Insurance Fraud NEWS
Lab sales rep sentenced for $430,000 in Medicare fraud involving senior housing residents
May 15, 2019, Washington, DC
A laboratory sales representative has been sentenced to more than four years in prison for defrauding the Medicare program of more than $430,000 while convincing residents of affordable senior housing communities to submit to genetic testing without seeing a healthcare professional, according to the Justice Department.
Seth Rehfuss previously pleaded guilty to one count of conspiracy to commit healthcare fraud.
According to case documents and court statements, Rehfuss used a purported nonprofit organization called The Good Samaritans of America to persuade residents to submit to the tests, not telling them that he was a sales representative for laboratories. He reportedly found healthcare professionals on Craigslist and paid them thousands of dollars per month to sign requisition forms authorizing testing for the residents although they never examined or interacted with them.
The Medicare program paid two clinical laboratories for the fraudulent test claims generated by the scheme, according to the Justice Department. Rehfuss, Sheila Kahl, Kenneth Johnson and others obtained and divided more than $100,000 in commission payments from the laboratories, the department said.
In addition to the prison term, Rehfuss was sentenced to three years of supervised release and ordered to pay $434,963 in restitution and forfeit $66,844. Kahl and Johnson previously pleaded guilty.
Source: McKnight's Senior Living