In a major crackdown on health care fraud in Florida, businessman Daniel Hurt has consented to cough up more than $27 million to settle allegations that he was the mastermind behind a scheme that bilked Medicare through bogus cancer genomic (CGx) tests. These tests were not only superfluous but were also part of a kickback-driven scheme to exploit Medicare referrals, a flagrant violation of the Anti-Kickback Statute (AKS), the Justice Department said Monday.
The payment is part of a civil settlement related to Hurt's prior guilty plea to criminal healthcare fraud offenses. According to the U.S. Attorney's Office for the Southern District of Florida, Hurt, who ran a swath of medical companies including Fountain Health Services LLC and Sonoran Desert Pathology Associates LLC, conspired to not only submit false Medicare claims but also to illegally pay and receive kickbacks between January 2019 and November 2021. He managed to quickly set up elaborate operations with telemarketers and telemedicine providers to ensnare Medicare beneficiaries under the guise of offering "free" CGx tests.
Federal prosecutors alleged that these tests were not medically necessary, making the claims to Medicare fraudulent. U.S. Attorney Markenzy Lapointe for the Southern District of Florida emphasized the government's resolve, saying, “As these schemes become more complex and cross district lines, we will continue to work and coordinate with our law enforcement partners and other districts to ensure vigorous enforcement of the law.”
The settlement also includes resolution of allegations brought forth in three lawsuits under the whistleblower provisions of the False Claims Act (FCA), noting that Robert Gerstein, a minor stakeholder in one of Hurt's operations, will receive up to $4.7 million, or 17% of the government’s recovery, for his role in exposing the fraud. Government officials, determined to protect critical services for millions of Americans, stated they "will not tolerate those who prey on older Americans to defraud Medicare." Assistant U.S. Attorney Rosaline Chan for the Southern District of Florida and other officials collaborated in a coordinated effort to spearhead this settlement.
Meanwhile, Deputy Inspector General of Investigations Christian J. Schrank of HHS-OIG underscored the commitment to steering federal health care programs away from fraudulent activities, saying, “This substantial settlement underscores our steadfast dedication to safeguarding federal health care programs.” Tips about potential health care fraud can be reported to the Department of Health and Human Services, ensuring that custodians of such vital programs maintain a vigilant stance against exploitation of the system, as per the Justice Department.
Though the allegations have been settled, no determination of liability has been made in the case. However, this substantial payout serves as a clear warning to would-be fraudsters that the government is watching—and they mean business.
