A 39-year-old Mississippi man has agreed to plead guilty to a $51 million Medicare fraud scheme that ran in New Jersey for four years.
Keaton Langston admitted to using several medical companies to bill for unnecessary tests and medical orders, the New Jersey District Attorney’s office said in a statement.
The scheme began around April 2017 and lasted through November 2021. Reimbursements totaling more than $51 million were unjustly obtained from Medicare, $10 million of which went directly to Mr. Langston’s pockets, the DA’s office said.
Mr. Langston set up the fraudulent kickback scheme with half a dozen co-conspirators, who together operated pharmacies, DME supply businesses, and even a clinical laboratory—which helped them to obtain the necessary authorization to be able to bill Medicare.
The fraudsters reached out to retired and elderly people through a network of telemedicine healthcare providers. The purpose was to sell unnecessary genetic cancer screening tests (GCX tests), compounded medications, and durable medical equipment (DME), which would then be billed to Medicare.
Sham contracts were made for the payout of the kickbacks to make it seem as if the co-conspirators were being paid by the hour or for alleged expenses when, in reality, the payments were on a per-reimbursement basis, court documents said.
For instance, targets would be talked into taking a CGX test and asked to send a DNA sample (typically a buccal swab). The laboratory would then submit reimbursement claims for the tests to the patient’s insurance carriers. These claims sometimes exceeded $10,000, with reimbursement rates sometimes exceeding $8,000 per test.
Similarly, DMEs—primarily leg, back, and arm braces—were sold without regard to medical necessity and billed to Medicare and other federal healthcare benefit programs, including TRICARE (the U.S. military health system) and CHAMPVA (the Veteran Affairs’ healthcare program), as well as some private health care benefit programs.
For each DME order procured, the fraudsters would receive a $265 kickback, while intermediaries received $30, the DA’s office said.
Past Dealings
The case has a couple of sensational tangents: In 2009, Mr. Langston’s father, Joey, was sentenced to 7 years in prison for his role in conspiring to bribe a Mississippi judge.
Mr. Langston was also identified as a co-conspirator in another healthcare fraud case involving Florida businessman Thomas Farese—according to the DOJ a member of the Colombo crime family. Mr. Langston has not yet been named as a defendant in that case.
President Joe Biden’s brother James was a past business associate of Mr. Langston’s and a longtime friend of his father’s.
A House Republican impeachment inquiry commission interviewed the president’s brother in February regarding his Mississippi business dealings. According to a publicly released transcript of the interview, James Biden distanced himself from Mr. Langston, saying he had no role in any of his companies.
James Biden has not been accused of criminal wrongdoing in the Medicare fraud scheme case.
Mr. Langston now faces up to 10 years in prison, plus a fine of $250,000 “or twice the gross gain or loss from the offense, whichever is greatest,” as stipulated by law. He will be sentenced on Oct. 1 in a federal court in Newark, New Jersey, the DOJ said.