A Maryland business collected more than $50 million in bogus payments by claiming his company was performing in-person COVID tests, but in reality was sending out over-the-counter, self-administered tests to people to perform at home, federal prosecutors said.
Marc Aaron Potash, a Montgomery County resident, received a clinical certification for his company, Fiero, by claiming he was doing the on-site testing at its own lab.
Authorities said he was actually just mailing the home tests, but was billing insurance companies and federal benefit programs such as Medicare and Medicaid for on-site testing and evaluation at Tiero’s “purported lab.”
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They said Tiero submitted more than $100 million in false claims between 2022 and this year and was paid more than $50 million.
No lawyer was listed in court documents Friday for Mr. Potash, who was indicted by a grand jury on Thursday.
Prosecutors, in the indictment, said they obtained a 2022 message in which Mr. Potash told Maryland state health officials, “Yes, we do test on site,” even though two months later he told a potential recruit they wouldn’t do any — but wanted the capability so the company could keep its certification.
The company even created a handbook with testing procedures to try to fool state officials, prosecutors said.
“We will not be doing any on-site tests,” Mr. Potash wrote. “But we are ready to do them to maintain the [certification] although we won’t be performing any actual tests.”
Medicare and Medicaid were paying between $35.33 and $445.23 for a COVID-19 test.
The Kaiser Foundation Health Plan, which runs hospitals and the Kaiser Permanente network, filed a lawsuit against Tiero in 2022 alleging fraudulent COVID test billing.
It said Tiero billed more than 80,000 claims for lab-based testing, amounting to $8.1 million, from 2020 to 2023. In reality, Kaiser said, the tests were at-home kits.
Kaiser said it was billed $100 per test, when an at-home test should cost about $12 — and during some of the period in question, the federal government was shipping tests for free.
In a reply to Kaiser’s lawsuit, Tiero said it was providing in-home kits and its service was helping consumers avoid the confusing or time-consuming process of submitting a claim to an insurance company.
Tiero said Kaiser wrongly rejected nearly 9,500 claims, violating what Tiero called the “Biden mandate” that insurers reimburse for home tests, including pricey options.
The case was dismissed last year.
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