Newark, New Jersey – United States Attorney Racheal A. Honig reported that on 19th November 2020, a man from Florida pleaded guilty to his participation and role in using his firm to swindle the Medicare Program concerning false and fraudulent orders for genetic tests.
Edward B. Kostishion, from Lakeland, Florida, age 60, admitted guilt to superseding information accusing him of two conspiracy counts to execute a crime against the U.S. regarding conspiracies to execute health care fraud and breach the Anti-Kickback Act. Edward Kostishion appeared via videoconferencing before Judge Brian R. Martinotti, United States District Judge. Edward Kostishion and five co-accused persons were prior indicted by an accusation in September 2019 concerning these schemes.
As per the documents filed in this matter and attestation made in the court;
Edward Kostishion and certain schemers controlled the operations of Ark Laboratory Network LLC, a firm that alleged to run a network of laboratories that facilitated genetic testing/screening. Ark Laboratory Network LLC collaborated with Privy Health Inc., a firm that another schemer controlled, another firm to receive DNA samples and Medicare information from hundreds of patients via numerous methods, such as offering 75 U.S. dollars gift cards to patients, all without the participation of a treating health care professional. Matthew S. Ellis, a doctor, based in Gainesville, Florida, and co-accused individual indicted in the charge, worked as the ordering doctor who approved genetic screening for hundreds of patients across the United States that he never treated, saw, or examined. This comprised patients from New Jersey and several other states where Matthew Ellis was not certified to practice medicine. Through this process, Edward Kostishion, Matthew Ellis, and other schemers submitted and caused the submission of false and fraudulent orders for genetic tests to multiple clinical laboratories. These orderly deceitfully certified that Matthew Ellis was the doctor treating patients and, in some instances, deceitfully showed that a patient had personal or family cancer history. In 2018, the Medicare program reimbursed at least 4.6 million U.S. dollars to clinical laboratories for genetic tests that Matthew Ellis order as part of this fraud scheme.
Besides, Edward Kostishion and certain other schemers reached into a kickback agreement with certain clinical laboratories under which the laboratories reimbursed Ark Laboratory Network LLC bribes in return for sending orders for DNA samples and genetic examinations. Among other things, Ark Laboratory Network LLC covered these kickback arrangements by issuing forged and fake invoices to laboratories that allegedly reflected services offered at an hourly rate. However, the parties had already set the bribe amount, which was derived from the returns the laboratories obtained from the Medicare program or an amount reimbursed for every DNA sample. The clinical laboratories reimbursed at least 1.8 million U.S. dollars to Ark Laboratory Network LLC in bribes in 2018.
Every conspiracy charge bears a maximum imprisonment sentence of five years in federal prison and 250,000 U.S. dollars fine, or double the net gain or loss from the crime. Edward Kostishion will be sentenced on 1st April 2021.
Co-accused persons, Kacey C. Plaisance, from Altamonte Springs, Florida, and Kyle D. McLean, from Arlington Heights, Illinois, previously admitted guilty. Kacey C. Plaisance’s sentencing is scheduled for 15th March 2021. Kyle D. McLean’s sentencing is scheduled for 12th April 2021.
United States Attorney Racheal A. Honig applauded and acknowledged the United States Health and Human Services Department – Office of Inspector General, under the instructions of Scott J. Lampert, the Special Agent in Charge of the department; and special agents of the Office of United States Attorney for the District of New Jersey, under the instructions of Thomas Mahoney, the Supervisory Special Agent, for their remarkable investigations leading to the 19th November 2020 plea of guilty.
United States Assistant Attorney Bernard J. Cooney, Acting Chief of the Opioid Abuse Prevention & Enforcement Unit, represented the United States government in the case.
The allegations and charges against the remaining co-accused persons are just accusations. These individuals are presumed not guilty until or unless proven liable or guilty of the charges against them.
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