St. Peters physician pleads guilty to false statements, resulting in $1.4 million Medicare and Medicaid fraud

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A St. Peters, Mo., physician has pleaded guilty in federal court to his role in a conspiracy to make false statements that resulted in more than $1.4 million in Medicare and Medicaid fraud.

“A trusted physician failed his obligation to provide true and accurate information regarding the health care of numerous patients,” said U.S. Attorney Teresa Moore. “He personally profited from this deceit but it cost the taxpaying public more than $1.4 million in fraudulent Medicare and Medicaid payments.”

Romel Izquierdo-Malon, also known as “Mera,” 55, waived his right to a grand jury and pleaded guilty before U.S. District Judge Howard F. Sachs on Wednesday, Jan. 31, to a federal information that charges him with one count of conspiracy to make false statements related to health care matters.

Izquierdo-Malon, a physician who practiced medicine in Missouri, entered into a contract with a company identified in court documents as “Company A.” Izquierdo-Malon provided alleged telemedicine consultation services to Company A’s clients and was paid $30 per consultation. He utilized electronic portals to receive information about the patients, as well as to sign patient forms, orders, and letters of medical necessity in which he certified that genetic tests were medically necessary.

Izquierdo-Malon admitted he had a doctor-patient relationship with very few, if any, of the Medicare or Medicaid beneficiaries for whom he ordered genetic testing and provided no follow-up care for these patients. He signed pre-printed patient forms that certified the genetic tests were “medically necessary” and that the “results will determine the patient’s medical management and treatment decision.” Izquierdo-Malon knew those statements were false and fraudulent because he knew that he would not receive the reports or use them to treat patients.

The orders were submitted to laboratories, many of which, unbeknownst to him, paid illegal kickbacks to the individuals and entities who conspired to submit false claims to Medicare and Medicaid.

Izquierdo-Malon admitted that he signed orders for genetic testing for Medicare beneficiaries that caused Medicare to pay approximately $1,030,906 to the laboratories that billed for those genetic tests from March 2017 to September 2019. Izquierdo-Malon also admitted that he signed orders for genetic testing for Medicaid beneficiaries that caused Medicaid to pay approximately $376,981 from November 2018 to October 2019.

Under the terms of his plea agreement, Izquierdo-Malon must pay $140,788 in restitution (or in such other amount as determined by the court) to the government.

Under federal statutes, Izquierdo-Malon is subject to a sentence of up to five years in federal prison without parole. The maximum statutory sentence is prescribed by Congress and is provided here for informational purposes, as the sentencing of the defendant will be determined by the court based on the advisory sentencing guidelines and other statutory factors. A sentencing hearing will be scheduled after the completion of a presentence investigation by the United States Probation Office.

This case is being prosecuted by Assistant U.S. Attorney Cindi Woolery. It was investigated by the Department of Health and Human Services, Office of Inspector General, and the Missouri Attorney General’s Medicaid Fraud Control Unit.

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