Two individuals were charged with submitting fraudulent COVID-19 testing claims to multiple insurance agencies, announced U.S. Attorney for the Northern District of Texas Leigha Simonton.
Terrance Barnard, 39, and Connie Jo Clampitt, 51, the owners of several alleged fake diagnostic laboratories, were indicted on Dec. 5 on one count each of conspiracy to commit healthcare fraud, ten counts each of healthcare fraud, seven counts each of aggravated identity theft, and one count each of conspiracy to commit money laundering. The defendants were arrested Thursday and made their initial appearances Friday morning.
“The COVID-19 pandemic has presented the most challenging circumstances our healthcare providers and insurers have faced in generations. Schemes to financially exploit the system when providers and insurers are facing these monumental challenges must be dismantled, and those responsible must be held to account,” said U.S. Attorney Leigha Simonton.
According to court documents, the pair allegedly received more than $7 million for fraudulent COVID-19 testing claims from Blue Cross Blue Shield of Texas, Cigna, United Healthcare, Aetna, Humana, and Molina Health Care.
Mr. Barnard allegedly used his position as a contract lab technician at various medical clinics to surreptitiously obtain patient names, addresses, dates of birth, and insurance subscriber information.
He and Ms. Clampitt then allegedly represented to the patients’ insurers that they had COVID-19 testing performed at sophisticated diagnostic laboratories, when no such testing was performed and no such labs existed.
They also allegedly opened bank accounts for their purported labs (TC Diagnostics, ME Diagnostics, and Rhine Enterprises dba PHR Diagnostics), deposited fraudulently-obtained reimbursement checks into those accounts, and then transferred the proceeds into personal bank accounts. They allegedly used the fraudulently-obtained funds to purchase real estate and luxury vehicles.
During the course of the investigation, law enforcement seized more than $1.5 million.
An indictment is merely an allegation of criminal conduct, not evidence. Mr. Barnard and Ms. Clampitt are presumed innocent until proven guilty in a court of law.
If convicted, they face up to up to ten years in federal prison for each count of health care fraud, conspiracy to commit health care fraud, and conspiracy to commit money laundering, and up to two years in federal prison for each count of aggravated identity theft. They will also be required to forfeit any proceeds or property traceable to the commission of the offenses of which they’re convicted.
The Dallas Regional Office of the United States Department of Labor – Employee Benefits Security Administration, the Dallas office of the Department of Labor – Office of Inspector General, and the Texas Department of Insurance Fraud Unit Fort Worth Field Office conducted the investigation. Assistant U.S. Attorney Renee Hunter is prosecuting the case; Assistant U.S. Attorney Dimitri Rocha is helping handle the forfeiture.