A New York doctor was found guilty by a federal jury for being part of a large and illegal Medicare fraud scheme that cost taxpayers over $24 million. Dr. Alexander Baldonado, a 69-year-old doctor from Queens, was convicted after a trial where prosecutors showed that he played a big role in submitting false claims for medical tests and devices. He was also caught accepting illegal payments in return for ordering unnecessary treatments.
A Web of Fraudulent Testing and Bribes
Dr. Baldonado was involved in a fraudulent scheme that caused Medicare to pay for expensive and unnecessary medical tests. These tests, including cancer genetic tests, were ordered by Baldonado for patients he had never treated or even spoken to. These tests were often done at COVID-19 testing events, which took place in assisted living facilities, adult day care centers, and retirement communities during 2020.
At these events, Medicare patients were given the tests, even though Baldonado had no real relationship with them. In many cases, he never even spoke to or examined the people before ordering expensive tests on their behalf. Several patients testified that they did not know Dr. Baldonado and had never met him. Despite this, he ordered the tests, and Medicare was billed millions of dollars for services that were never really needed.
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Moreover, Baldonado also charged Medicare for office visits that he never provided. Some of the patients who were included in the scheme testified that they never saw Baldonado in person, nor did they have any consultations with him. After the tests were done, Baldonado did not follow up with the patients to explain their results, and in some cases, the patients never even received their test results.
Illegal Cash Kickbacks for Orthotic Braces
In addition to ordering unnecessary laboratory tests, Dr. Baldonado was also involved in another part of the scheme involving durable medical equipment. This time, he accepted cash kickbacks to order orthotic braces, which are medical devices used to support or correct body parts.
He received these illegal payments from the owner of a company that supplied these medical devices. In exchange, Baldonado signed prescriptions for braces that were not needed by the patients. Undercover video footage showed Baldonado accepting large sums of cash in exchange for his signature, allowing Medicare to be billed for the unneeded equipment.
As a result, Medicare was charged for millions of dollars worth of these unnecessary orthotic braces. The fraud not only affected Medicare but also cost taxpayers an enormous amount of money.
The Costs of the Fraud Scheme
The fraudulent scheme carried out by Dr. Baldonado led to over $24 million in false Medicare claims. Medicare ended up paying more than $2.1 million to the laboratories and companies involved in these fraudulent activities. These false claims, however, were not limited to just a few people—they impacted many Medicare beneficiaries, including senior citizens and other vulnerable groups who rely on the program for their healthcare needs.
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Serious Charges and Consequences
The charges against Baldonado were serious. He was found guilty of one count of conspiracy to commit health care fraud, six counts of health care fraud, and several other counts related to accepting and soliciting kickbacks. He now faces the possibility of a lengthy prison sentence. He could spend up to 10 years in prison for each of the most serious charges, while other charges may carry sentences of up to five years.
Baldonado was arrested after the trial, and the U.S. Marshals took him into custody. His sentencing will happen later this year, on June 26. The judge will decide the exact sentence, taking into account the facts of the case and any other legal factors.
This case is part of a much larger effort by federal law enforcement agencies to combat healthcare fraud. In the past, similar efforts have led to the prosecution of thousands of people who have been involved in defrauding Medicare and other health programs. Since 2007, the Health Care Fraud Strike Force has charged over 5,800 defendants, who together have billed over $30 billion in fraudulent claims.
This case serves as a reminder of how important it is to prevent fraud in healthcare programs. The money that was stolen through this scheme could have been used to help provide essential medical care to those who really need it.
