Reading Business Owner Charged In $44 Million Medicare Fraud: Feds

READING, MA — The Reading owner of a telemedicine company has been charged in a $44 million Medicare fraud scheme. David Santana, 38, has agreed to plead guilty to one count of conspiracy to commit health care fraud, prosecutors said in a statement.

Santana, via his companies Conclave Media and Nationwide Health Advocates, entered into business relationships with telemarketing firms that generated leads by targeting Medicare beneficiaries.

The telemarketers paid Santana's companies, Conclave and Nationwide, on a per-order basis to generate orders for unnecessary medical equipment, such as knee and back braces, and genetic testing. Santana worked with medical staffing companies to find doctors and nurses who were willing to review and sign prepopulated orders, typically without any contact with the beneficiaries, prosecutors claim.

The records falsely portrayed the medical providers as having performed exams on the beneficiaries, according to prosecutors. Santana is accused of providing the signed orders to the telemarketing companies which sold the orders to medical equipment suppliers and laboratories.

Santana is accused of knowing suppliers and laboratories would use the signed orders to submit claims to Medicare for equipment and genetic testing that were medically unnecessary, based on false documentation, and tainted by kickbacks, according to prosecutors.

Santana faces up to 10 years in prison as well as a $250,000 fine and up to 3 years of supervised release.