Business ProfileforLotus Health, LLC

USA v Garipoldi. 9:19-cr-80196-RS-1 S.D. Fla.
As of September 27, 2019, U.S. Dept. Of Justice: Case # 9:19-cr-80196-RS-1

A federal law enforcement action involving fraudulent genetic cancer testing has resulted in charges in five federal districts against 35 defendants associated with dozens of telemedicine companies and cancer genetic testing laboratories (CGx) for their alleged participation in one of the largest health care fraud schemes ever charged. According to the charges, these defendants fraudulently billed Medicare more than $2.1 billion for these CGx tests. Among those charged today are 10 medical professionals, including nine doctors.

The coordinated federal investigation targeted an alleged scheme involving the payment of illegal kickbacks and bribes by CGx laboratories in exchange for the referral of Medicare beneficiaries by medical professionals working with fraudulent telemedicine companies for expensive cancer genetic tests that were medically unnecessary.

Often, the test results were not provided to the beneficiaries or were worthless to their actual doctors. Some of the defendants allegedly controlled a telemarketing network that lured hundreds of thousands of elderly and/or disabled patients into a criminal scheme that affected victims nationwide. The defendants allegedly paid doctors to prescribe CGx testing, either without any patient interaction or with only a brief telephonic conversation with patients they had never met or seen.

In the Southern District of Florida, the following defendants were charged:

Richard Garipoli, 42, of Loxahatchee, Florida, the owner of a telemedicine company Lotus Health LLC (Lotus Health), located in Loxahatchee, is charged with conspiracy to commit health care fraud, conspiracy to pay and receive kickbacks, and substantive counts of health care fraud and receiving kickbacks. The indictment charges that from January 2017 through September 2019, Garipoli, and unnamed co-conspirators, billed Medicare and Medicare Advantage plans over $326 million, for which Medicare paid over $84 million, for false and fraudulent Cancer Genomic tests (CGx Tests) that were not medically necessary, and not eligible for Medicare reimbursement. Doctors contracted with Lotus Health allegedly authorized bogus doctors' orders that the CGx Tests were medically necessary when the doctors did not engage in treatment of the beneficiaries, had no physician-patient relationship with them, and often did not even speak with the beneficiaries for whom they ordered tests. The Indictment alleges that various companies paid kickbacks to Lotus Health in exchange for ordering and arranging for the ordering of CGx tests for Medicare beneficiaries, without regard to whether the CGx tests were medically necessary or eligible for Medicare reimbursement, and without regard for the fact that the tests were prescribed without any physician-patient relationship. Various laboratories including Clio Laboratories in Lawrenceville, Georgia and LabSolutions in Atlanta, Georgia and Easton, Pennsylvania then allegedly submitted false and fraudulent claims to Medicare and Medicare Advantage plans for the false and fraudulent CGx tests that were not medically necessary and not eligible for Medicare reimbursement. Garipoli and others allegedly concealed the submission of these false and fraudulent claims to Medicare and Medicare Advantage plans; and diverted fraud proceeds for their personal use and benefit, the use and benefit of others and to further the fraud. The case is being prosecuted by Trial Attorneys James Hayes and Tim Loper of the Criminal Division's Fraud Section.

For further assistance please contact
U.S. Attorney's Office
99 N.E. 4th Street
Miami, Fl. 33132
(305) 961-9001

Email: [email protected]

LINK: https://www.justice.gov/opa/pr/federal-law-enforcement-action-involving-fraudulent-genetic-testing-results-charges-against