interest and need to preserve your procedural rights. Federal crimes are extremely serious. After a defendant is indicted, federal prosecutors will use every resource at their disposal to try to secure a conviction, and indictment may not occur until years after a clandestine investigation has occurred. Attorney William Wallshein is a seasoned West Palm Beach criminal defense attorney, with more than thirty five years of experience handling state and federal crimes. If retained, he will go to work defending your rights and liberties to achieve the best outcome on your behalf. Don’t go it alone and leave your freedom up to chance. Call William Wallshein, P.A. today to schedule a consultation.