Benjamin T. Toh, of Chicago, has been charged for his role in a $9.5 million healthcare fraud conspiracy. He was arrested in Chicago Dec. 14 and indicted in the Middle District of Tennessee on Monday.
Toh, a medical doctor licensed in multiple states, was a consulting provider and gained access to Medicare and Medicaid patients through telemedicine companies. He then allegedly signed orders––without regard to whether they were medically necessary––for cancer genetic testing in exchange for kickback payments.
According to the Department of Justice, “Toh was not the treating physician of the patients and he did not conduct an actual telemedicine visit, nor did he follow up with patients on the test results.”
Co-conspirators in the case include Advanced Tele-Genetic Counseling, a telemedicine company based in Kentucky. Owner Elizabeth Turner pleaded guilty to healthcare fraud conspiracy in the Middle District of Tennessee last year.
“ATGC received kickback payments from marketers in exchange for providing orders signed by doctors, including Toh,” the Justice Department alleged. “The marketers targeted Medicare and Medicaid patients through door-to-door marketing, at senior fairs, at nursing homes and at other locations, and convinced patients to provide their genetic material via a mouth swab kit.”
The marketers provided swab kits to Crestar Labs for cancer genetic testing in exchange for kickbacks paid by Crestar Labs. Fadel Alshalab, owner of Crestar Labs, along with several marketers, are also charged with healthcare fraud offenses in a separate indictment.
The Justice Department alleges the offenses took place from March 2019 through September 2019, during which time Toh and conspirators “caused the submission of more than $9.5 million in false and fraudulent claims to Medicare and Medicaid for cancer genetic tests.” Toh faces up to 10 years in prison and a $250,000 fine.
The case comes as the Justice Department has been cracking down on telemedicine fraud cases after the COVID-19 pandemic ushered in a rise in popularity for the care services.