U.S. Department of Justice

12/16/2024 | Press release | Distributed by Public on 12/16/2024 16:20

Doctor Pleads Guilty in $5.5M COVID-19 Fraud Scheme

A Texas physician pleaded guilty today in connection with his role in a $5.5 million over-the-counter (OTC) COVID-19 test fraud scheme.

According to court documents, Mark Mazzare M.D., 57, of Tyler, purchased Medicare beneficiary identifiers (BINs) that were used to bill Medicare millions of dollars for OTC COVID-19 test kits, many of which had not been requested by the beneficiaries. Mazzare entered into a sham agreement with a purported marketer to conceal the purchase of BINs as "lead packages," which in reality consisted of BINs and fraudulently generated audio recordings purporting to be the voices of the beneficiaries requesting the OTC COVID-19 tests. Mazzare caused OTC COVID-19 tests to be shipped to Medicare beneficiaries whose BINs had been purchased, regardless of whether the Medicare beneficiaries had requested or needed the tests. From in or around November 2022 to in or around June 2023, Mazzare caused more than $5.5 million in claims to be submitted to Medicare for OTC COVID-19 tests that were medically unnecessary and ineligible for reimbursement. Medicare paid approximately $3.44 million on those claims.

Mazzare pleaded guilty to conspiracy to defraud the United States and to purchase, sell, and distribute Medicare beneficiary identification numbers. He faces a maximum penalty of five years in prison. A sentencing hearing will be set at a later date, when a federal district court judge will determine any sentence after considering the U.S. Sentencing Guidelines and other statutory factors.

Principal Deputy Assistant Attorney General Nicole M. Argentieri, head of the Justice Department's Criminal Division; U.S. Attorney Damien M. Diggs for the Eastern District of Texas; Special Agent in Charge Jason E. Meadows of the Department of Health and Human Services Office of Inspector General (HHS-OIG) Dallas Regional Office; and Inspector-in-Charge Kai Pickens of the U.S. Postal Inspection Service (USPIS) Fort Worth Division made the announcement.

HHS-OIG and USPIS are investigating the case, with significant assistance provided by the Texas Attorney General's Medicaid Fraud Control Unit.

Assistant Chief Brynn Schiess of the Criminal Division's Fraud Section and Assistant U.S. Attorney Robert Austin Wells for the Eastern District of Texas are prosecuting the case.

The Fraud Section leads the Criminal Division's efforts to combat health care fraud through the Health Care Fraud Strike Force Program. Since March 2007, this program, currently comprised of nine strike forces operating in 27 federal districts, has charged more than 5,400 defendants who collectively have billed federal health care programs and private insurers more than $27 billion. In addition, the Centers for Medicare & Medicaid Services, working in conjunction with HHS-OIG, are taking steps to hold providers accountable for their involvement in health care fraud schemes. More information can be found at www.justice.gov/criminal-fraud/health-care-fraud-unit.