An investigation found that a California laboratory owner fraudulently billed $369 million for unnecessary respiratory pathogen panel tests during the COVID-19 pandemic, receiving $46.7 million in reimbursements.


RT’s Three Key Takeaways:

  1. Nine-Year Prison Sentence – A California laboratory owner was sentenced to nine years in prison for her role in fraudulently billing for respiratory pathogen panel tests during the COVID-19 pandemic.
  2. Financial Penalties and Additional Sentences – The scheme resulted in $46.7 million in reimbursements, with court orders for $14.5 million in forfeitures and $46.7 million in restitution, according to the Department of Justice. 
  3. Unnecessary Testing and Fraudulent Billing – According to the Department of Justice, the laboratory performed and billed for respiratory pathogen panel tests that were not medically necessary and not ordered by healthcare providers, submitting fraudulent claims to Medicare, a private insurer, and the HRSA COVID-19 Uninsured Program.

A California woman was sentenced to nine years in prison for her role in fraudulently submitting claims during the COVID‑19 pandemic for unnecessary respiratory pathogen panel tests. 

Lourdes Navarro, 66, of Glendale, and Imran Shams owned and controlled Matias Clinical Laboratory, doing business as Health Care Providers Laboratory (HCPL), when they obtained nasal swab specimens that enabled HCPL to test for COVID-19, as well as to obtain testing orders from physicians and other medical professionals, the US Department of Justice (DOJ) reported

The specimens were collected from residents and staff at nursing homes, assisted living facilities, rehabilitation facilities, and similar types of facilities, and from students and staff at primary and secondary schools, for the purported purpose of conducting screening tests to identify and isolate individuals infected with COVID-19. 

“However, Navarro and Shams caused HCPL to perform [respiratory pathogen panel] tests on most of the specimens, even though only COVID-19 testing had been ordered, and there was no medical justification for conducting [respiratory pathogen panel] tests on asymptomatic individuals who needed only COVID-19 screening tests,” the DOJ states.  

Navarro and Shams billed approximately $369 million for the tests to Medicare, the Health Resources and Services Administration COVID-19 Uninsured Program, and a private health insurance company and were reimbursed approximately $46.7 million, according to the DOJ.

Navarro was also ordered to forfeit $11,662,939 in funds that the government had previously seized from three bank accounts. The total amount seized and forfeited from Navarro and Shams is $14,518,485. Navarro also was ordered to pay $46,735,400 in restitution.

Navarro pleaded guilty on Oct 5, 2023, to conspiracy to commit health care fraud and wire fraud. Shams pleaded guilty on Jan 24, 2023, in the Central District of California to conspiracy to commit health care fraud and concealment of his exclusion from Medicare and was sentenced to 10 years in prison on Jan 30, 2024. 

Shams was sentenced to five years in prison on May 29, 2024, in connection with a 2017 plea in the Eastern District of New York to conspiracy to commit money laundering, conspiracy to pay and receive kickbacks, and defrauding the United States by obstructing the lawful functions of the IRS, of which three years were ordered to run consecutive to the Central District of California sentence.

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