A physician from Texas has pleaded guilty to his involvement in a fraudulent scheme amounting to $5.5 million related to over-the-counter (OTC) COVID-19 tests. The Department of Justice (DOJ) announced the charges against the Texas doctor, highlighting the ongoing efforts to combat healthcare fraud.
Mark Mazzare M.D., 57, residing in Tyler, Texas, admitted to purchasing Medicare Beneficiary Identifiers (BINs). These BINs were then utilized to fraudulently bill Medicare for millions of dollars for OTC COVID-19 test kits. Crucially, many of these test kits were sent to beneficiaries who had neither requested nor needed them.
To mask his illicit activities, Mazzare entered into a deceptive agreement with a supposed marketer. This agreement was designed to disguise the BIN purchases as legitimate “lead packages.” However, these packages actually contained BINs and fabricated audio recordings. These recordings were falsely presented as beneficiary requests for the OTC COVID-19 tests, adding a layer of deception to the scheme.
Despite knowing that many beneficiaries had not requested or required the tests, Mazzare proceeded to arrange the shipment of OTC COVID-19 tests to Medicare beneficiaries whose BINs he had acquired. This action demonstrates a clear disregard for medical necessity and ethical practice, prioritizing financial gain over patient welfare.
The fraudulent activities spanned from approximately November 2022 to June 2023. During this period, Mazzare orchestrated the submission of over $5.5 million in claims to Medicare. These claims were for OTC COVID-19 tests deemed medically unnecessary and therefore ineligible for reimbursement under Medicare guidelines. Of the submitted claims, Medicare unfortunately paid out approximately $3.44 million.
Mazzare has pleaded guilty to two significant charges: conspiracy to defraud the United States and to the illegal purchase, sale, and distribution of Medicare beneficiary identification numbers. He now faces a maximum prison sentence of five years. The sentencing hearing is scheduled for a later date, at which point a federal district court judge will determine the final sentence. This decision will be based on the U.S. Sentencing Guidelines and other relevant statutory factors.
The announcement of this guilty plea was a joint effort from key officials, including Principal Deputy Assistant Attorney General Nicole M. Argentieri, U.S. Attorney Damien M. Diggs for the Eastern District of Texas, Special Agent in Charge Jason E. Meadows of HHS-OIG Dallas Regional Office, and Inspector-in-Charge Kai Pickens of USPIS Fort Worth Division.
The Health and Human Services Office of Inspector General (HHS-OIG) and the U.S. Postal Inspection Service (USPIS) are actively conducting the investigation. The Texas Attorney General’s Medicaid Fraud Control Unit has also provided significant assistance in this case, highlighting the collaborative effort in combating healthcare fraud at both federal and state levels.
The prosecution is being handled by 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. This case underscores the Justice Department’s commitment to fighting healthcare fraud through initiatives like the Health Care Fraud Strike Force Program. Since 2007, this program has charged over 5,400 defendants who have collectively billed federal health care programs and private insurers for more than $27 billion. The Centers for Medicare & Medicaid Services (CMS) is also working alongside HHS-OIG to ensure accountability from providers involved in fraudulent schemes.
Further information about these efforts can be found at the DOJ’s website dedicated to combating health care fraud.
